Share of Out-of-Pocket Expenditure (OOPE) declines from 62.6% in 2014-15 to 47.1% in 2019-20

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National Health Accounts Estimate for India

The share of Out-of-Pocket Expenditure (OOPE) in Total Health Expenditure has declined from 62.6% in 2014-15 to 47.1% in 2019-20 as per the National Health Accounts Estimate for India (2019-20) released on Tuesday.

Releasing the National Health Accounts (NHA) Estimates, Dr. Vinod K. Paul, Member (Health) of NITI Aayog, said, “Through National Health Accounts Estimates report we can see that indicators like Out-of-pocket expenditure (OOPE) reduction are going hand in hand with increased public spending in healthcare. Thus, showcasing the right trajectory country is taking towards achieving milestones of Universal Health Coverage”.

Highlighting investments in strengthening primary healthcare, Dr. Paul said, “report highlights the increased public spending in primary healthcare, which is in line with National Health policy 2017 where it states that two-thirds of public health spending must be in Primary Health systems. This is also a result of great developments/initiatives taken at grassroot level such as opening of over 1.6 lakh Ayushman Bharat Health and Wellness Centres (AB-HWCs) which are providing a plethora of health services to the people.”

The continuous decline in the OOPE in the overall health spending shows progress towards ensuring financial protection and Universal Health Coverage for citizens. During this period, the share of Government Health Expenditure (GHE) in the overall GDP of the country has increased from 1.13% in 2014-15 to 1.35% in 2019-20., said the health ministry.

In per capita terms, GHE has doubled from Rs. 1,108 to Rs. 2,014 between 2014-15 to 2019-20, as per the report. The government spending on health between 2018-19 and 2019-20 has increased by 12%, more than double the growth rate between 2017-18 and 2018-19 which was at 5%. In the Total Health Expenditure (THE) of the country between 2014-15 and 2019-20, the share of GHE has increased from 29% to 41.4%. The report also underlines that the share of primary healthcare in Current Government Health Expenditure (CGHE) has increased from 51.3% in 2014-15 to 55.9% in 2019-20.

According to the report, the share of Social Security Expenditure (SSE) on healthcare, which includes government-funded health insurance, medical reimbursement to government employees, and social health insurance programs, in THE, has also increased from 5.7% in 2014-15 to 9.3% in 2019-20. This increase in social security has a direct impact on reducing out-of-pocket payments.

Highlighting the significance of promotive and preventive health, Union Health Secretary Shri Rajesh Bhushan said, “we need to persist with this trend of expenditure on primary healthcare so that promotive and preventive health, which mostly take place at primary level, can be focused upon.” Mr Bhushan also pointed out that social security expenditure, which includes the social health insurance program, government-financed health insurance schemes, and medical reimbursements made to government employees, has drastically increased from 5% to 9.3%.

The National Health Account (NHA) estimates for India 2019-20 is the seventh consecutive NHA estimates report prepared by NHSRC, designated as National Health Accounts Technical Secretariat (NHATS) in 2014 by the Union Health Ministry. The NHA estimates are prepared by using an accounting framework based on the internationally accepted standard of System of Health Accounts, 2011, developed by the World Health Organization (WHO).