Lok Sabha Question No. 2245 (UNSTARRED), answered on 2016-05-06
Subject: Spending on Health Treatment
Ministry: HEALTH AND FAMILY WELFARE
Asked by: LALLU SINGH, CHANDRAKANT BHAURAO KHAIRE, RAM TAHAL CHOUDHARY, R. VANAROJA

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

## LOK SABHA UNSTARRED QUESTION NO. 2245 TO BE ANSWERED ON 6 TH MAY, 2016

## SPENDING ON HEALTH T REATMENT

## 2245. SHRI LALLU SINGH:

## SHRI CHANDRAKANT KHAIRE: SHRI RAM TAHAL CHOUDHARY: SHRIMATI VANAROJA R.

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

(a) whether the Government is aware that a large section of the population in the c untry spends about  60  per  cent  of  their annual  income  i n  out  patient  healthcare treatment  due  to  skewed primary care system, if so, the details thereof; and

(b) whether Government has taken note that better OPD covers can prevent 44% hospitalisation, if so, the details thereof; and

- (c) whether the Government spends less than one and a half per cent of Gross Domestic Product (GDP) on health care which is far below comparable to international standards, if so, the details thereof and the reasons therefor; and
- (d) the corrective steps taken by the Government inthis regard including increasing the health spending to five per cent of the GDP?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

- (a): The Federation of Indian Chambers of Commerce & Industry (FICCI) in their report titled  'A Guiding Framework for OPD & Preventive Health Insurance in India' have stated that  'about  66%  of  healthcare  spend  is  on  OPD  treatment'.  It  has  further  been  stated  that 'Primary healthcare in India is still largely unorganised and private sector healthcare supply is disproportionately skewed to urban over rural segments'.
- (b): Hospitalisation of a patient is correlated to the seriousness of the ailment. As publication titled 'Health in India - NSS 71 st Round (January - June 2014) brought out  by t he National Sample Survey Office(NSSO), Ministry of Statistics and Programme Implementation, 21- 29%  of  treatment  are  accounted  for  by  the  private  hospitals  and  about  40 - 41%    of hospitalised cases belong to the broad ailment categories of infections, eye, e ar and gastric intestinal.

Whether  OPD  covers,  can  prevent  hospitalisation  is  dependent,  inter  alia,  on seriousness of the ailments, OPD coverage benefits offered, sum insured, and the proced covered.

(c): As per Economic Survey 2015 - 16, th e expenditure by Government (Central and State Governments combined) on health as percentage of Gross Domestic Product (GDP) for 2015 -16 (BE), is 1.3 per cent. International Standards have not been prescribed by World Health Organisation (WHO). The WHO has never formally adopted/recommended a target size for the health sector as a share of GDP.

(d): Public Health is a State subject. The flagship Programme of National Health Missi (NHM) is aimed to support the States mainly to strengthen their primary healthcare netw Support  is  provided  to  State/UTs  for  setting  up  new  facilities  or  renovation  of existing facilities,  health  human  resource  on  contractual  basis,  drugs,  equipment,  diagnos Ambulances, Mobile Medical Units etc based on the requirement posed by the States/UTs i their  Programme  Implementation  Plans  (PIPs).  The  Government  has  already taken  steps towards provision of free services for maternal health, child health, adolescent health, planning, universal immunization programme, and for major diseases such as TB, vector bor diseases such as Malaria, Dengue and Kala Azar, leprosy etc. Other major initiatives for which states are being supported include Janani Shishu Suraksha Karyakram (JSSK), Rashtriya B Swasthya Karyakram (RBSK), Rashtriya Kishor Swasthya Karyakram (RKSK), implementation of National Health Mission Free Drugs Se rvice Initiative and National Health Mission Free Diagnostics Service Initiative, Strengthening District Hospitals implementation of National Quality Assurance Framework. Support  is  also  being  made  available  to  States  for  making  primary  care  comprehen sive. Additionally, the enhanced tax devolution to States, of 42 per cent of Union's net tax r as per the recommendations of XIVth Finance Commission , will allow States greater autonomy in financing and designing of schemes as per their needs.

As  per  the  12 th Five  Year  Plan  document,  total  publicly  funded  by  the  Centre  and States, plan and non - plan, on core health is envisaged to increase to 1.87 per cent of G DP by the end of the Twelfth Plan. The Draft National Health Policy 2015 envisages raising public health expenditure to 2.5% of the GDP in a phased manner.