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The Ministry of Health and Family Welfare recently released the National Health Accounts (NHA) Estimates for India 2022–23, highlighting significant improvements in public health financing, increased government investment in healthcare, and a decline in the financial burden borne by households. The report reflects India's sustained efforts to strengthen its health system and move towards the goals of Universal Health Coverage (UHC) envisaged under the National Health Policy, 2017 and the Sustainable Development Goals (SDGs).

What are National Health Accounts?

The National Health Accounts (NHA) provide a comprehensive and systematic assessment of health expenditures incurred by the government, households, private sector, insurance providers, and external agencies. Released annually, the estimates offer a time-series analysis of healthcare financing patterns in the country.

The NHA Estimates 2022–23 represent the 10th edition of the series that began in 2013–14. They are prepared by the National Health Accounts Technical Secretariat (NHATS) under the National Health Systems Resource Centre (NHSRC), Ministry of Health and Family Welfare, using the internationally accepted System of Health Accounts (SHA) 2011 framework developed by international organizations such as the OECD, WHO, and Eurostat.

Rising Public Investment in Healthcare

One of the most significant findings of the report is the steady increase in government expenditure on healthcare over the past decade.

Government Health Expenditure (GHE) increased from ?1.30 lakh crore in 2013–14 to ?3.85 lakh crore in 2022–23, reflecting a nearly three-fold rise in public spending. The share of government health expenditure in GDP also increased from 1.15% in 2013–14 to 1.43% in 2022–23, which stands at 1.48% according to the revised GDP series with base year 2022–23.

Similarly, the share of health expenditure in total government expenditure rose from 3.78% to 4.89% during the same period, indicating greater prioritization of healthcare within public budgets.

Increased Per Capita Health Spending

The report reveals a substantial rise in per capita government health expenditure. Between 2013–14 and 2022–23, per capita spending increased from ?1,042 to ?2,786, representing a nearly 2.7-fold increase.

This increase reflects expanded investments in health infrastructure, primary healthcare services, disease control programmes, insurance coverage, and public health interventions across the country.

Declining Out-of-Pocket Expenditure

A major achievement highlighted in the report is the decline in Out-of-Pocket Expenditure (OOPE) by households, which remains a key indicator of financial protection in healthcare.

OOPE as a share of total health expenditure declined significantly from 64.2% in 2013–14 to 43.4% in 2022–23. This reduction suggests that government-funded schemes and insurance mechanisms are increasingly protecting citizens from catastrophic health expenditures.

The decline is particularly important in a country where healthcare-related expenses have historically pushed millions of households into poverty.

Expansion of Social Security and Health Insurance

The report also records a significant increase in Social Security Expenditure (SSE), which includes government-funded health insurance programmes such as Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), social health insurance schemes, and medical reimbursements for government employees.

The share of SSE in total health expenditure increased from 6% in 2013–14 to 9.9% in 2022–23.

At the same time, the contribution of private health insurance rose from 3.4% to 9.2%, indicating increasing insurance penetration and risk pooling in the healthcare sector.

Strengthening Primary Healthcare

The report highlights a major increase in spending on primary healthcare, which forms the foundation of an effective health system. Government expenditure on primary healthcare increased from ?0.5 lakh crore in 2013–14 to ?1.4 lakh crore in 2022–23, more than doubling over the decade.

This reflects the government's focus on preventive, promotive, and community-based healthcare through initiatives such as Ayushman Arogya Mandirs (formerly Health and Wellness Centres), maternal and child health programmes, immunisation drives, and disease prevention strategies.