Indians spent eight times more on private hospitals and twice as much on transporting patients compared to costs in government hospitals, according to the National Health Accounts (NHA) Estimates for the financial year 2013-14. The data was recently released by the Health Ministry after almost a decade.
The estimates say that households spent Rs. 64,628 crore on private hospitals compared to just Rs. 8,193 crore on government hospitals. A total of Rs. 18,149 crore was spent on patient transportation services, like use of an ambulance.
Considering all revenue sources, including government funding, expenditure on private hospitals — Rs. 88,552 crore — was double that on government hospitals — Rs. 41,797 crore.
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The NHA monitors the flow of resources in the country’s health system and provides details of health finances.
Low public spending
India spent a total of Rs. 4.5 lakh crore on healthcare in 2013-14 at 4 per cent of the GDP, of which Rs. 3.06 lakh crore came from households.
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Public spending is abysmally low, constituting around 29 per cent of the total health expenditure — 1 per cent of GDP. There has been a marginal improvement from 2004-05, when the share of government spending was just 22 per cent.
Preventive care gets just 9.6 per cent of the total money that flows in India’s healthcare system. The current expenditure on preventive care is estimated at Rs 40,627 crore. All the government-funded national health programmes such as the National Disease Control Programmes are covered under this category.
High out-of-pocket costs
Indians’ out-of-pocket (OOP) expenditure on healthcare, which is the money individuals pay on their own rather than being covered by insurance or health benefits, has been estimated to be around Rs. 2.9 lakh crore or 69 per cent of total health expenditure (THE) in the country. This is alarmingly high and India stands among the highest in this metric worldwide.
The share of OOP as a percentage of Current Health Expenditure (CHE) has however, decreased from 69.4 per cent in 2004-05 to 64.2 per cent in 2013-14. The CHE comprises 93 per cent, the rest 7 per cent going to Capital Expenditure.
Abysmal public spending
Half of all the household money that is spent on healthcare — around Rs. 1.5 lakh crore — goes to pharmacies. This includes chemists, community and independent pharmacies.