Govt healthcare gains ground: Economic Survey shows enhanced accessibility and health improvements

Indicating a shift from private to government healthcare services, the Economic Survey 2023-2024, presented on Monday in Parliament by Union Minister of Finance and Corporate Affairs, Nirmala Sitharaman, shows that expenditure on primary and secondary care in the private sector declined from 83.0% to 73.7% between FY15 and FY20. This shift, the Survey says, is attributed to the growing burden of tertiary diseases and greater utilization of government healthcare facilities.

The Survey, which highlights improvements in healthcare affordability and accessibility, draws on the most recent National Health Accounts (NHA) estimates, reflecting advancements in government health expenditure (GHE) and overall health outcomes.

"The share of GHE in the total Gross Domestic Product (GDP) and in Total Health Expenditure (THE) has increased," the Survey noted. Specifically, with a focus on primary healthcare, the Survey indicated an increase in its expenditure share from 51.3% of GHE in FY15 to 55.9% in FY20. Combined primary and secondary care followed a similar trajectory, increasing from 73.2% in FY15 to 85.5% in FY20.

An increase was also noted in social security expenditure on health, rising from 5.7% in FY15 to 9.3% in FY20. Additionally, out-of-pocket expenditure (OOPE) as a percentage of THE experienced a decline, suggesting enhanced financial protection for citizens.

In conjunction with these fiscal trends, key health indicators have improved, the Survey showed. "The Infant Mortality Rate (IMR) decreased from 39 per 1,000 live births in 2013 to 28 per 1,000 in 2020," the Survey stated. Similarly, the Maternal Mortality Rate (MMR) saw a reduction from 167 per lakh live births in 2014 to 97 per lakh in 2020, showcasing progress in maternal and child health.

Looking ahead, the Survey recommended prioritizing healthy eating and mental health to sustain and enhance current health improvements. It also highlighted the role of State and local governance in the effective implementation of national health programs, ensuring they reach the remotest corners of the country. "Effective local governance is essential to ensure that national health programs achieve their maximum reach," the Survey emphasized.

The Economic Survey 2023-2024 also highlighted the critical impact of healthcare on economic resilience. The Survey detailed major government initiatives, including the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), which provides ₹5 lakh annual health insurance for underprivileged families, and the PM Jan Aushadhi Kendras, offering medicines at reduced rates.

It highlighted the AMRIT scheme for subsidized critical medicines and the Ayushman Bhav Campaign, which has achieved significant outreach through wellness sessions, tele-consultations, and free healthcare services. The Ayushman Bharat Digital Mission (ABDM) has created extensive digital health records, while the eSanjeevani scheme has provided telemedicine services to millions, the Survey further said. These initiatives collectively aim to enhance healthcare accessibility and affordability, contributing to improved national well-being and economic stability, according to the government.

"The Economic Survey 2023-24 reveals substantial progress in India's healthcare sector. Key initiatives like Ayushman Bharat, Jan Aushadhi Kendras, and digital health missions have expanded healthcare access and affordability. The focus on women's health and digital integration is promising. However, challenges remain in ensuring consistent quality across regions and sustaining these programs long-term," said Himanshu Sikka, Lead - Health, IPE Global, an international development consulting firm.

"While the achievements are noteworthy, continued investment and focus are needed to achieve comprehensive healthcare coverage for all Indians. The Survey highlights the government's recognition of healthcare as a crucial component of economic resilience and inclusive growth," he added.