India has experienced a considerable transformation in its healthcare funding, as revealed by the Union Ministry of Health and Family Welfare’s recent report. The National Health Accounts (NHA) Estimates for the fiscal year 2022-23 indicate that Government Health Expenditure (GHE) increased nearly threefold, rising from ₹1.30 lakh crore in 2013-14 to ₹3.85 lakh crore in 2022-23. This reflects a notable commitment to public health funding over the past decade.

The report, produced by the National Health Accounts Technical Secretariat (NHATS), marks the tenth assessment under the System of Health Accounts framework established in 2011. In proportional terms, GHE as a share of Gross Domestic Product (GDP) has also seen a rise, increasing from 1.15 per cent in 2013-14 to 1.43 per cent in 2022-23, and slightly higher at 1.48 per cent when adjusted for the revised GDP with a base year of 2022-23.

Furthermore, as a percentage of General Government Expenditure (GGE), GHE grew from 3.78 per cent to 4.89 per cent during the same timeframe. This upward trend demonstrates a greater prioritisation of health within public spending strategies.

Decline in Out-of-Pocket Expenditure

A significant finding of the report is the reduction in Out-of-Pocket Expenditure (OOPE), which has decreased from 64.2 per cent in 2013-14 to 43.4 per cent in 2022-23 as a share of Total Health Expenditure (THE). This change is attributed to enhanced public health initiatives and expanded financial protection measures aimed at improving access and affordability for citizens.

Additionally, the share of GHE within Total Health Expenditure has escalated from 28.6 per cent to 43.7 per cent over the decade. This shift reflects a structural transformation towards increased public financing in healthcare, contributing to efforts for achieving Universal Health Coverage and ensuring a more equitable health system.

During the COVID-19 pandemic, GHE saw a notable spike, peaking at 1.84 per cent of GDP in 2021-22. This surge was driven by emergency measures, including the Emergency COVID Response Package and a nationwide vaccination initiative.

Growth in Social Security Expenditure and Private Health Insurance

Social Security Expenditure (SSE) on health has also increased, going from 6 per cent of Total Health Expenditure in 2013-14 to 9.9 per cent in 2022-23. This category encompasses government-funded insurance schemes and reimbursements for government employees along with social health protection programmes.

Moreover, the report indicates that the segment of private health insurance in Total Health Expenditure grew from 3.4 per cent to 9.2 per cent during the same period. This increase illustrates heightened awareness regarding health insurance and the improved ability of the population to invest in medical coverage.

The Ministry of Health and Family Welfare concluded that these trends indicate a consistent strengthening of India’s public healthcare financing system, particularly emphasising accelerated advancements during and following the COVID-19 crisis. The ongoing improvements signal a robust enhancement in the healthcare framework of the country.

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