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Rewa: The parliamentary standing committee report on affordability and accessibility of healthcare has said that Indian households continue to remain vulnerable to catastrophic health expenditure and impoverishment due to medical expenses. The report was released on August 11, four days after being tabled in the Parliament.

The government has constantly projected that the out-of-pocket expenditure (OOPE) has declined. The OOPE is the money that a person spends from their pocket to avail themselves of healthcare. The committee acknowledges this fact and adds that the current government’s health expenditure is merely 1.43% of GDP. “[This] severely hinders the mitigation of catastrophic health expenditures and medical impoverishment,” the committee states.

The National Health Policy, 2017, which was framed by the Narendra Modi-led government nine years ago had envisaged increasing the expenditure to 2.5% of GDP by 2025. 

Lok Sabha MP Ram Gopal Yadav is the chairman of the 31-member committee. It comprises members of Lok Sabha and Rajya Sabha.

A very important observation that the committee has made is that the government’s expenditure on health was 1.84% of GDP in 2021-22. This spending was actually driven by “one-off COVID relief and vaccination spending.” 

This figure wrongly created an impression that the government had increased the health expenditure compared with the years prior to the pandemic. It also gave the impression that the government was slowly moving to achieve the target of spending 2.5% of GDP on health by 2025. 

The subsequent revisions in health allocation declined to 1.43% of the GDP – a proportion which was the same as the pre-pandemic years. In other words, there has been no actual increase in the government’s health spending for the last six years, at least. 

Incidentally, the Union government has repeatedly claimed that it has increased allocation to the health sector. 

An important caveat to point out here is that the “1.43% of the GDP” figure combines expenditures of both the state and Union governments. The latter’s actual and sole expenditure has been only around 0.28% to 0.33% of the GDP on health in the last five years, per the report.

A NITI Aayog report published in 2021 said 7% of India’s population – about 10 crore people – are pushed into poverty every year due to the exorbitant amount of money they spend on seeking healthcare. However, some of them come out of this poverty eventually.

What is more worrisome, as this report reveals, is that people distress sell assets or land or land in catastrophic debt to afford healthcare. 

A large proportion of this trend is driven by the fact that private hospitalisation averages Rs 50,508 as compared to Rs 6,631 in public facilities. Moreover, private sector services account for over 70% of all OPD consultations. Similarly they accommodate 60% of all inpatient care for which patients need to be admitted in a hospital. 

But people don’t go to private facilities by choice. The 361-page report says that low government expenditure on health has constrained the quality and capacity of public sector healthcare. 

Also read: Health Budget 2026-27: A Tale of Rising Allocations, Falling Accountability

The overwhelming reliance on the private sector has resulted in creating an environment where the prices of diagnostics, consumables, medicines, and intensive care remain unregulated. 

Though the report does not link this lack of regulation and capping of prices, it is a widely discussed fact that had the state........

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