Lok Sabha Question No. 3300 (UNSTARRED), answered on 2017-08-04
Subject: Out of Pocket Payment
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KIRIT PREMJIBHAI SOLANKI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3300 TO BE ANSWERED ON 4 TH AUGUST , 2017

## OUT OF POCKET PAYMEN T

## 3300. DR. KIRIT P. SOLANKI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the bulk of the public money spent out of health accounts goes to wages and s of human resource instead of providing medical services as revealed by a study and if details thereof and the reasons therefor;
- (b) the steps taken by the Government to address this issue;
- (c) whether the per capita total cost of care is mostly cheaper in the public sector than in the private sector and if so, the details thereof and the reasons theref or;
- (d) the measures undertaken by the Government to resolve the above anomaly;
- (e)  whether  the  bulk  of  the  total  money  circulating  in  Indian  healthcare  comes  from Pocket Payment and if so, the details and the reasons therefor; and
- (f) the action taken by the Government to reduce the OOP expenditure of citizens?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA PATEL )

- (a)& (b):  Data  on  wages  and  salaries  towards  human  resources  or  any  factors  of  provid healthcare, is not published in the National Health Accounts (NHA) Estimation  for India -14 and other reports based on the NHA estimates 2013 - 14. However, a study of State Health Accounts conducted by Public Health Foundation of India (PHFI) indicates the  proportion  of  public  money  spent  on  wages  and  salaries  of  human  resources  in  Ker (65%), Madhya Pradesh (52%) an d Maharashtra (72%) in Financial Year 2013 - 14.  The detailed methodology, authenticity and   veracity  of the study is not known by the Ministry.
- (c ) & (d): As per the Publication titled 'Health in India NSS 71 st Round' (January - June 2014) brought out by the National Sample Survey Organisation (NSSO), t he rural population spent, on an average, Rs.5636 for a hospitalised treatment in a public sector hospital and Rs.21 that in a private sector hospital. In Urban area it was Rs. 32375 in private ho spital and Rs.7670 in public hospital.

Contd……..

The health care in India comprises of a mix of both public and private sector. Whi private sector is generally guided by the profit motive, the underlying sentiment of t health system i n India is to provide accessible, affordable and accountable health care se especially to the poor and vulnerable sections of the population.

(e): As per National Health Accounts Estimates for India 2013 - 14, out of pocket spending as percentage of total health expenditure is estimated at 64.21%.

(f): Public health and hospitals being a State subject, the primary responsibility of pro accessible,  affordable  and  quality  healthcare  lies  with  respective  State  Governments. National H ealth Mission to reduce out of pocket expenditure on healthcare, support is be provided to States/UTs for strengthening of their healthcare system based on the require posed by them in their Programme Implementation Plans.

I n  order  to  reduce the  out  of  pocket    expenditure  of the  people  of  the  country, especially the poor, the Government of India has taken several steps which inter - alia includes:

- Implementation  of  National  Health  Mission  Free  Drugs  and  Free  Diagnostic  initiativ provide e ssential drugs and diagnostics free of cost in public health facilities.
- Implementation  of  Janani  Shishu  Suraksha  Karyakaram  (JSSK),  Rashtriya  Bal  Swasthya Karyakaram (RBSK), Rashtriya Kishor Swasthya Karyakaram (RKSK) and implementation of  other  National programmes  like    Revised  National  Tuberculosis  Control  Programme (RNTCP),  National  Vector  Borne  Disease  Control  Programme  (NVBDCP),  National Leprosy Eradication Programme(NLEP), National AIDS Control Programme ( NACP ) etc. where free treatment is provided to patients of Tuberculosis(TB) , HIV/AIDS, Vector Borne, Leprosy diseases etc.
- Decision to transform Sub - Health Centres/PHCs to Health and Wellness Centres to provide comprehensive primary care, to undertake promotive and health promotion activities.
- Screening and Management of 5 common NCDs of hypertension, diabetes, and cancers of oral, cervix and breast.
- Pradhan Mantri National Dialysis Programme for free dialysis services to the poor in hospitals.
- Making ` available tertiar y health   care services in the public sector through strengthenin of hospitals, establishment of AIIMS institutions in the States and up -gradation of existing Government medical colleges across the country.
- Making  available  quality  gene ric  medicines  at  affordable  prices  to  all,  under  'Jan Aushadhi Scheme', in collaboration with the State Governments.

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