India’s out-of-pocket expenses on healthcare still hover around 50 per cent of the total health expenditure, though the situation has improved in the last ten years, says the Economic Survey 2023-24, which has also flagged obesity as one of the major public health concerns.
The out of pocket expenditure on healthcare is over 47 per cent in 2019-20, which is certainly a drop from a high of 64 per cent registered in 2013-14, but still not anywhere close to the 35 per cent mark recommended by the Survey three years ago.
The share of primary healthcare in government health expenditure has increased by less than 5 per cent between FY15 and FY20. But when the share of primary and secondary healthcare are taken together, the rise is by more than 11 per cent in the same period, suggesting an increase in the use of government hospitals.
On the other hand, the share of primary and secondary care in private health expenditure has declined by around 9 per cent in the same period, attributable to rising tertiary disease burden and utilisation of government facilities for primary healthcare.
India has one of the world's highest out of pocket expenditures resulting in poor households being disproportionately impacted by out-of-pocket-expenditure and being pushed below the poverty line. Experts say only an increase in public health spending can prevent this.
The Survey recommends proactive roles by the states to take the flagship schemes like the PMJAY Ayushman Bharat to the last mile. It also underscores the need to promote healthy eating to stem the growth of obesity and non-communicable diseases like type-II diabetes.
As per the National Family Health Survey-5, nearly a quarter of Indian men and women are overweight and obese while the incidence of diabetes increased from less than 2 per cent to more than 20 per cent in the last 50 years.
On mental health, the Survey says the second edition of the National Mental Health Survey is in progress. The first one, carried out in 2015-16, reported some form of mental illness in over 10 per cent of Indians. There are gaps like the number of psychiatrists – 0.75 per lakh as against the WHO norm of 3 – that need to be plugged, it adds.
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Published 22 July 2024, 13:56 IST