The Ministry of Health and Family Welfare has released the tenth National Health Accounts estimates for the financial year 2022-23, highlighting a significant expansion in public health spending over the last decade. India’s total health expenditure for the fiscal year reached 8.81 lakh crore rupees, representing 3.37% of the national gross domestic product. This comprehensive report tracks funding sources and expenditure trends to assess the country’s progress toward achieving universal health coverage.
Decadal Growth in India’s Health Expenditure
Public financing for healthcare has seen a steady increase over the ten-year period from the financial year 2013-14 to 2022-23. The Government Health Expenditure grew nearly three times, rising from 1.30 lakh crore rupees in 2013-14 to 3.85 lakh crore rupees in 2022-23. This expansion highlights the central and state governments’ growing commitment to strengthening public health infrastructure.
In terms of economic output, public health spending as a share of the national gross domestic product rose from 1.15% in 2013-14 to 1.43% in 2022-23. Under the updated economic series using the 2022-23 base year, this share is estimated at 1.48%. In per capita terms, the government’s investment in health rose from 1,042 rupees to 2,786 rupees over the decade, reflecting a 2.7-fold increase.
The following table summarizes the key growth indicators of public health spending over the decade:
| Indicator | Financial Year 2013-14 | Financial Year 2022-23 | Growth Factor / Share |
|---|---|---|---|
| Government Health Expenditure | 1.30 lakh crore rupees | 3.85 lakh crore rupees | Nearly threefold increase |
| Share of Gross Domestic Product | 1.15% | 1.43% (1.48% revised) | Expanded by 0.28% of GDP |
| Per Capita Government Spending | 1,042 rupees | 2,786 rupees | 2.7 times increase |
| Share in Total Health Expenditure | 28.6% | 43.7% | Increase of 15.1% points |
Shifts in Healthcare Financing and Household Burden
A critical metric of healthcare accessibility and financial protection is the out-of-pocket expenditure incurred by households. Direct health spending by families has registered a significant long-term decline over the decade. The share of out-of-pocket expenditure in the total health expenditure fell from 64.2% in 2013-14 to 43.4% in 2022-23. In absolute terms, household out-of-pocket expenditure for 2022-23 stood at 3.82 lakh crore rupees.
While the decadal trend demonstrates a substantial drop in household financial vulnerability, the share of out-of-pocket expenses rose slightly from the 39.4% recorded in the previous year of 2021-22. This annual fluctuation is attributed to the normalization of healthcare services, outpatient consultations, and elective treatments in private facilities after the disruptions of the pandemic years.
Concurrently, the government’s share within the total health expenditure expanded from 28.6% in 2013-14 to 43.7% in 2022-23. This change signifies that public funding has increasingly stepped in to shoulder the country’s healthcare needs, helping to insulate citizens from catastrophic medical expenses.
Rising Role of Social Security and Insurance
A key driver behind the reduction in out-of-pocket expenditure is the expansion of risk-pooling mechanisms, particularly social security programs and health insurance schemes. The share of Social Security Expenditure on health increased from 6.0% of the total health expenditure in 2013-14 to 9.9% in 2022-23. This expenditure includes government-financed health insurance programs such as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, medical reimbursements to government employees, and other public social health insurance schemes.
Parallel to government efforts, private insurance coverage has also expanded. The share of private health insurance in total health spending grew from 3.4% in 2013-14 to 9.2% in 2022-23. This upward trend reflects rising public awareness of financial risk management in healthcare and a greater penetration of insurance products across the population.
Together, the rise in both public social security and private insurance spending indicates a structural shift in India’s healthcare financing. The country is moving away from direct cash payments at the point of care toward pre-paid, pooled financing systems. This transition is essential for building a resilient healthcare safety net for households.
Technical Framework of the National Health Accounts
The National Health Accounts estimates are compiled using a highly standardized technical process to ensure accuracy and international comparability. The tenth NHA report was prepared by the National Health Accounts Technical Secretariat, which operates under the National Health Systems Resource Centre. The secretariat was officially designated in August 2014 by the Ministry of Health and Family Welfare to institutionalize health accounts reporting in India.
The methodology used for preparing these estimates is based on the System of Health Accounts 2011 framework. This framework is a globally recognized standard developed jointly by the World Health Organization, the Organisation for Economic Co-operation and Development, and Eurostat. By adopting this system, the secretariat tracks the flow of financial resources from funding sources to healthcare providers and functions, ensuring that India’s domestic expenditure data can be compared with global benchmarks.
To maintain professional standards and policy relevance, the compilation process is guided by the NHA Steering Committee and the NHA Expert Group. These bodies comprise senior officials, health economists, and statistical experts who oversee data collection and validate the final estimates. This institutional setup ensures that the data serves as a reliable evidence base for policymakers tracking progress toward universal health coverage.
Key Takeaways
- The tenth National Health Accounts estimates for the financial year 2022-23 estimate India’s total health expenditure at 8.81 lakh crore rupees, which constitutes 3.37% of the national gross domestic product.
- Government Health Expenditure rose nearly threefold over a decade, increasing from 1.30 lakh crore rupees in 2013-14 to 3.85 lakh crore rupees in 2022-23.
- Households’ out-of-pocket expenditure as a share of the total health expenditure declined from 64.2% in 2013-14 to 43.4% in 2022-23.
- The share of Social Security Expenditure on health, which includes public health insurance schemes like Ayushman Bharat, grew from 6.0% to 9.9% over the decade.
- The National Health Accounts Technical Secretariat, functioning under the National Health Systems Resource Centre, prepared the estimates using the international System of Health Accounts 2011 framework.
