HEalth Exp

8/17/2019 HEalth Exp

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EXPENDITUREEXPENDITURE

ON HEALTHON HEALTH

IN INDIAIN INDIA

1


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SOME FACTS..SOME FACTS..

Only 15% Indians have some form of healthOnly 15% Indians have some form of health

insurance.insurance.

Hospitalized Indians spend 58% of their totalHospitalized Indians spend 58% of their total

annual expenditure on health care.annual expenditure on health care. Over 40% of hospitalized Indians orro! heavilyOver 40% of hospitalized Indians orro! heavily

or sell assets to cover expenses.or sell assets to cover expenses.

Over "5% of hospitalized Indians fall #$Over "5% of hospitalized Indians fall #$

ecause of hospital expenses.ecause of hospital expenses.


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3

Public ExpenditurePublic Expenditure

It is the value of the &oods and services ou&ht y the state and itsIt is the value of the &oods and services ou&ht y the state and itsarticulationsarticulations


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Public Expenditure On HealthPublic Expenditure On Health

It refers to 'xpenditure on health care incurredIt refers to 'xpenditure on health care incurredy pulic funds.y pulic funds.

It includes spendin& on(It includes spendin& on(

1. Health ) *amily +elfare(1. Health ) *amily +elfare(

(NRHM , National Health Programmes, MedicalEducation)

". ,-/H". ,-/H

. ,I/ 2ontrol. ,I/ 2ontrol

4. Health 3esearch4. Health 3esearch

#oth recurrent and capital expenditure are included#oth recurrent and capital expenditure are included


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5

Determinants Of PublicDeterminants Of Public

ExpenditureExpenditure

$ast choices$ast choices #ureaucracy#ureaucracy

$olitical !ill$olitical !ill


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6

Current Healt !cenari"Current Healt !cenari"

1.1. $oor health of poor people.$oor health of poor people.

".". Hi&h maternal and Infant mortality.Hi&h maternal and Infant mortality.

.. Hi&h child malnutrition and ,nemia amon&Hi&h child malnutrition and ,nemia amon&!omen.!omen.

4.4. ual urden of communicale and nonual urden of communicale and non

communicale disease.communicale disease.

5.5. Increasin& urden of disease6HI7,I/ )Increasin& urden of disease6HI7,I/ )emer&ence of ne! disease.emer&ence of ne! disease.

9.9. Increasin& demand for health care services.Increasin& demand for health care services.


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Funding and Expenditure in IndiaFunding and Expenditure in India

:otal pulic fundin& on core health( 1.04% of ;$in 11th plan.

*rom perspective of the roader health sector

!hich includes schemes of


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:he total expenditure on health care in Indiata>in& oth pulic and private expenditure !asaout 4.1 per cent of ;$ in 11th $lan.

The percentage for this broader definition of healthThe percentage for this broader definition of healthsector related resources needs to be increased to 2.5 persector related resources needs to be increased to 2.5 per

cent by the end of the Twelfth Plan.cent by the end of the Twelfth Plan.

For financing the 12For financing the 12thth plan proections en!isageplan proections en!isageincreasing total public funding" on core health fro# 1.$4increasing total public funding" on core health fro# 1.$4

per cent of %&P in 2$11'12 to 1.(7 per cent of %&P byper cent of %&P in 2$11'12 to 1.(7 per cent of %&P by

the end of the Twelfth Plan..the end of the Twelfth Plan..

(


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Allocation and spending by MoHFW Allocation and spending by MoHFW

in 11in 11thth

planplan

Department 11th Plan Allocation

(s incrores!

Ele"enthPlan

elease

11th PlanExpenditure

#Expenditure

to elease

)*F+ 125,23 (746$ (34$7 ,5.4-

f which under/0)

(,47( 6($64 66127 ,7.2-

) 3,(( 3$(3 2,,4 ,7.1-

&)0 44,6 1,3( 1(7$ ,6.5-

& ontrol 572( 15$$ 13$5 (7.$-

Total 14$135 ,3,(1 (,576 ,5.3-

,


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$udget %upport &or Department o&$udget %upport &or Department o&

MoHFW in 1'MoHFW in 1'thth PlanPlan

Department o&

MoHFW

11th Plan

Expenditure

1'th Plan

utlay

# 1'th ) 11th

Plan)*F+ (34$7 26(551 322-

) 2,,4 1$$44 335-

&)0 1(7$ 1$$2, 536-

& ontrol 13$5 113,4 (73-

Total o)F+ (,576 3$$$1( 335-

1$


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Funding &or Health in 11Funding &or Health in 11thth PlanPlan

*ear +entre+ore

Health

%tates+ore

Health

#,DP(+ore Health!

