What patients shell out from their pockets is close to double of what the Centre and State governments spend on public healthcare in India.

According to the latest National Health Accounts (NHA) estimates released on Wednesday, patients bear a big chunk of health expenses — as high as 61 per cent of the total health expenditure — by themselves.

The total expenses incurred on healthcare stood at ₹5,28, 484 crorein FY16, while household Out Of Pocket Expenditure (OOPE) on health totalled ₹3,20,211 crore (60.6 per cent of the total health spend).

On the other hand, the government’s health expenditure (GHE) stood at ₹1,61,863 crore (30.6 per cent of the total health expenditure).

Patients end up spending out of their pockets on medicines, doctors’ fees, bed charges, diagnostic tests, drugs and products such as vitamin supplements at public and private hospitals and pharmacies despite various public healthcare schemes.

Changing dynamics

Over the years, the share of GHE has increased, from 22.5 per cent in FY05 to 30.6 per cent in FY16, while that of OOPE has decreased from 69.4 per cent in to 60.6 per cent. But the latter still accounts for a massive chunk of health expenses.

While GHE was 1.18 per cent of the total GDP (₹1,37,64,037 crorein FY16), OOPE was 2.33 per cent of the GDP that year, showed NHA estimates. The Centre, through the National Health Policy — 2017, committed to increase health allocation to 2.5 per cent of GDP till 2025. However, in FY19, there was no such increase.

In per capita terms, while the Central and State governments spend ₹1,261 on each citizen over healthcare, the individual OOPE stands at ₹2,494.

NHA estimates also suggest that the penetration of private health insurance has risen from 1.6 per cent in FY05 to 4.2 per cent in FY16. Private health insurance expenditure is pegged at ₹22,013 crore.

Of the total healthcare expenditure, the amount spent to buy medicines at pharmacies (₹1,38,061 crore, or 27.9 per cent), and on expenses at private general hospitals (₹1,28,011 crore, or 25.9 per cent), comprised a major chunk, compared to expenditure for treatment in government general hospitals (₹64,585 crore, or 13 per cent).

State-wise spends

Among States, the share of OOPE against the overall expenditure was the highest in Bihar, at 79.9 per cent, against the national average of 60.6 per cent.

The Central and State governments spent ₹4,756 crore on healthcare in Bihar, where OOPE stood at ₹19,890 crore.

OOPE was the lowest in Gujarat, at 50.4 per cent. However, that still came to ₹10,589 crore, against government spending of ₹7,808 crore.