{"id":54469,"date":"2025-09-18T19:22:28","date_gmt":"2025-09-18T13:52:28","guid":{"rendered":"https:\/\/www.nextias.com\/ca\/?p=54469"},"modified":"2025-09-19T13:34:29","modified_gmt":"2025-09-19T08:04:29","slug":"india-out-of-pocket-health-expenditure","status":"publish","type":"post","link":"https:\/\/www.nextias.com\/ca\/current-affairs\/18-09-2025\/india-out-of-pocket-health-expenditure","title":{"rendered":"Out-of-Pocket Health Expenditure (OOPE) in India"},"content":{"rendered":"\n<p><strong>Syllabus: GS2\/Issues Related To Health<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Context<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Despite a sharp decline in <strong>out-of-pocket expenditure (OOPE)<\/strong> on health in India, closer scrutiny <strong>reveals persistent concerns<\/strong> associated with it.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>About Out-of-Pocket Expenditure (OOPE)<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It refers to the direct payments individuals make for healthcare services \u2014 without reimbursement.<\/li>\n\n\n\n<li>It includes costs for doctor consultations, medicines and diagnostics, hospitalization and surgeries, transportation and informal care etc.<\/li>\n\n\n\n<li>In India, OOPE has <strong>historically been one of the highest in the world<\/strong>, often pushing families into poverty or debt due to medical expenses.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Recent Trends in OOPE in India<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>According to the <strong>National Health Accounts (NHA)<\/strong> <strong>Estimates<\/strong>, India\u2019s OOPE as a share of <strong>Total Health Expenditure <\/strong>has declined from 64% in 2013-14 to 49% in 2017-18, and further down to 39% in 2021-22.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Reasons For Decline in OOPE<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Increased Government Health Expenditure:<\/strong> From 1.13% of GDP in 2014\u201315 to 1.84% in 2021\u201322 and 1.9% in FY 2023-24.\n<ul class=\"wp-block-list\">\n<li>However, the <strong>National Health Policy (NHP) 2017<\/strong> targets <strong>2.5% of GDP by 2025.<\/strong><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Ayushman Bharat \u2013 PMJAY:<\/strong> Targeting the bottom 40% of India\u2019s population \u2014 approximately 55 crore individuals across 12 crore families.<\/li>\n\n\n\n<li><strong>Free Drugs &amp; Diagnostics Initiatives:<\/strong> Under the<a href=\"https:\/\/www.nextias.com\/ca\/current-affairs\/05-03-2025\/success-of-national-health-mission\"> <strong>National Health Mission<\/strong><\/a>, the government rolled out:\n<ul class=\"wp-block-list\">\n<li>National Free Drugs Service Initiative;<\/li>\n\n\n\n<li>Free Diagnostic Service Initiative.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Affordable Medicines Programs: <\/strong>Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) and AMRIT Pharmacies.<\/li>\n\n\n\n<li><strong>Infrastructure &amp; Budget Expansion:<\/strong>\n<ul class=\"wp-block-list\">\n<li>The <strong>Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)<\/strong> strengthens primary and tertiary care systems.<\/li>\n\n\n\n<li>The <strong>Health Budget<\/strong> increased by 85% from \u20b947,353 crore in 2017\u201318 to \u20b987,657 crore in 2024\u201325.<\/li>\n\n\n\n<li>The <strong>15th Finance Commission<\/strong> allocated \u20b970,051 crore in grants to local governments for health.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Concerns &amp; Issues Surrounding OOPE<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Dependence on NSS Data:<\/strong> NHA estimates heavily rely on the <strong>National Sample Survey (NSS) 75th round (2017-18).<\/strong>\n<ul class=\"wp-block-list\">\n<li>Any underreporting of ailments or reduced hospitalisation utilisation would artificially deflate OOPE estimates.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>COVID-19 Blind Spot:<\/strong> The NHA framework fails to capture the massive distress during the pandemic, as<strong> no NSS data were collected in this period.<\/strong><\/li>\n\n\n\n<li><strong>Consumer Expenditure Survey (CES) 2022-23:<\/strong> It shows OOPE as a share of household consumption expenditure has increased \u2014 from <strong>5.5% to 5.9% in rural areas<\/strong> and<strong> 6.9% to 7.1% in urban areas<\/strong> between 2011-12 and 2022-23.