National Health Accounts figures indicate high burden of health care costs on people

2026-05-29 · 3 min

UPSC CSE Context Why in News: National Health Accounts 2022 23 shows out of pocket expenditure remains nearly half of current health expenditure. Syllabus Connection: GS Paper 2: Social Justice – Health; GS Paper 3: Inclusive Growth; GS Paper 1: Society – Health indicators. Exam Relevance: Highlights persistent gaps in public health financing, privatisation, and financial protection – key for Mains and Prelims. Core Issue High out of pocket health expenditure despite increased government spending. Key Development: Government Health Expenditure share in GDP rose to 1.43% but remains below NHP target of 2.5%. Stakeholders: Households Government Centre & States Private hospitals Insurance companies Jan Swasthya Abhiyan Static Knowledge High Value Background: National Health Accounts NHA estimate health expenditure flows in India annually. Exam Linkage: Useful for questions on health financing, universal health coverage, and public private mix. Concepts in Context: Current Health Expenditu

## UPSC CSE Context **Why in News:** National Health Accounts 2022-23 shows out-of-pocket expenditure remains nearly half of current health expenditure.

**Syllabus Connection:** GS Paper 2: Social Justice – Health; GS Paper 3: Inclusive Growth; GS Paper 1: Society – Health indicators.

**Exam Relevance:** Highlights persistent gaps in public health financing, privatisation, and financial protection – key for Mains and Prelims.

## Core Issue High out-of-pocket health expenditure despite increased government spending.

**Key Development:** Government Health Expenditure share in GDP rose to 1.43% but remains below NHP target of 2.5%.

**Stakeholders:** - Households - Government (Centre & States) - Private hospitals - Insurance companies - Jan Swasthya Abhiyan

## Static Knowledge

**High-Value Background:** - National Health Accounts (NHA) estimate health expenditure flows in India annually.

**Exam Linkage:** - Useful for questions on health financing, universal health coverage, and public-private mix.

**Concepts in Context:** - Current Health Expenditure (CHE) excludes capital expenditure, measures final consumption. - Government-financed health insurance includes PMJAY and state schemes.

**Institutions and Mechanisms:** - National Health Accounts prepared by National Health Systems Resource Centre (NHSRC). - Pradhan Mantri Jan Arogya Yojana (PMJAY) – flagship public health insurance.

## Dynamic Analysis

### Governance - Public health spending at 1.43% of GDP is far below WHO recommendation of 5% and NHP target of 2.5%. - COVID-era surge in public spending was not sustained; GHE share in CHE dropped from 41.1% to 35.6% in one year. - State governments bear over 63% of government health expenditure, indicating fiscal strain on states. - Low spending on preventive care (8.88% of CHE) reflects reactive rather than proactive health policy.

### Economy - Private health insurance (9.2% of THE) is three times government-financed insurance (3%), indicating low public coverage. - High OOPE pushes families into poverty and reduces access to healthcare.

### Society - Unregulated privatisation leads to inequities in access, rising costs, and irrational treatment. - Non-communicable diseases cause 60% of deaths, yet preventive care spending is low. - Financial protection remains incomplete despite insurance schemes, especially for poor and vulnerable.

## Prelims Takeaways - National Health Accounts 2022-23: OOPE is 49.9% of Current Health Expenditure. - Government Health Expenditure as % of GDP: 1.43% (2022-23).

## Mains Value Addition

**Arguments:** - Increased public spending alone insufficient without addressing privatisation and insurance gaps. - Low preventive care spending undermines long-term health outcomes and increases curative costs. - State-dominated health expenditure without adequate central transfers strains state finances. - Private insurance growth without regulation can exacerbate inequities.

**Examples:** - PMJAY covers only 3% of total health expenditure, showing limited financial protection.

**Counterpoints:** - Government claims increased prioritisation; GHE per capita rose 2.7 times in a decade. - Insurance schemes may reduce OOPE for some but overall burden remains high.

## Way Forward - Increase public health spending to at least 2.5% of GDP as per NHP 2017. - Strengthen primary and preventive care to reduce curative burden and NCDs. - Regulate private healthcare costs and ensure transparency in treatment pricing. - Expand government-financed insurance coverage and reduce reliance on private insurance. - Enhance central fiscal transfers for health to ease state burden.

Source: The Hindu