Healthcare has become more affordable and accessible: Eco Survey

Healthcare has become more affordable and accessible for people, notes the Economic Survey 2023-24, as the share of government health expenditure (GHE) has increased in the total GDP as well as in the total health expenditure (THE).

The latest National Health Accounts (NHA) for FY20 show an increase in the share of GHE in the total GDP as well as the share of GHE in THE. The share of primary healthcare expenditure has increased from 51.3 per cent of GHE in FY15 to 55.9 per cent of GHE in FY20.

On the other hand, the share of primary and secondary care in private health expenditure has declined from 83.0 per cent to 73.7 per cent during the same period, attributable to the rising tertiary disease burden and utilisation of government facilities for primary healthcare, the Economic Survey noted.

 

As such, out-of-pocket expenditure (OOPE) as a percentage of THE has come down from 64.2 per cent in FY14 to 47.1 per cent in FY20.

The government’s flagship health insurance scheme Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY) that offers health insurance cover of Rs 5 lakh per year for underprivileged families for secondary and tertiary hospitalisation has saved more than Rs 1.25 lakh crore OOPE for poor and deprived families (as of January 12, 2024). More than 347.3 million Ayushman Bharat cards have been generated and 49 per cent of beneficiaries are female (as of July 8, 2024). The scheme has covered 73.7 million hospital admissions.

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Apart from the flagship health insurance scheme PMJAY, the proliferation of Pradhan Mantri Bhartiya Janaushadhi Kendras (PMBJK) which sell generic medicines at 50-90 per cent cheaper than the market rates has also had a role to play – more than 12,500 PMBJKs have been opened covering all districts. These outlets sell 1,965 varieties of medicines and 293 surgical equipment.

In FY24, the Pharmaceuticals & Medical Devices Bureau of India sold Jan Aushadhi medicines worth Rs 1,470 crore, leading to savings of approximately Rs 7,350 crore. On average, 1-1.2 million people visit Jan Aushadhi Kendras daily.

More than 300 AMRIT (Affordable Medicines and Reliable Implants for Treatment) pharmacies have been opened which sell subsidised medicines for critical illnesses. Under the Ayushman Bhav Campaign (September 2023), 18.9 million tele-consultations, free drugs availed by 116.4 million people, and free diagnostic services by 92.8 million people were recorded. More than 20 million patients consulted general OPD, while 906.9 million patients consulted specialist OPD, and 65,094 major surgeries and 196,156 minor surgeries were conducted.

NPA rate declines in PMJAY-implemented districts

A recent study that investigates the influence of PMJAY on credit market dynamics in India has found that the non-performing assets (NPA) rate in PMJAY-implemented districts decreased by 3.7 to 4 percentage points compared to non-implemented regions. This represents a 34.6 per cent to 34.1 per cent reduction relative to the average NPA rates, an economically significant impact. A similar reduction in NPA rates was observed in eligible small agricultural loans, underscoring PMJAY’s broad economic impact. The study sample includes data on nearly 12 million loans across 636 districts in India. It underscores the impact of public health insurance programmes on enhancing economic stability, indicating mitigating healthcare costs is anticipated to improve financial stability and loan repayment capacity.