Lok Sabha Question No. 186 (STARRED), answered on 2016-05-06
Subject: Healthcare
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PANKAJ CHOWDHARY, UDAY PRATAP SINGH

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

## LOK SABHA STARRED QUESTION NO. 186 TO BE ANSWERED ON THE 06 TH MAY, 2016 HEALTHCARE

## †*186. SHRI PANKAJ CHAUDHARY: SHRI UDAY PRATAP SINGH:

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

- (a) whether the Government is aware that households with low and average inc are unable to avail expensive treatment in private hospitals, if so, the det along with the he alth insurance penetration amongst them;
- (b) whether any low cost insurance cover scheme is proposed for the benefit o and Below Poverty Line (BPL) families, if so, the details thereof;
- (c)  whether  the  Government  has  formulated/proposes  to  formul ate  any  policy  to provide accessible, affordable and quality health services in urban and rura such vulnerable group, if so, the details thereof;
- (d) the steps taken by the Government in this regard along with the funds a and utilised b y States/UTs during each of the last three financial years; and
- (e) whether the Government has sought/proposes to seek assistance from the W Health  Organisation,  World  Bank  and  other  International  Agencies  to  impr healthcare in rural and non - metro cities, if so, the details thereof and the outc thereon?

## ANSWER

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

- (a) to ( e):  A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 186 * FOR 06 TH MAY, 2016

(a)The  Government  is  aware  that  poor  people  are  unable  to  afford  expens treatment in private hospitals. The Out of Pocket Expenditure on health high and has been estimated at  62% for 2014. Some of the key find ings of 71st Round  survey  on  Social  Consumption  on  Health  of  National  Sample  Survey Organization (NSSO) is at Annexure -I.

As  per  NSSO,  11%  persons  in  lowest  two  quintiles  in  rural  areas  and  10 persons in lowest two quintiles in urban areas are covered under som  insurance schemes.  As  per  information  provided  by  the  Insurance  Regulatory  a Development  Authority  of  India  (IRDAI),  the  number  of  lives  covered  und health  insurance  policies  during  financial  2014 - 15  was  28.80  crore  including government spo nsored schemes like RSBY.

(b)The  Central  Government  plans  to  start a  new  health  protection  scheme as announced in the Budget 2016 - 17 which will provide a cover upto Rs. 1 lakh with  additional  top  up  of  Rs.  30,000 per senior  citizen  in  those  families. The proposed scheme envisages coverage of poor and vulnerable families on fam floater  basis  with  no  capping  on  family  size.  Detailed  modalities  are worked out.

(c)The Government has formulated a draft National Health Policy, 2015 ,which envisages a ttainment of the highest possible level of good health and well with priority to the needs of the most vulnerable, the marginalized or excluded and the poor.  Under the National Health Mission (NHM) ,the Central Government  supplements  the  eff orts  of  the  State/UT  governments to  provide quality,  accessible, equitableand affordable  healthcare  to  all  its  citizen particularly the poor and vulnerable population in both rural and urban areas.

(d)The funds released and utilized by States/UTs under NHM during FY 2013 - 14 to  2015 - 16  is  at  Annexure - II.  Further,  details  of  funds  released  to  St Governments under RSBY for FY 2013 - 14 to 2015 - 16 is at Annexure - II I .

(e) Currently, there is no such proposal by the Ministry of Health and F Welfare.

## Annexure - I

(i) 2.3% of ailing persons in rural and 2% in urban areas did not seek me advice due to financial constraint.

(ii) In  rural  areas,  71.1%  of  household  in  top  quintile  as  against  44. households in the lowest two quintiles are using private hospi tals for hospitalized care.  In urban areas, 81.3% of household in top quintile as against 54. households in the lowest two quintiles are using private hospitals for hos care. The average treatment cost for the lowest two quintiles in rural and urban areas is Rs. 10711 and Rs.12866 respectively. The average medical expendi in the top quintile is Rs. 21293 in rural areas and Rs. 42675 in urban area

(iii) The average medical expenditure on hospitalization is Rs 25850 in pri facilities as compared to Rs 6120 in public facilities. The average total expenditure per  childbirth shows  that  expenditure  in  public  facilities  was  ju Rs 1587 as against Rs 14778 in private facilities in rural areas and Rs 2117 in public facilit ies as against Rs 20328 in private facilities in urban areas.

