Over 90m Indians Struggle with High Healthcare Expenditure, Putting Household Budgets at Risk

New Delhi: Over 90 million Indians face steep financial burden due to high healthcare expenditure, says a report cited in The Times of India. In fact, the rising costs of medical treatments and services are adversely affecting individuals and families, putting a strain on their household budgets. This is despite government measures to control drug prices, aiming to make essential medications more affordable and accessible to the population.

According to Oxfam's Sustainable Development Goals National Indicator Framework Progress Report 2023’, released by the statistics ministry, a significant number of Indians live in households where healthcare expenses exceed 10% of their total expenditure. Out of these, 31 million individuals reside in families where health spending accounts for more than a quarter of their household expenditure. The report further reveals an increase in households spending over 10% or 25% of their income on healthcare between 2017-18 and 2022-23.

Catastrophic Health Spending and Universal Health Coverage

The report defines the concept of Catastrophic Health Expenditure (CHE) as medical expenses exceeding 10% of household consumption expenditure, posing a threat to the household's financial stability. Recall that the third Sustainable Development Goal (SDG) aims to achieve Universal Health Coverage (UHC), ensuring access to quality healthcare, affordable medicines, and vaccines for everyone.

However, as healthcare becomes increasingly unaffordable, a significant portion of household income goes toward healthcare often at the expense of other essential needs, says the report.

State-wise Analysis

The report reveals that in the 2022-23 period, Kerala had the highest proportion of people spending over 10% or 25% of their household expenditure on health, followed by Maharashtra. Kerala also witnessed the largest increase in this proportion between 2017-18 and 2022-23. Other states, including Uttar Pradesh, Andhra Pradesh, Himachal Pradesh, Karnataka, Odisha, and Telangana, also experienced a significant rise in the proportion of households with high healthcare expenditures.

According to the National Health Accounts 2019-20, Kerala and Uttar Pradesh had the second and highest proportion of Out-of-Pocket Expenditure (OOPE) as a percentage of total health expenditure.

The report states that at least 400 million people, or about 30% of the population, lacked financial protection for health, leading to high out-of-pocket expenditure and impoverishment. The uncovered population is likely higher due to coverage gaps and overlaps between different healthcare schemes, it says.

Fixing Drug Prices

 The National Pharmaceutical Pricing Authority (NPPA) has recently fixed the ceiling prices for various drug formulations to address the affordability issue. This includes anti-coagulant drugs, medicines for diabetes management, and treatments for depression. The ceiling price is the maximum price set by the government for retailers. Manufacturers or marketing companies failing to comply with the retail price regulations may be penalised under the Drugs (Prices Control) Order, 2013.

 Inclusion of coronary stents in the National List of Essential Medicines: In 2022, the health ministry included coronary stents in the National List of Essential Medicines, aiming to make these life-saving medical devices more affordable. This inclusion is expected to reduce the cost of angioplasty, a minimally invasive procedure to open blocked arteries, making it more accessible to the population.

Yet, rising healthcare expenditure in is draining the finances of over 90 million individuals and their households, which highlights the crying need for further government interventions to ensure affordable and accessible healthcare for all, and moving closer to the goal of Universal Health Coverage