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

Published 2026-05-29 · Updated 2026-05-29 · 3 min · 481 words

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.

Primary/reference source: The Hindu