The Union Health Ministry released the National Health Account (NHA) estimates for India 2020-21 and 2021-22. These estimates are the eighth and ninth in the series of reports released annually by the Union Ministry of Health & Family Welfare.

Addressing the session, Dr V K Paul, Member (Health), NITI Aayog said that “the methodology taken for these NHA estimates has improved over the last 9 years and has resulted in a more robust and accurate account of the government’s expenditure on Health”. He said, “the decline in Out-of-Pocket expenditure out of Total Health Expenditure from 64.2% in 2013-14 to 39.4% in 2021-22 reflects a very positive indicator.”

Dr Paul highlighted that “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 also stated that other schemes like the Free Dialysis scheme, launched in 2015-16 has benefited 25 lakh people.”

Speaking on the occasion, Union Health Secretary Shri Apurva Chandra said that “a substantial increase has been noticed in the health expenditure of the government while the out-of-pocket expenditure has come down which is a good sign.” He highlighted that the total health expenditure has also made a significant increase which reflects the emphasis of the government towards health.

The NHA estimates are based on the globally accepted framework of ‘A System of Health Accounts (SHA), 2011’ which facilitates inter-country comparisons. This report provides a systematic description of the financial flows in India’s health system by different sources, how the money is spent, how healthcare is provided, and the nature of healthcare services that are used.

The NHA estimates for 2021-22 show that Government expenditure for healthcare continues to increase in the country, highlighting the efforts of the Government to increase public investments in the health sector. The share of Government Health Expenditure (GHE) in the overall GDP of the country has increased from 1.13% in 2014-15 to 1.84% in 2021-22. In terms of share in the General Government Expenditure (GGE), it has increased from 3.94% in 2014-15 to 6.12% in 2021-22.

Figure 1: Government Health Expenditure (GHE) as % of GDP

Figure 2: Government Health Expenditure (GHE) as % of General Government Expenditure (GGE)

In per capita terms, GHE has tripled, from Rs. 1,108 to Rs. 3,169   between 2014-15 to 2021-22. The Government spending on health between 2019-20 and 2020-21 increased by 16.6%, while between 2020-21 and 2021-22, it grew by an unprecedented rate of 37%, highlighting the proactive role played by the Government in tackling the COVID-19 pandemic.

The increase in Government spending on health has an important implication for the reduction of financial hardship endured by households. In the Total Health Expenditure (THE) of the country between 2014-15 and 2021-22, the share of GHE has increased from 29% to 48%. During the same period, the share of Out-of-Pocket Expenditure (OOPE) in THE declined from 62.6% to 39.4%.

The continuous decline in the OOPE in the overall health spending vindicates the substantial efforts made by the Government in the progress towards ensuring financial protection and Universal Health Coverage for its citizens. 

Figure 3: Government Health Expenditure (GHE) and Out-Of-Pocket Expenditure (OOPE) as % of Total Health Expenditure (THE)

Another positive trend in the country’s health financing space is the increase in Social Security Expenditure (SSE) on healthcare. This increase in social security has a direct impact on reducing out-of-pocket payments. A robust social security mechanism ensures that individuals will not face financial hardship and the risk of poverty as a consequence of accessing essential healthcare services. The share of SSE on health, which includes Government-funded health insurance, medical reimbursement to Government employees, and social health insurance programs, in THE, has increased from 5.7% in 2014-15 to 8.7% in 2021-22.

The NHA Estimates for 2020-21 and 2021-22 released today can be accessed here: https://nhsrcindia.org/national-health-accounts-records.

Smt. Punya Sasila Srivastava, Officer on Special Duty, Health Ministry; Shri Jaideep Kumar Mishra, Addl. Secy and Financial Adviser, Health Ministry; Smt. L S Changsan, Addl. Secy, Health Ministry; Smt. Aradhana Patnaik, Addl. Secy, Health Ministry; Smt. Indrani Kaushal, Senior Economic Advisor, Health Ministry; Shri Saurabh Jain, Joint Secretary, Health Ministry and other senior officers

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MV

HFW/ Release of NHA Estimates/25^th September 2024/4