erala spends 6.5 per cent of its Gross State Domestic Product (GSDP) on health care, out of which public expenditure constitutes 1.5 per cent of the GSDP, as per the 2013-14 figures. In terms of money spent, the State’s average annual expenditure on health is about Rs.25,000 crore, out of which the government’s expenditure comes to about Rs.6,000 crore, while the rest is private expenditure. Kerala has the highest per capita expenditure on health in the country during 2013-14, at Rs.7,636. Out of this, the public per capita spending comes to about Rs.1,765, still one of the highest in the country.
Households pay for more than three-quarter of all health-care expenses in the State (76 per cent), while the government contribution accounts for less than a fifth, at 19.6 per cent. Public and private enterprises and NGOs together contribute 3.4 per cent of the total health spending in Kerala. “But it is noteworthy that in the last 10 years, the government expenditure has risen by 5.2 times, from a mere 9 per cent to the current level of 19.6 per cent. Even though Kerala tops in out-of-pocket spending (OOPS), increased public spending has, in fact, brought down OOPS in Kerala by 1.7 per cent, resulting in a total 2 per cent decline in health expenditure,” Sakthivel Selvaraj, senior health economist, PHFI, told The Hindu.
“The spending on preventive care looks good on paper but in fact, a chunk of this expenditure is eaten away by HR expenses, training and IEC activities, while very little is actually spend on grassroots level preventive activities,” K. Ellangovan, Secretary, Health, said. “In order to bring down the increasing OOPS, it is critical that the government doubles its health spending in the next five years. Despite the highest per capita spending on health in the country, the government’s investment does not seem to be enough to meet the growing health needs of the population. Strengthening primary and preventive care pathways, making a total shift to generic medicines and regulating the private health sector would be crucial for curbing the cost of care,” Dr. Selvaraj said.