## Annexure - II

## Statement Showing State - wise Release and Expenditure under NHM for the period from F.Y.2013 - 14 to 2015- 16

Rs. in crore

| Sl. No.   | States                    | 2013- 14        | 2013- 14   | 2014- 15        | 2014- 15       | 2015- 16        | 2015- 16   |
|-----------|---------------------------|-----------------|------------|-----------------|----------------|-----------------|------------|
| Sl. No.   | States                    | Central Release | Exp        | Central Release | Exp            | Central Release | Exp        |
| 1         | Andaman & Nicobar Islands | 29.06           | 29.12      | 23.36           | 24.33          | 37.26           | 7.46       |
| 2         | Andhra Pradesh            | 878.73          | 1044.81    | 519.73          | 902.91         | 642.89          | 538.39     |
| 3         | Arunachal Pradesh         | 78.60           | 92.03      | 139.41          | 69.50          | 160.94          | 110.70     |
| 4         | Assam                     | 1077.81         | 956.89     | 877.13          | 915.88         | 959.46          | 857.52     |
| 5         | Bihar                     | 1110.32         | 1480.68    | 1148.32         | 1427.40        | 1139.28         | 812.81     |
| 6         | Chandigarh                | 11.46           | 14.42      | 12.15           | 15.26          | 23.53           | 13.84      |
| 7         | Chattisgarh               | 355.98          | 805.50     | 500.41          | 716.04         | 410.80          | 440.70     |
| 8         | Dadra & Nagar Haveli      | 9.23            | 9.83       | 8.40            | 8.56           | 13.80           | 8.37       |
| 9         | Daman & Diu               | 6.50            | 8.40       | 6.91            | 7.67           | 10.53           | 8.31       |
| 10        | Delhi                     | 129.78          | 132.59     | 154.04          | 222.64         | 164.61          | 82.29      |
| 11        | Goa                       | 19.35           | 30.58      | 26.03           | 29.50          | 16.77           | 21.29      |
| 12        | Gujarat                   | 833.72          | 977.48     | 832.86          | 873.66         | 693.78          | 713.18     |
| 13        | Haryana                   | 315.94          | 423.79     | 273.60          | 438.18         | 291.96          | 310.90     |
| 14        | HimachalPradesh           | 205.29          | 158.60     | 185.84          | 306.92         | 246.49          | 171.15     |
| 15        | Jammu & Kashmir           | 395.10          | 391.10     | 335.51          | 393.29         | 367.89          | 230.12     |
| 16        | Jharkhand                 | 396.38          | 521.49     | 359.62          | 372.01         | 395.15          | 379.60     |
| 17        | Karnataka                 | 611.11          | 812.56     | 697.24          | 858.18         | 740.35          | 740.74     |
| 18        | Kerala                    | 360.98          | 673.07     | 521.99          | 509.83         | 304.14          | 406.92     |
| 19        | Lakshadweep               | 3.20            | 2.28       | 5.08            | 1.36           | 5.69            | 1.79       |
| 20        | Madhya Pradesh            | 865.94          | 1583.60    | 1162.50         | 1738.02        | 1132.22         | 1285.82    |
| 21        | Maharashtra               | 1218.51         | 1806.86    | 1431.76         | 1834.40        | 1085.92         | 1088.92    |
| 22        | Manipur                   | 88.93           | 74.57      | 128.81          | 86.91          | 112.11          | 66.13      |
| 23        | Meghalaya                 | 125.51          | 71.53      | 104.13          | 70.72          | 99.93           | 66.29      |
| 24        | Mizoram                   | 77.43           | 91.89      | 103.28          | 93.29          | 83.81           | 69.47      |
| 25        | Nagaland                  | 99.73           | 90.40      | 114.92          | 63.04          | 104.00          | 48.87      |
| 26        | Orissa                    | 604.20          | 901.65     | 667.16          | 944.10         | 644.52          | 715.86     |
| 27        | Puducherry                | 18.10           | 25.43      | 22.56           | 23.35          | 20.20           | 17.36      |
| 28        | Punjab                    | 333.47          | 437.57     | 379.35          | 460.59         | 294.70          | 434.85     |
| 29        | Rajasthan                 | 922.93          | 1457.06    | 1115.96         | 1722.69        | 1284.66         | 1242.42    |
| 30        | Sikkim                    | 45.91           | 44.82      | 51.60           | 41.36          | 36.70           | 33.89      |
| 31        | Tamil Nadu                | 906.24          | 1430.28    | 952.75          | 2248.06        | 1093.22         | 1003.43    |
| 32        | Tripura                   | 140.15          | 101.93     | 123.11          |                | 132.58          | 77.80      |
| 33        | Uttar Pradesh             | 3024.60         | 2924.38    | 2431.06         | 130.15 3671.26 | 2862.23         | 2279.56    |

