Despite a steady rise in government spending on healthcare over the past decade, Indians continue to spend a large share of their own money on medical treatment, according to the latest National Health Accounts (NHA) Estimates 2022-23 released by the Union Health Ministry. The report highlights that out-of-pocket expenditure (OOPE) on healthcare, though declining gradually, remains high compared to many developing and neighbouring countries.
The data showed that household spending on healthcare as a share of total health expenditure fell from 64.2 percent in 2013-14 to 43.4 percent in 2022-23. While this marks a significant improvement over the past decade, experts say Indian families still bear a substantial financial burden when seeking treatment, especially through private healthcare services.
The report attributed the reduction in OOPE partly to higher government investment in healthcare infrastructure, public insurance schemes, and welfare programmes. Government Health Expenditure (GHE) increased nearly threefold during the same period, rising from Rs 1.30 lakh crore in 2013-14 to Rs 3.85 lakh crore in 2022-23. The share of government healthcare spending in India’s GDP also increased from 1.15 percent to 1.43 percent.
According to the Health Ministry, the rise in public spending has helped reduce the direct financial burden on households and improve access to healthcare services. Government-funded initiatives such as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), free diagnostic services, subsidised medicines, and Ayushman Arogya Mandirs have contributed to improving healthcare access across the country.
However, experts noted that India’s OOPE levels remain significantly higher than the global average. Many households continue to rely heavily on private hospitals and clinics due to concerns over the quality, accessibility, and infrastructure of public healthcare facilities. Medical expenses related to medicines, diagnostics, and hospitalisation continue to push many families into debt or financial distress.
Healthcare analysts also pointed out that lower OOPE figures do not always indicate stronger healthcare access. In some poorer states, reduced spending may reflect delayed treatment or avoidance of medical care due to financial hardship rather than improved affordability. Studies have shown that many households still postpone treatment, borrow money, or sell assets to manage healthcare costs.
The NHA report further revealed that social security expenditure on healthcare increased from 6 percent to 9.9 percent between 2013-14 and 2022-23. Private health insurance coverage also expanded during this period, indicating greater awareness and uptake of health protection mechanisms among citizens.
Experts stressed that India still needs stronger public healthcare systems, better primary health centres, and higher public investment to reduce dependence on expensive private treatment. The National Health Policy 2017 had proposed raising government health expenditure to 2.5 percent of GDP by 2025, but current levels remain below that target.
Public health researchers also highlighted major regional disparities in healthcare spending. While smaller and northeastern states were found to be spending a larger proportion of their Gross State Domestic Product on healthcare, several economically stronger states lagged behind in proportional health investment.
The report reflects both progress and continuing challenges in India’s healthcare financing system. Although increased public spending and welfare schemes have reduced the financial burden on households over the years, healthcare affordability remains a serious concern for millions of Indian families, particularly those without insurance coverage or access to quality public health services.
