Health costs forcing families into debt

Data shows private sector’s dominance in health, education

Updated - December 04, 2021 11:06 pm IST

Published - July 03, 2015 11:46 pm IST - NEW DELHI:

Early results from an official survey on expenditure on health and education show that people are spending far beyond their means on these requirements.

From January to June last year, the National Sample Survey Office collected data from 66,000 households on their utilisation of, and expenditure on, education and health. The data show the growing dominance of the private sector in health and education.

Over 70 per cent of all people who reported an illness in the 15 days preceding the survey went to a private doctor, clinic or hospital in both rural and urban India. The usage of private facilities further rises with income. The frequency of usage of public and private hospitals has not changed much in rural areas, but in urban areas, the usage of private hospitals grew by six percentage points over the past decade.

Allopathy dominates in both rural and urban areas and across all income groups. This despite the fact that treatment in a private hospital costs four times as much as it does in a public hospital on an average, with the treatment of cancer and cardiovascular diseases proving to be most expensive.

As a result, hospitalisation proves well beyond the means of most; it can cost a person in the poorest 20 per cent of the country over 15 times their usual monthly expenditure. Even among the richest 20 per cent, hospitalisation tends to cost over five times the person’s monthly expenditure.

Yet 85 per cent of the people have no health expenditure support, either from a government scheme or through an employer or private insurance. As a result, over two of three households dip into their savings to pay for hospitalisation, and another 20 per cent have to borrow money.

Boys are taken to doctors more frequently than girls in childhood. In the reproductive age, women are hospitalised more frequently than men.


When it comes to education, the public sector still dominates from primary to higher secondary schools, while the private sector dominates when it comes to diploma, graduation and above.

At all levels, a household’s expenditure on education has doubled since 2007-08.

Families spend more on education of boys than girls, and far more in urban than in rural areas. In urban areas, the average expenditure ranges from Rs. 10,000 a year for primary education to Rs. 23,000 a year for a diploma course. In urban areas, education in private institutions costs five times as much as in public schools.

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