The Ministry of Health and Family Welfare has released the National Health Accounts Report for 2017-18.
Findings:
As a share of total health expenditure, OOPE has come down to 48.8% in 2017-18 from 64.2% in 2013-14.
Even in case of per capita OOPE, there has been decline from ₹2,336 to ₹2,097 between 2013-14 to 2017-18.
Government expenditure on health has increased from 1.15% in 2013-14 to 1.35% in 2017-18.
Additionally, the share of Government Health Expenditure in total health expenditure has also increased over time. In 2017-18, the share of Government expenditure was 40.8%, which is much higher than 28.6% in 2013-14,”.
in per capita terms, the Government health expenditure has increased from ₹1,042 to ₹1,753 between 2013-14 to 2017-18.
Also the share of social security expenditure on health, which includes the social health insurance programme, Government financed health insurance schemes, and medical reimbursements made to Government employees, has increased.
Concern:
Increase in defense expenditure:
Much of this increase has actually happened on account of a tripling of expenditure of the Defence Medical Services (DMS).
Though the increased spending for the health of defence personnel is a good thing, such spending does not benefit the general population.
The problem in accounting capital expenditure:
If we take out the capital expenditure, current health expenditure comes down to only 0.97% of GDP. This is only a marginal increase.
The context of decline in out-of-pocket expenditure:
The decline in out-of-pocket expenditure is essentially due to a decline in utilisation of care rather than greater financial protection or increased public spending.
As purchasing power declined, after demonetisation, healthcare would have become more unaffordable, forcing people to forgo care.
The reduction of out-of-pocket expenditure could be a sign of distress and a result of methodological limitations, rather than a sign of increased financial protection.
Conclusion:
The NHA report for 2017-18, will help us prepare for health-system enhancement in the post-Covid years.
