High out of pocket expenses on Health care Inspite of Insurance, Ayushman, CGHS; MP Arora

In reply to a question on affordable healthcare the Union Minister of State for Health and Family Welfare Dr Bharati Pravin Pawar has recently stated Rajya Sabha that as per National Health Accounts Estimates 2018-19, the Out-of-pocket expenditure (OOPE) as percentage of Total Health Expenditure (THE) is 48.2%.

High out of pocket expenses on Health care Inspite of Insurance, Ayushman, CGHS; MP Arora
Sanjeev Arora MP Rajya Sabha.

Ludhiana, March 30, 2023: In reply to a question on affordable healthcare the Union Minister of State for Health and Family Welfare Dr Bharati Pravin Pawar has recently stated Rajya Sabha that as per National Health Accounts Estimates 2018-19, the Out-of-pocket expenditure (OOPE) as percentage of Total Health Expenditure (THE) is 48.2%. OOPE on health as percentage of THE in the country for the year 2015-16, 2016-17, 2017-18 and 2018-19 are 60.6%, 58.7%, 48.8% and 48.2% respectively and therefore there is declining trend in OOPE as percentage of THE. According to Arora if we add amount spent on insurance premium and unaccounted spent on health it would be around 60% compared to world average of 18%. According to official data of the Government it is 70% in UP which is a highest populated state in country. 

State-wise Out of Pocket Expenditure (OOPE), as per National Health Accounts Estimates for India for the year 2018-19, is as under: Assam (Rs.3228 Crore), Andhra Pradesh (Rs.16326 Crore), Bihar (Rs. 9731 Crore), Chhattisgarh (Rs.3407 Crore), Gujarat (Rs.10922 Crore),  Haryana (Rs.6359 Crore), Jammu & Kashmir (Rs.1772 Crore), Jharkhand (Rs.7086 Crore), Karnataka (Rs.10723 Crore), Kerala (Rs.23702 Crore), Madhya Pradesh (Rs.11550 Crore), Maharashtra (Rs.32251 Crore), Odisha (Rs.7873 Crore), Punjab (Rs.9196), Rajasthan (Rs.13438 Crore), Tamil Nadu (Rs.14509 Crore), Uttar Pradesh(Rs.55829 Crore), Uttarakhand (Rs 1338 Crore), West Bengal (Rs.31115 Crore), Telangana (Rs.7332 Crore) and Himachal Pradesh (Rs.2226 Crore).

The Union Minister gave this reply to a question asked by AAP MP (Rajya Sabha) from Ludhiana Sanjeev Arora.  Arora had asked about the steps taken by the Ministry to make the healthcare affordable and reduce out of pocket expenses; and the details out of pocket expenses for healthcare, State/UT-wise.

Giving this information here today, Arora said he is not completely satisfied with the Minister’s reply as the required data made available is not updated. “The Union Minister should have provided latest and updated data to analyze the things in the present scenario”, he pointed out. He added there might be a lot of changes after 2018-19, he pointed out.  In today’s IT enabled world why data being given is so old, he asked.

Arora said the Union Minister, in his reply, also mentioned that the budget allocation for Department of Health and Family Welfare (DoHFW) has increased by 82% from Rs.47,353 Crores in 2017-18 to Rs. 86,175 crores in 2023-24. DoHFW is making continuous efforts to increase allocation in health budget. Further, the 15th Finance Commission has provided Rs.70,051 Crores Grants for health through the local Governments. According to Arora, this amount of 2023-24 is only 1.98% of GDP against a world average of around 7%.

The Union Minister further informed that the Tele Mental Health Assistance and Networking Across States (Tele-MANAS) was launched on 10th October 2022 with the aim to provide free tele-mental health services all over the country round the clock, particularly to under-served areas and people remotely located. The program includes a network of 23 tele-mental health centers of excellence, with NIMHANS as the nodal center and International Institute of Information Technology-Bangalore (IIITB) providing technology support. Arora appreciated this step of Central Government.

Further, the Union Minister, in his reply, mentioned that besides, quality generic medicines are made available at affordable prices to all under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have been set up in some hospitals/institutions.
 

Out-of-Pocket Expenditures on Healthcare (OOPE) are payments made by an individual at the point of receiving healthcare services or goods. OOPE is usually incurred when an individual’s visit to healthcare provider (clinic/ hospital/ pharmacy/ laboratory etc.) is not provided for ‘free’ through a government health facility or a facility run by a not-for-profit organization or if this individual is not covered under a government/ private health insurance or social protection scheme.