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8 May
2017
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Indians (The Total Investment & Insurance Solutions)
Indians
were the sixth-biggest out-of-pocket health spenders in the low-middle income
group of 50 nations in 2014, according to an IndiaSpend analysis of two recent
studies by The Lancet, a British medical journal. The Total Investment & Insurance Solutions
The
Lancet had conducted two studies -- published on April 19 -- across 184 nations
on public and private spending on health. The first showed that while total
health spending varies directly with economic development, there is substantial
variation among countries. The second predicted that government spending in
low-income countries will need to grow substantially, because private per
capita health spending in these countries will not grow as fast as required.
Among
the 184 nations surveyed, Indians, along with Bangladeshis, stood sixth among
the biggest out-of-pocket spenders. At 65.6 per cent, private expenditure on
health by Indians stood 37.45 percentage points higher than the world median of
28.15 per cent.
In
the South Asia region comprising Bangladesh, Bhutan, India, Nepal and Pakistan,
the out-of-pocket health expenditure of Indians and Bangladeshis was 10.2
percentage points more than the region's median of 55.4 per cent, our analysis
showed.
Indians
also topped the BRICS group (Brazil, Russia, India, China and South Africa) in
out-of-pocket health expenses, shelling out 31 percentage points more than the
group median of 34.6 per cent. The Total
Investment & Insurance Solutions
In
terms of spending on public health, India ranked 147 among 184 countries, a
notch below Pakistan, in 2014. At 31.3 per cent of their citizens' total health
spending in 2014, the government's contribution was 23.7 percentage points
short of the world median of 55 per cent, the IndiaSpend analysis showed.
Among
the 50 lower-middle-income countries, India's government ranked 39 in 2014,
spending 15.9 percentage points less than the group median of 47.2 per cent.
Among the five South Asia region countries, the country's government was the
median country in the year, contributing 31.3 per cent to total per capita
health spending. Government share of total health spending in India is a little
less than in Pakistan (32.1 per cent) and less than half of that in Bhutan
(70.7 per cent).
Among
BRICS nations, India spent the least on public health -- 15.7 percentage points
less than the group median of 47 per cent in the year.
The
Lancet research studied the relation between economic development and health
spending in 184 countries between 1995 and 2014. The researchers concluded that
though economic development and health spending do not necessarily go hand in
hand globally, on average, the government's share of total per capita health
spending increases while of out-of-pocket spending decreases with economic
development. The Total Investment & Insurance
Solutions
In
2014, the Indian government spent about four percentage points more -- and
Indians spent about five percentage points less out of their pockets -- on
health as a share of total health spending than in 1995, World Health
Organisation data show.
In
the 10 years to 2014, out-of-pocket health spending has pushed 50.6 million
people back into poverty, an analysis of the 68th and 71st rounds of the
National Sample Survey by Shailendra Kumar Hooda at the Institute for Studies
in Industrial Development, New Delhi, shows.
Compared
with public provisioning of health facilities, insurance-based government
initiatives have been largely unsuccessful in reducing out-of-pocket health
spending as a share of total household spending, according to Hooda. Households
in districts where central and state governments target insurance policies more
heavily are more likely to fall below the poverty line than those where
enrolment under pro-poor health insurance scheme is low, Hooda showed.
The
Indian government aims to increase health spending to 2.5 per cent of GDP, from
1.16 per cent in 2015, according to the new national health policy released in
March. The WHO recommends spending five per cent of GDP.
The
good news is that Indians are likely to see a greater fall in out-of-pocket
health spending by 2040 (11.3 percentage points) than an average global fall
(1.4 percentage points), our analysis of The Lancet's projections for 2040,
based on its 1995-2014 data, found.
The
Lancet forecast used economic data for 184 countries during 1980-2015 (health
spending data during 1995-2014) to estimate the relation between economic development
and health spending patterns for the next 25 years from 2015.
Yet,
54.3 per cent Indians are still projected to spend 29.4 percentage points more
out of their pockets than the world median (24.9 per cent) and 19.1 percentage
points more than the low-middle income group median (35.2 per cent) in 2040.
The
projected increase in government's share in total health spending in 2040 is
just short of the average increase for the South Asia super region (12.5
percentage points) at 12.4 percentage points, but higher than the average
increase for the world (6.1 percentage points) and lower-middle-income group
(9.7 percentage points).
The
Indian government's share in total health spending in 2040 will still fall
short of the world median (62.05 per cent) by 18.35 percentage points, the
lower-middle-group median (52.6 per cent) by 8.9 percentage points and the
BRICS group median by 10.1 percentage points. In the South Asian region, the
Indian government's contribution is projected to remain the median in 2040. The Total Investment & Insurance Solutions
Among
the BRICS nations, the Indian government is projected to spend the least on
public health in 2040. While in the World Bank income group it is forecasted to
have inched up to 36 in 2040 from 39 in 2014, in the world it will have moved
up to 143 from 147. The Total Investment
& Insurance Solutions
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