New Delhi: Union Minister of State for Health and Family Welfare, Smt. Anupriya Patel, informed the Lok Sabha that out-of-pocket expenditure (OOPE) as a percentage of total health expenditure in states has decreased in recent years. She highlighted that this improvement is evident from the latest estimates of the National Health Accounts (NHA).
Notably, in Odisha, where 53.4% of health expenditure was borne by individuals in 2019-20, the figure dropped to 37.1% in 2021-22. This decline indicates improved access to healthcare services and increased government investment in the state.
Additionally, states like Assam, Bihar, Jharkhand, and Uttar Pradesh have also seen reductions in OOPE. For instance, Assam’s OOPE decreased from 34.9% to 27.6%, while Jharkhand’s fell from 64.7% to 47.5%. Similarly, Uttar Pradesh, which had the highest OOPE at 71.8% in 2019-20, still remains high at 63.7%.
Kerala and West Bengal also reported reductions in OOPE; however, the figures remain relatively high. In 2021-22, Kerala recorded 59.1%, and West Bengal reported 58.3%.
The minister emphasized that the central government is committed to reducing the financial burden of healthcare on citizens. Through health schemes and welfare programs, efforts are being made to ensure affordable and accessible healthcare for all.
However, the persisting high OOPE in some states highlights the need for further improvements in healthcare services. Success stories like Odisha’s progress could serve as inspiration for other states.
As per National Health Accounts Estimates 2021-22, the Out-of-Pocket Expenditure (OOPE) as a percentage of Total Health Expenditure (THE) is 39.4%. OOPE on health as a percentage of THE in the country for the year 2017-18, 2018-19, 2019-20, 2020-21, and 2021-22 are 48.8%, 48.2%, 47.1%, 44.4%, and 39.4% respectively and therefore there is a declining trend in OOPE as a percentage of THE. Available State-wise OOPE as a percentage of State THE for the last three years as per National Health Accounts Estimates for India is placed as Annexure.
The Ministry of Health and Family Welfare (MoHFW) has taken up with States to prioritize allocation to the health sector and enhance their health budgets by at least 10% every year. The budget allocation for the Department of Health & Family Welfare (DoHFW) has increased by 85% from Rs. 47,353 crores in 2017-18 (BE) to Rs. 87,657 crores in 2024-25 (BE). Further, the 15th Finance Commission provided Rs. 70,051 crore Grants for health through the local Governments.
The Central Government has taken several initiatives to supplement the efforts of the States to provide quality and affordable healthcare services to the people and reduce the OOPE. Under the National Health Mission, the Government has taken many steps towards universal health coverage, by supporting the State Governments in providing accessible and affordable healthcare to people. The National Health Mission provides support for improvement in health infrastructure, availability of adequate human resources to manage health facilities, to improve availability and accessibility to quality healthcare, especially for the underserved and marginalized groups in rural areas.
In this regard, the Government has launched mission mode projects, namely Pradhan Mantri -Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), Ayushman Aarogya Mandir (erstwhile AB-HWC) and Pradhan Mantri Jan Arogya Yojana (PM-JAY).
PM-ABHIM was launched as a mission to develop the capacities of primary, secondary, and tertiary health care systems; strengthen existing national institutions, and create new institutions to cater to the detection and cure of new and emerging diseases. PM-ABHIM is a Centrally Sponsored Scheme with some Central Sector components with an outlay of Rs 64,180 crore.
A total of 1,75,418 Ayushman Arogya Mandirs (AAMs) have been established and operationalized, till 10th December 2024, by transforming existing Sub-Health Centres (SHC) and Primary Health Centres (PHC) in rural and urban areas. The purpose of AAMs are to deliver the expanded range of comprehensive primary healthcare services that includes preventive, promotive, curative, palliative and rehabilitative services encompassing Reproductive and Child care services, Communicable diseases, Non-communicable diseases and all health issues, which are universal, free, and closer to the community.
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) provides health cover of Rs. 5 lakh per family per year for secondary and tertiary care hospitalization to approximately 55 crore beneficiaries corresponding to 12.37 crore families, constituting the bottom 40% of India’s population. The Central Government has also recently approved health coverage for all senior citizens of age 70 years and above irrespective of their income under PM-JAY.
National Free Drugs Service initiative and Free Diagnostic Service has been rolled out to ensure the availability of essential drugs and diagnostic facilities and reduce out-of-pocket expenditure of the patients visiting public health facilities.
Besides, quality generic medicines are made available at affordable prices to all under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have been set up in some hospitals/institutions.
Source: PIB
