Lok Sabha Question No. 2653 (UNSTARRED), answered on 2023-08-04
Subject: Out of Pocket Expenditure
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sanjeev Kumar Singari

## GOVERNMENT OFINDIA

## MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2653 TO BE ANSWERED ON 04 TH AUGUST, 2023

## OUTOFPOCKETEXPENDITURE

## 2653. DR. SANJEEV KUMAR SINGARI:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) whether the Government is aware that India has one of the highest percentage of out-ofpocket (OOPE) spending at 48.8 per cent as per NHA reports in 2017-2018;
- (b) if so, the reasons therefor and the steps taken to reduce the said expenditure;
- (c) whether the Ayushman Bharat healthcare scheme has led to any reduction of out-ofpocket (OOPE) expenses for its beneficiaries;
- (d) if so, details thereof and if not, the reasons therefor;
- (e) whether the Government plans to include the coverage of outpatient treatment and diagnostic procedures in the scheme as outpatient treatment alone amounts for almost twothirds of OOPE expenses; and
- (f) if so, details thereof and if not, the reasons therefor?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(PROF. S. P. SINGH BAGHEL)

(a) to (f) : As per latest National Health Account (NHA) estimates 2019-20, India ranks 67th in the list of 189 countries in OOPE per capita in purchasing power parity (int $) for 2018.

As per National Health Account (NHA) estimates 2019-20, there is decling trend in Out of Pocket Expenditure (OOPE) as percentage of Total Health Expenditure (THE). During 201314 to 2019-20, OOPE as a percentage of THE has declined from 64.2% to 47.1%. During the same period, Government Health Expenditure (GHE) as a percentage of THE has increased from 28.6% to 41.4%.

National Health Policy (NHP), 2017 envisages raising government health expenditure to 2.5% of GDP in a time bound manner. Further, NHP 2017, also envisages that States should increase their health spending to atleast 8% of their budget and two thirds of such expenditure should be on primary care. The budget allocation for Department of Health & Family Welfare (DoHFW) has increased by 82% from Rs. 47,353 crore in 2017-18 (BE) to Rs. 86,175 crore in 2023-24 (BE). Government is making continuous efforts to increase allocation in health budget.

The Government has launched four mission mode projects, namely PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), Ayushman Bharat Health & Wellness Centres

(ABHWCs), Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Ayushman Bharat Digital Mission (ABDM). Other notable initiatives are National Health Mission (NHM), setting up of new AIIMS, upgrading of Government medical colleges under the Pradhan Mantri Swasthya Suraksha Yojna (PMSSY), support to States/UTs for setting up of new medical colleges as well as for increasing UG and PG medical seats, provision of free drugs and free diagnostic facilities at Primary Health Centres (PHC)/ Community Health Centres (CHC) and district hospital level, substantial increase in availability of government ambulances etc.

Under NHM, many important steps have been taken towards universal health coverage by supporting the State Government in providing accessible & affordable healthcare to people. Financial and technical support are provided to States/UTs to provide accessible, affordable and quality healthcare, especially to the poor and vulnerable sections of the population, in both urban and rural areas. The NHM provides support for improvement in health infrastructure, availability of adequate human resources etc to improve availability and accessibility to quality health care especially for the underserved and marginalized groups in rural areas. Major initiatives for which States are supported include Janani Shishu Suraksha Karyakram (JSSK), Rashtriya Bal Swasthya Karyakram (RBSK), Rashtriya Kishor Swasthya Karyakram (RKSK), PM National Dialysis Programme and implementation of National Quality Assurance Framework.

PM-ABHIM has been launched as a mission to develop the capacities of primary, secondary and tertiary health care systems, strengthen existing national institutions and create new institutions to cater to detection and cure of new and emerging diseases. PM-ABHIM has an outlay of Rs 64,180 crore.

Under Ayushman Bharat Health & Wellness Centres (HWCs), Comprehensive Primary Healthcare by strengthening Sub Health Centres (SHCs) and Primary Health Centres (PHCs) are facilitated. The HWCs provide Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative and rehabilitative services which are universal, free, and closer to the community.

Ayushman Bharat Pradhan Mantri - Jan Arogya Yojana (AB PM-JAY) is the largest publicly funded health assurance scheme in the world which aims to provide health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to 12 crore families. Further, many States/UTs implementing AB PM-JAY have expanded the beneficiary base under the scheme to approximately 15.5 crore families, at their own cost.

Ayushman Bharat Digital Mission (ABDM) has been launched with aim to develop the backbone necessary to support the integrated digital health infrastructure of the country.

The 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.