| 34    | Uttarakhand   |   245.25 |   255.28 |   270.55 |   324.42 |   275.88 |   213.79 |
|-------|---------------|----------|----------|----------|----------|----------|----------|
| 35    | West Bengal   |   948.51 |  1271.71 |  1058.62 |  1196.78 |   957.92 |   955.4  |
| 36    | Telangana     |     0    |     0    |   378.72 |   334.68 |   436.24 |   229.32 |
| Total | Total         | 16493.9  | 21134.2  | 17124.5  | 23076.9  | 17282.2  | 15685.3  |

## Note:

1. The above fi gure excludes kind grants under Immunisation.
2. Expenditure includes expenditure against central Release, state release & unspent balances at the beginni of the year. Expenditure for the F.Y. 2015 - 16 (up to 31.12.2015 as per FMR) is provisional.
3. Release for the F.Y. 2015 - 16 is updated upto 31.03.2016 and is provisional.
4. The above Releases relate to Central Govt. Grants & do not include state share contribution.

## Funds released by the Central Government as central share on Premium to State Governments under RSBY

| S No.       | Name of State    |   2013- 14 | 2014- 15   | 2015- 16   |
|-------------|------------------|------------|------------|------------|
| 1           | Assam            |      35.68 | 1.06       | 23.24      |
| 2           | Bihar            |     152.71 | 34.07      | -          |
| 3           | Chhattisgarh     |      48.34 | 58.81      | 88.77      |
| 4           | Gujarat          |      60.59 | 18.47      | 74.24      |
| 5           | Haryana          |      13.01 | 5.38       | 4.67       |
| 6           | Himachal Pradesh |       9.03 | 3.75       | 13.90      |
| 7           | Jammu & Kashmir  |       0.53 | -          | -          |
| 8           | Jharkhand        |      51.25 | 5.51       | -          |
| 9           | Karnataka        |      31.59 | -          | 94.99      |
| 10          | Kerala           |     115.49 | 110.43     | 112.37     |
| 11          | Madhya Pradesh   |       2.82 | 8.21       | 1.00       |
| 12          | Maharashtra      |      13.88 | -          | -          |
| 13          | Manipur          |       2.52 | 1.73       | 1.17       |
| 14          | Meghalaya        |       1.79 | 1.25       | 4.10       |
| 15          | Mizoram          |       4.31 | 10.35      | 9.43       |
| 16          | Nagaland         |       2.07 | 4.66       | -          |
| 17          | Odisha           |      70.51 | 93.64      | 59.55      |
| 18          | Puducherry       |       0    | -          | 0.17       |
| 19          | Punjab           |       5.58 | 2.59       | 2.80       |
| 20          | Rajasthan        |      10.72 | 32.10      | 53.57      |
| 21          | Tripura          |      18.7  | 14.29      | 15.64      |
| 22          | Uttar Pradesh    |      72.56 | 36.47      | 11.91      |
| 23          | Uttarakhand      |       1.78 | -          | 10.20      |
| 24          | West Bengal      |     160.45 | 101.65     | 93.38      |
| Grand Total | Grand Total      |     885.91 | 544.42     | 675.10     |