National Health Accounts Estimates: Out-of-pocket expenditure in total health expenditure sees 16% decline from 2014-15 to 2019-20

The National Health Accounts Estimates 2019-20 that was launched on Tuesday reveals that there has been a consistent decline in the share of out-of-pocket expenditure in total health expenditure. The report showed that such expenses stood at 62.6 percent in 2014-15, and have dropped sharply to 47.1 percent in 2019-20. The data reflected that the government health expenditure (GHE) as a share of the total health expenditure (THE) increased from 29 per cent to 41.4 per cent during the same period.

Speaking at the launch, Dr. Vinod K. Paul, Member (Health) of NITI Aayog, said that the National Health Accounts Estimates report shows that indicators like out-of-pocket expenditure (OOPE) reduction are going hand-in-hand with increased public spending in healthcare. Hence, it showed that the country is taking the right trajectory towards achieving milestones of Universal Health Coverage. 

Highlighting the efforts of the government towards public investments in the health sector, findings from National Health Accounts (NHA) show that various indicators have demonstrated an encouraging trend on a sustained basis.

Overall, the government health expenditure as per cent of GDP has increased over the years from 1.13 per cent in 2014-15 to 1.35 per cent in 2019-20. For the same period, GHE as per cent of general government expenditure (GGE) has increased from 3.94 per cent to 5.02 per cent.

In per capita terms, GHE has doubled from Rs 1,108 to Rs 2,014 between 2014-15 to 2019-20. The government spending on health between 2018-19 and 2019-20 increased by 12 per cent, more than double the growth rate between 2017-18 and 2018-19 which was at 5 per cent, said Dr V K Paul, Member (Health), NITI Aayog as he launched the National Health Accounts (NHA) Estimates for India for 2019-20.

Additionally, in the General Government Expenditure, the share of health sector spending has steadily increased from 3.94 per cent to 5.02 per cent between 2014-15 and 2019-20.

Highlighting that healthcare has been the priority for public investment in the country, Dr Paul said, “Government is ensuring that healthcare services that are required, be made readily available and accessible to the citizens without financial hardships.” 

“Report highlights the increased public spending in primary healthcare, which is in line with National Health Policy 2017 where it states that two-thirds of public health spending must be in Primary Health systems. This is also a result of great developments/initiatives taken at grassroot level such as opening of over 1.6 lakh Ayushman Bharat Health and Wellness Centres (AB-HWCs) which are providing plethora of health services to the people,” he further added.

He also threw light on the fact that private health insurance share has gone up. He said that “this shows a sign of maturity for a country in terms of insurance arena as those who can afford, will afford it from private players too. This complements the government system of primary, secondary and tertiary care.”

The NHA estimates for 2019-20 which is seventh in the series of reports released annually, clearly show that government expenditure for healthcare continues to be the priority.

The share of Out-of-Pocket Expenditure (OOPE) in total Health Expenditure (THE) declined from 62.6% to 47.1%. The continuous decline in the OOPE in the overall health spending show progress towards ensuring financial protection and Universal Health Coverage for citizens.

During this period, the share of Government Health Expenditure (GHE) in the overall GDP of the country has increased from 1.13% in 2014-15 to 1.35% in 2019-20.