#,DP ($road Health!

entre tates Total entre tates Total

1$th Plan 47$77 1$7$46 $.2,- $.65- $.,4- $.56- 1.1(- 1.74-

11th Plan 11,364 22,,2( $.35- $.6(- 1.$4- $.75- 1.22- 1.,7-

11


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Inter#c"untr$ C"mparis"n OfInter#c"untr$ C"mparis"n Of

Public Expenditure On Healt As APublic Expenditure On Healt As A

% &DP% &DP

COUNTR' %

#razil ."

Aorea 1.8

:hailand 1."

2hina 0.@

India 0.?

!"urce( )"rld Healt Rep"rt* +,,-


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!tren.ts!tren.ts

1.1. ar&e s>illed health manpo!er.ar&e s>illed health manpo!er.

".". /i&niBcant research capaility./i&niBcant research capaility.

..

;ro!in& hospital infrastructure.;ro!in& hospital infrastructure.

4.4.


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%0P 12 14

Opp"rtunitiesOpp"rtunities

1.1. Increasin& demand for health care services.Increasin& demand for health care services.

".". /ystematic policy ma>in& and plannin& for/ystematic policy ma>in& and plannin& for

pulic health services.pulic health services.


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Callen.esCallen.es

1.1. 3aise resources innovatively and ma>e the3aise resources innovatively and ma>e the

pro&ramme sustainale.pro&ramme sustainale.

".". 'nsure access and Duality of service to'nsure access and Duality of service to

those !ith no inEuence or voice.those !ith no inEuence or voice.

.. :o provide eFective and aFordale family :o provide eFective and aFordale family

care to rural populationcare to rural population


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TreatsTreats

1.1. Hi&h out of poc>et expenditure.Hi&h out of poc>et expenditure.

".".


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G,:IOG,G,:IOG,

H',:HH',:H

,22OG:/,22OG:/

17


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NHA c"nstitute a s$stematic*

c"mpreensi/e* and

c"nsistent m"nit"rin. "f

res"urce 0"1s in a c"untr$2s

ealt s$stem f"r a .i/en

peri"d3

1(


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)$ NHA 4

•It is a tried and tested tool for summarizin&descriin& and analyzin& the Bnancin& of

national health systems.

• :he advanta&e of national health accounts isthat they not only depict the current use of

resources in the health system in detail ut ifimplemented on a re&ular asis can also trac>health expenditure trends and ma>e Bnancialproection of a countryCs health system

reDuirements. 1,


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• NHP#+,,+ empasi5ed te need 6

rec"mmended establisment "f an

NHA s$stem in te c"untr$ b$ te

$ear +,,-3

• Te 7inistr$ "f Healt and 8amil$

)elfare 97OH8): establised an

NHA Cell in c"llab"rati"n 1it )HO2$


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+here do the resources come from sources J K+here do the resources come from sources J K

+here do the resources &o a&ents J K+here do the resources &o a&ents J K +ho provides !hat services providers J K+ho provides !hat services providers J K

+hat >ind of services and &oods do they purchase+hat >ind of services and &oods do they purchase

functionsJ KfunctionsJ K

+hat inputs are used for providin& servicesK+hat inputs are used for providin& servicesK +hom do they eneBtK+hom do they eneBtK

+hat is total spendin& on healthK+hat is total spendin& on healthK

+ho is spendin& itK poorrichK ruraluranK+ho is spendin& itK poorrichK ruraluranK

northsouthKJnorthsouthKJ +hat is it ein& spent onK $H2K hospitalsK


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nternational lassification fornternational lassification for

)ealth ccounts 9 ) :)ealth ccounts 9 ) :

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*inancin& /ources are institutions or entities thatprovide funds used in health care system yBnancin& a&ents. :hey are the ones !ho earexpenses of Bnancin& health care in the country.

8inancin. !"urces8inancin. !"urces

• 2entral ;overnment• /tate ;overnment• ocal ;ovt #s ) $3IsJ

• Households out6of6poc>et expenditureJ• 'mployer *unds for /ocial Insurance• $ulic ) $rivate *irms providin& employee medicaleneBtsJ•

Gon $roBt Institutions /ervin& HouseholdsG$I/HsG;OsJ 26


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*inancin& a&ents are institutions or entities thatchannel funds provided y Bnancin& sources and usethose funds to pay for or purchase the activities &ivenin the health accounts oundary.

8inancin. A.ents8inancin. A.ents

•


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$roviders are entities that receive money in exchan&e for or inanticipation of producin& activities inside the health accountsoundary.

Pr"/iders

• $ulic Hospitals•

ispensaries•*amily +elfare 2entres•$ulic Health as #lood #an>s•$rovider of


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*unctions are the types of &oods and services andactivities provided !ithin the health accounts

oundary.

8uncti"ns8uncti"ns

• 2urative 2are• 3ehailitative care•

/ervices of lon& term6nursin& care• ,ncillary services to health care•


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Limitati"ns "f NHALimitati"ns "f NHA

3$


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THAN=

'OU

HEalth Exp

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