Healthcare left to pvt sector mercy

January 10, 2010: The Times of India

Take any measure, juggle the figures, change the basis of comparison — no matter what you do, India has one of the most privatized healthcare systems in the world. Pakistan is a constant companion in this club along with countries like Burundi, Ivory Coast, Laos and Congo. 

If you take public expenditure on health as a percentage of GDP, in India it is a mere 0.9%, among the lowest in the world and ahead of only four countries — Burundi, Myanmar, Pakistan, Guinea and Laos. If you take the share of the government in total health expenditure, again India figures at the bottom of the pile with government spending accounting for just 25% of the total health spend in the country. The only other countries with lower public health expenditure are Burundi (8%), Pakistan (16%), Laos (19%), Congo (19%), Cameroon (21%) and Ivory Coast (24%). The share of government in health spending varies from 76% in Europe to 34% in South-East Asia. India’s spending falls below the lowest even in this range. 

If you were to consider the share of health expenditure in total government expenditure, India again has among the lowest proportions — a mere 3.4%. Only Pakistan (1.3%) and Burundi (2.3%) allocate a lower portion on health.

Costly healthcare pushes 39m into poverty

In India, private spending on health is 4.2% of GDP. More than 70% of all health expenditure in India is paid for by people from their own pockets and this expenditure has been rising, especially for the poorest with increasing privatization of healthcare. 

According to a Planning Commission paper of May 2009, several studies conducted in villages showed that healthcare expense was responsible for over half of all the cases of decline into poverty. It is estimated that in 2004-05, an additional 39 million people were pushed into poverty due to out-of-pocket payments. 

NSSO data for 2004-05 shows that of the total medical expenditure per capita, medicines alone accounted for 74% of the expenses in rural areas and 67% in urban areas. If we were to consider only non-institutional medical care, which constitutes the bulk of health expenses, drugs constitute over 80% of people’s expenditure.


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