There has been a significant decline in out-of-pocket expenditure (OOPE) on health, dropping from 64.2 per cent in 2013-14 to 39.4 per cent in 2021-22, data available from the National Health Account (NHA) has revealed, reflecting a major shift towards more equitable healthcare access in the country.

Describing the trend as a “very positive indicator,” Dr V K Paul member (Health) of NITI Aayog said that the substantial savings—over Rs 1 lakh crore— has been resulted from the central health flagship Ayushman Bharat PMJAY scheme.

Additionally, other initiatives, like the free dialysis scheme launched in 2015-16, have positively impacted millions of individuals.

“More than Rs 1 lakh crore savings have accrued from the Ayushman Bharat PMJAY and this has had a positive impact on the recent NHA estimates,” he added. He also stated that other schemes “like the free dialysis scheme, launched in 2015-16 have benefited 25 lakh people, he said while releasing the Union Health Ministry’s National Health Account (NHA) estimates for India 2020-21 and 2021-22.

A crucial measure of healthcare accessibility and financial burden, as high levels of such spending can lead to significant financial strain for families, OOPE refers to the payments made directly by individuals at the time they receive healthcare services or goods including medical consultations, hospital stays, medications, diagnostic tests, and other health-related costs that are not covered by insurance or government programs.

Since catastrophic health expenditure often leading to debt or financial hardship, the India’s National Health Policy 2017 has set ambitious goals. It aims for a significant decrease in OOPE, targeting a 25 per cent reduction in the proportion of households facing catastrophic health expenditure by 2025.

Union Health Secretary Apurva Chandra added that the increase in government health expenditure (GHE), rose from 1.13 per cent of GDP in 2014-15 to 1.84 per cent in 2021-22, and from 3.94 per cent to 6.12 per cent of general government expenditure (GGE). Per capita GHE tripled from Rs 1,108 to Rs 3,169 during the same period, with a notable increase of 37 per cent from 2020-21 to 2021-22.

These changes reflect the government’s commitment to enhancing public health investment, with GHE’s share of total health expenditure growing from 29 per cent to 48 per cent.