Our Healthcare Boom Hides a Public-System Deficit, Pg11

Key Highlights:

• India's government health expenditure was 1.43% of GDP in 2022-23, falling short of the National Health Policy 2017 target of 2.5%.
• The number of medical colleges has increased to 818, with undergraduate medical seats reaching 1,28,875.
• Ayushman Bharat is recognized as one of the world’s largest publicly funded health insurance programs.
• A Parliamentary Standing Committee report indicates persistent struggles with basic capacity, affordability, and regulation within the healthcare system.
• Out-of-pocket expenditure (OOPE) constituted 43.4% of total health expenditure in 2022-23, despite a substantial decline over the decade.

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Detailed Insights:

• Despite the increase in medical seats, rural Community Health Centres face a specialist shortage of approximately 70-80%.
• There are 17,788 sub-centres operating without dedicated buildings, highlighting infrastructure deficits.
• The private sector services over 60% of hospitalizations and around 70% of outpatient care in India.
• Average hospitalization expenditure is higher in government hospitals (Rs 86,631) compared to private hospitals (Rs 50,508), indicating a lack of accessible public alternatives.
• While insurance schemes like Ayushman Bharat provide financial protection, they do not effectively control rising healthcare costs.
• Private capital is increasingly investing in the healthcare sector, driven by consistent demand and opportunities for market consolidation.
• The 2026 Lancet Commission Report on a Citizen-Centred Health System for India advocates for a stronger publicly financed and provided health system as the foundation for universal healthcare.

Key Concepts Involved:

• National Health Policy 2017: A policy aiming to increase government health expenditure to 2.5% of GDP by 2025 and achieve universal access to quality healthcare.
• Ayushman Bharat: A national health protection scheme providing health insurance coverage of up to ₹5 lakh per family per year for secondary and tertiary care.
• Out-of-pocket expenditure (OOPE): Direct payments made by individuals for healthcare services at the point of use, without reimbursement from insurance or government schemes.
• Community Health Centres (CHCs): Block-level health facilities in rural areas, intended to provide specialist services and secondary healthcare.