Lok Sabha Question No. 382 (UNSTARRED), answered on 2023-07-21
Subject: Out of Pocket Expenditure
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Pocha Brahmananda Reddy, M. K. Raghavan

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH & FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION No. 382 TO BE ANSWERED ON 21 ST July, 2023

## OUT OF POCKET EXPENDITURE

## 382: SHRI POCHA BRAHMANANDAREDDY: SHRI M.K. RAGHAVAN:

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

- (a) the details of the health expenditure as a percentage of GDP during each of the last three years;
- (b) whether Out-of-Pocket Expenditure (OOPE) on health in the country is one of the highest across the world and if so, the details thereof along with the necessary steps taken by the Government to bring down OOPE on health in the country;
- (c) whether the Government proposes to increase the spending on health in order to meet its targets and if so, the details thereof and if not, the reasons therefor;
- (d) whether irregularity in the treatment costs across hospitals is causing a meteoric rise in OOPE in the country and if so, the details thereof; and
- (e) The present status of AIIMS, Kozhikode along with total amount of funds provided for health infrastructure development of Kerala?

## ANSWER THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (PROF. SATYA PAL SINGH BAGHEL)

(a) to ( d) : As per the National Health Accounts (NHA) Estimates for India, the Total Health Expenditure (THE) as percentage of GDP and Out-of-Pocket Expenditure (OOPE) on health as percentage of THE for the years 2017-18 - 2019-20 are as under:

| Indicator                                 |   2017-18 |   2018-19 |   2019-20 |
|-------------------------------------------|-----------|-----------|-----------|
| Total Health Expenditure as percentage of |       3.3 |       3.2 |       3.3 |
| OOPE as %age of THE                       |      48.8 |      48.2 |      47.1 |

There is declining trend in the OOPE in the country.

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), Pradhan Mantri Jan Arogya Yojana (PMJAY) and Ayushman Bharat Digital Mission (ABDM). Other notable initiatives are National Health Mission (NHM), setting up of new AIIMS and upgrading of Government medical colleges under the Pradhan Mantri Swasthya Suraksha Yojna (PMSSY), support to State/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. The Fifteenth Finance Commission has also recommended health grants aggregating to Rs. 70,051 crore to local government for addressing the gaps in primary health infrastructure in rural and urban areas.

The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted by the Central Government to provide for the registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them.

( e) : Setting up of AIIMS in Kerala has not been sanctioned, however, Government of India has taken upgradation of the following Government Medical Colleges in the State of Kerala in Phase-I, III and V of PMSSY, details of which is as follows:

|     |                                                                           |       | Approved Project Cost (Rs. in Crore)   | Approved Project Cost (Rs. in Crore)   | Approved Project Cost (Rs. in Crore)   | Central Share Released (Rs. in   |
|-----|---------------------------------------------------------------------------|-------|----------------------------------------|----------------------------------------|----------------------------------------|----------------------------------|
| Sl. | Name of Govt. Medical College                                             | Phase | Central Share                          | State / Administrative Ministry Share  | Total                                  | Crore)                           |
| 1   | Thiruvananthapuram Medical College                                        | I     | 100                                    | 20                                     | 120                                    | 96.26                            |
| 2   | Government Medical College, Kozhikode                                     | III   | 120                                    | 30                                     | 150                                    | 90.90                            |
| 3   | TD Medical College, Alappuzha                                             | III   | 120                                    | 30                                     | 150                                    | 99.53                            |
| 4   | Sree Chitra Tirunal Institute of Medical Sciences &Technology, Trivandrum | V(A)  | 120                                    | 110 (Administrative Ministry Share)    | 230                                    | 180.94                           |