Over 90 million Indians live in households where spending onhealthcareaccounts for more than 10% of their total expenditure. Of these, 31 million live in families where the Health spend is more
than a quarter of household expenditure. The proportion of households spending over 10% or 25% of their expenditure on healthcare has gone up between 2017-18 and 2022-23.This was revealed in theSustainable Development Goals NationalIndicator Framework Progress Report 2023, released recently by thestatistics ministry. Catastrophic health expenditure is defined as health spending exceeding 10% of household consumption expenditure. The third of the United Nation’s Goals (SDG) is to provide universal health coverage (UHC) and to improve financial protection, thus preventing catastrophic spending.UHCincludes securing access to quality healthcare and safe, affordable medicines and Vaccines for everyone.
According to the progress report, the proportion of households where more than 10% of expenditure was on health went up from 4.5% to 6.7% while that of those spending over 25% on healthcare went up from 1.6% to 2.3%.
In 2022-23, the highest proportion of people spending more than 10% or 25% of household expenditure on health were in Kerala, 16% and 6% respectively, followed by Maharashtra where it was 9% and 3% respectively. Kerala also saw the biggest jump in this proportion between 2017-18 and 2022-23. Other states which saw a significant increase are Karnataka, Odisha and Telangana in that order.
According to the National Health Accounts 2019-20, out of pocket expenditure (OOPE) as a proportion of the total health expenditure (68%) was the second highest in Kerala, just below Uttar Pradeshwhere it was 72%. Uttar Pradesh is among the five states with the highest proportion of households spending more than 10% or 25% of their expenditure on health. However, in the case of Karnataka, though OOPE as a proportion of total health expenditure is the lowest among the bigger states (31.8%), the state is among those which have witnessed the highest increase in the proportion of households using more than 10% and 25% of the expenditure on healthcare.
In June 2021, the NITI Aayog estimated that at least 400 million people or about 30% of the Population did not have any financial protection for health, leading to high out-of-pocket expenditure and impoverishment. It also estimated that the actual uncovered population would be higher due to existing coverage gaps in PMJAY and overlaps between schemes.
In 2022, the health ministry had notified the inclusion of coronary stents in the National List of Essential Medicines (NLEM), 2022, to make the life-saving medical devices more affordable. Doctors say the inclusion of stents in NLEM will help reduce the cost of angioplasty a minimally invasive procedure to open up blocked arteries and thus make it more accessible.