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Public healthcare in India UPSC NOTE

 Critical state of public healthcare in India

  • Current total health spending is about 3.5%. 

  • Of this, public health spending is about 1.35%. 

  • Low public spending implies high out- of-pocket expenditure by household

  • Demonetisation, GST and the COVID pandemic in quick succession adversely impacted millions of households living at the margin with stagnant wages, high prices of food and borrowings, making ‘affordability’ of health care critical. 

  • While 13.4% of households in rural areas and 8.5% in urban areas borrowed money to pay medical bills, the rest either sought access to free public care, denied themselves health care or availed substandard care that is within their budget

  • An estimated 60-80 million households are reported to have fallen below the poverty line for availing medical care.

  • With States averaging a 5% spending of their revenue budgets against the targeted 8%, overall public health spending is not just low but disproportionately low in the poorer States like Bihar.


  • Till the supply position improves, demand-side interventions like Ayushman Bharat (PMJAY) are of marginal value, more so, with out-patient care not being insured. 

  • Systems in States must be developed and the Finance Ministry must make a beginning with not only substantially increasing health budgets, particularly for NHM, but in addition, allocate all the money collected under the 4% health cess to the health budget.

  • In addition to strengthening the public health systems, there is a need to rationalise the GST levies on health products, such as 18% GST on health insurance premiums or 5% GST on insulin and hepatitis diagnostics when the number of diabetics and those prone to hepatitis are increasing. 

  • Disincentives also need to be considered for those private entities that are increasing the cost of care despite full GST exemptions and a huge number of other sops being extended from time to time



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Learnerz IAS | Concept oriented UPSC Classes in Malayalam: Public healthcare in India UPSC NOTE
Public healthcare in India UPSC NOTE
Learnerz IAS | Concept oriented UPSC Classes in Malayalam
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