Key Highlights
- Government health outlays rose from 1.15% to 1.43% of GDP between 2013‑14 and 2022‑23, reaching 1.48% under the revised GDP base.
- Per‑capita public health spending more than doubled, climbing from ₹1,042 to ₹2,786.
- Out‑of‑pocket (OOP) spending dropped sharply, falling from 64.2% to 43.4% of total health expenditure.
- Public share of total health spending increased from 28.6% to 43.7%, reflecting deeper state involvement.
- Social‑security‑linked health financing and private insurance coverage both expanded markedly.
Detailed Insights
The 10th National Health Accounts (NHA) report, compiled by the National Health Accounts Technical Secretariat under the NHSRC, adopts the System of Health Accounts 2011 framework to quantify every source of health financing in India. Over the past ten years, the Union Health Ministry has consistently raised the fiscal envelope for health, pushing the Government Health Expenditure (GHE) share of General Government Expenditure from 3.78% to 4.89%.
Per‑capita GHE, a proxy for the breadth of services accessible to each citizen, surged to nearly three times its 2013‑14 level. This expansion is linked to larger infrastructure programmes, the rollout of Ayushman Bharat‑PMJAY, and targeted employee reimbursement schemes.
Simultaneously, the burden of direct household payments shrank considerably. The proportion of total health outlays paid out‑of‑pocket fell to 43.4% in 2022‑23, evidence of stronger risk‑pooling mechanisms and expanded public coverage.
COVID‑19 intensified public spending, with GHE peaking at 1.84% of GDP in 2021‑22 to fund emergency response packages, mass vaccination drives, and pandemic‑related operational costs.
Social security spending on health rose from 6% to 9.9% of total health expenditure, while private health‑insurance participation more than doubled, climbing from 3.4% to 9.2% of the total health spend, signalling heightened awareness and insurance penetration.
Key Concepts
- Government Health Expenditure (GHE): Total fiscal resources allocated by central, state and local authorities to health‑related services and infrastructure.
- Out‑of‑Pocket Expenditure (OOPE): Direct payments made by households at the point of service, not reimbursed by any third‑party payer.
- Social Security Expenditure (SSE): Public funds channeled through schemes such as PM‑JAY, employee health reimbursements, and other social health insurance mechanisms.
- System of Health Accounts (SHA) 2011: Internationally recognised classification that standardises the measurement of health financing flows.
- Private Health Insurance Share: Portion of total health spending financed by commercial or voluntary insurance policies.