<\/li>\n\n\n\n<li><strong>CPHS-CMIE Data:<\/strong> Indicates a <strong>\u2018V\u2019- shaped trend <\/strong>\u2014 steep decline in OOPE during COVID-19, followed by a sharp rise \u2014 completely missing from NHA trends.<\/li>\n\n\n\n<li><strong>National Income Accounts (NIA):<\/strong> It records a steady increase in household health spending as a share of GDP, <strong>contradicting NHA\u2019s reported decline.<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Way Forward: Solutions to Reduce OOPE<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Strengthening Data Capture:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Triangulation of Data Sources:<\/strong> Complement NSS with CES, NFHS, LASI, CMIE, and private sector data.<\/li>\n\n\n\n<li><strong>Capturing Crisis Effects:<\/strong> Incorporate pandemic-related shocks and post-pandemic recovery trends.<\/li>\n\n\n\n<li><strong>Continuous Monitoring:<\/strong> Develop a more dynamic, multi-source approach for tracking household health expenditure.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Strengthening Primary Healthcare:<\/strong> Investing in primary health centers, especially in urban and semi-urban areas, can reduce dependence on costly tertiary care.\n<ul class=\"wp-block-list\">\n<li>Preventive services and early diagnosis are key to lowering long-term costs.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Expand Insurance Coverage:<\/strong> Include outpatient services, diagnostics, and essential medicines under public insurance schemes like AB-PMJAY.<\/li>\n\n\n\n<li><strong>Promote Affordable Medicines:<\/strong> Scale up initiatives like Jan Aushadhi Kendras and AMRIT pharmacies to ensure access to low-cost, quality generics across the country.<\/li>\n\n\n\n<li><strong>Improve Budget Efficiency:<\/strong> Ensure that health budgets are not only increased but also effectively utilized.\n<ul class=\"wp-block-list\">\n<li>Greater transparency and accountability in fund allocation can enhance service delivery and reduce leakages.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Health Literacy &amp; Behavior Change:<\/strong> Educate citizens on preventive care, rational drug use, and the benefits of public health services.\n<ul class=\"wp-block-list\">\n<li>Behavioral change campaigns can reduce unnecessary medical visits and promote healthier lifestyles.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/epaper.thehindu.com\/ccidist-ws\/th\/th_international\/issues\/148578\/OPS\/GV2ESKHF6.1+GBMETNTU1.1.html\" rel=\"nofollow noopener\" target=\"_blank\">Source: TH<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<h3><strong>Context<\/strong><\/h3>\n<li class=\"ms-5\">Despite a sharp decline in out-of-pocket expenditure (OOPE) on health in India, closer scrutiny reveals persistent concerns associated with it.<\/li>\n<p><\/p>\n<h3><strong>About Out-of-Pocket Expenditure (OOPE)<\/strong><\/h3>\n<li class=\"ms-5\">It refers to the direct payments individuals make for healthcare services \u2014 without reimbursement.<\/li>\n<li class=\"ms-5\">It includes costs for doctor consultations, medicines and diagnostics, hospitalization and surgeries, transportation and informal care etc.<\/li>\n<p><a href=\"https:\/\/www.nextias.com\/ca\/current-affairs\/18-09-2025\/india-out-of-pocket-health-expenditure\" class=\"btn btn-primary btn-sm float-end\">Read\u00a0More<\/a><\/p>\n","protected":false},"author":15,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[21],"tags":[],"class_list":["post-54469","post","type-post","status-publish","format-standard","hentry","category-current-affairs"],"acf":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/54469","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/comments?post=54469"}],"version-history":[{"count":4,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/54469\/revisions"}],"predecessor-version":[{"id":54529,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/posts\/54469\/revisions\/54529"}],"wp:attachment":[{"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/media?parent=54469"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/categories?post=54469"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nextias.com\/ca\/wp-json\/wp\/v2\/tags?post=54469"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}