Despite rising public funds, the latest National Health Accounts data reveals a deeply privatized system where citizens still pay nearly half of all medical costs out of pocket.

The recently released National Health Accounts (NHA) Estimates for India (2022-23) underscore a persistent structural challenge: despite marginal increases in public financing, households continue to bear the primary burden of healthcare costs.

Key Fiscal Indicators

• Public Spending Trajectory: Government Health Expenditure (GHE) as a percentage of GDP rose from 1.15% in 2013-14 to 1.43% in 2022-23 (1.48% under the new GDP series). GHE as a share of General Government Expenditure also increased from 3.78% to 4.89% over the same period.
• The Policy Shortfall: Current spending levels remain significantly lower than the WHO global recommendation of dedicating at least 5% of GDP to public health, as well as India's own National Health Policy target of 2.5% of GDP.
• Post-COVID Retraction: Experts point out that the temporary surge in public health spending witnessed during the pandemic has receded. GHE as a share of Current Health Expenditure (CHE) dropped sharply from 41.1% in 2021-22 to 35.6% in 2022-23.

Out-of-Pocket Expenditure (OOPE) and Privatization

• The Burden on Citizens: Out-of-pocket expenditure remains alarmingly high, accounting for nearly half of the current health expenditure at 49.90% of CHE.
• Insurance Deficit: Total spending under government-financed health insurance schemes—including the Pradhan Mantri Jan Arogya Yojana (PMJAY)—was ₹26,266 crore, representing a meager 3% of India's Total Health Expenditure (THE). In contrast, private health insurance expenditures stand at 9.2% of THE, signaling that government schemes are falling short of providing substantial financial protection.
• Institutional Dominance: Private hospitals dominate the healthcare ecosystem, consuming the largest share of CHE at 30.83%, compared to just 16.73% by government facilities.

Another major area of concern is the lopsided distribution of funds, with preventive healthcare receiving only 8.88% of the total CHE spending. This raises massive challenges for a country dealing with a rising burden of non-communicable diseases.

The data clearly demonstrates that unregulated privatization is deepening inequities, necessitating stricter domestic regulatory frameworks and a genuine scaling up of public health infrastructure.

Try this :

Consider the following statements regarding the National Health Accounts (NHA) Estimates for India (2022–23):

1. Government Health Expenditure (GHE) as a percentage of GDP remains below both the WHO recommendation and India's National Health Policy target.
2. Out-of-Pocket Expenditure (OOPE) accounts for nearly half of the Current Health Expenditure (CHE).
3. Expenditure under government-financed health insurance schemes exceeds that of private health insurance.
4. Preventive healthcare accounts for less than one-tenth of India's Current Health Expenditure.

Which of the statements given above are correct?
A. 1 and 2 only
B. 2, 3 and 4 only
C. 1, 2 and 4 only
D. 1, 2, 3 and 4