India’s health spending triples to ₹4.14 lakh crore, but out-of-pocket share drops to 42.7%: NHA

The estimates also showed the share of out-of-pocket spending by households dropped by 21.5 percentage points over the same period, highlighting a significant transformation in the country’s healthcare financing. File

The Union government’s health expenditure more than tripled to ₹4.14 lakh crore in 2023-24, from ₹1.30 lakh crore in 2013-14, according to the latest National Health Accounts (NHA) estimates released by the Health Ministry.

The estimates also showed the share of out-of-pocket spending by households dropped by 21.5 percentage points over the same period, highlighting a significant transformation in the country’s healthcare financing.

As a share of total health expenditure, out-of-pocket spending fell from 64.2% in 2013-14 to 42.7% in 2023-24.

“The simultaneous increase in public healthcare financing and decline in the proportion of spending borne directly by households reflect India’s progress towards a more accessible, affordable, and financially protective healthcare system,” the Ministry said in a statement. It said out-of-pocket expenditure declined from 43.4% in 2022-23 to 42.7% in 2023-24.

“The sustained downward trend reflects the expanding role of government-supported healthcare services and financial protection mechanisms. Initiatives aimed at improving access to free and affordable treatment, medicines, diagnostics and hospital services are supporting efforts to reduce dependence on direct household spending,” it said.

The government’s share in total health expenditure increased by 14.9 percentage points over the decade, the estimates showed, while per capita government health expenditure rose from ₹1,042 in 2013-14 to ₹2,959 in 2023-24, an increase of nearly three times. Social security expenditure on health rose from 6% of total health expenditure in 2013-14 to 11% in 2023-24.

This includes government-financed health insurance schemes such as Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, State insurance schemes, social health insurance, and medical expenditure for government employees. Private health insurance expenditure grew even faster, with its share rising from 3.4% to 10.2% over the decade.

The government’s expenditure on primary healthcare stood at about ₹1.53 lakh crore in 2023-24, underscoring the increased focus on primary and community-level healthcare, the Ministry said.

Initiatives such as Ayushman Arogya Mandirs, free drugs and diagnostics, the Pradhan Mantri National Dialysis Programme, the Pradhan Mantri Bhartiya Janaushadhi Pariyojana and AMRIT pharmacies had contributed to efforts to improve access to affordable healthcare, it said.

The Ayushman Bharat-PMJAY had also strengthened financial protection by providing cashless hospitalisation benefits to eligible beneficiaries, it added.

The NHA Estimates for India 2023-24 are the 11th round of estimates prepared by the NHA3 Technical Secretariat, which operates within the National Health Systems Resource Centre of the Union Ministry of Health and Family Welfare. They are prepared using the internationally recognised System of Health Accounts 2011 framework.