Skip to main content

High medical costs pushed 38 million Indians into poverty, led to financial catastrophe of 18% households

By Rajiv Shah
A recent paper, published in a top London-based research journal, BMP Open, has said that the out of pocket (OOP) expenditure on healthcare in general and medicines in particular, over the last two decades, has gone up from 4.49% to 6.77% in India, leading to “financial catastrophe” of 18% of the country’s households.
Calling it a “significant increase since 1993–1994”, the paper, “Quantifying the financial burden of households’ out-of-pocket payments on medicines in India”, by Sakthivel Selvaraj, Habib Hasan Farooqui and Anup Karan, says that, as against this, the proportion of OOP expenditure on food and non-food items has remained more or less stagnant.
The paper further says that OOP on medical expenditure was particularly “catastrophic” for the poorer 10% of the population, pushing 3.09% or 38 million persons, into poverty. “Among the leading cause of diseases that caused significant OOP payments are cancers, injuries, cardiovascular diseases, genitourinary conditions and mental disorders”, the report adds.
At the same time, the paper says, "The number of households facing catastrophe" on account of medical expenditure "is approximately 46 millions", of which 29 million households incurred catastrophe on account of OOP payments on medicines alone."
Of the 18% of Indian households that “appear to suffer financial catastrophe” as a result of OOP spending, the paper underlines, of this, “medicines’ OOP expenditure alone contributed an estimated 11%.”
The paper further states, “Recent evidence from the National Health Accounts for India points out that during 2013–2014, an estimated INR1331 per capita was spent on medicines, while households alone contributed INR1200 per capita, accounting for 90% of all medicines expenditure in the country.”
On the other hand, the paper says, evidence about government expenditure on medicines in India shows that, on an average, government spent about 10% of health expenditure on medicines. However, the national average masks significant under-spending on medicines by several state governments, “with many reportedly spending less than 5% of their health budgets.
Pointing out that the supply of free drugs in government health system in the outpatient care setting has “declined sharply” from about 18% to 5%, the paper says, “Drugs prescribed during hospitalisation for free also declined significantly from one-third.”
Basing on secondary data of the nationwide Consumer Expenditure Surveys for the years 1993–1994, 2004–2005 and 2011–2012, carried out by the Government of India’s National Sample Survey Organization (NSSO), and NSSO’s “Health and Morbidity Survey”, 2014, the paper says, “Over three-fourth of all healthcare payments are paid out of pocket (OOP) at the point of service delivery while medicines purchase.”
According to the paper, “Over 80% of populations are reportedly spending OOP while seeking treatment”, adding, two decades earlier, the “proportion of population reporting any OOP payments” was “about 60%”. It adds, “In respect to medicines spending, approximately every OOP spending is associated with expenditure on medicines.”
“If we were to net out food expenditure from total household consumption spending, which are considered a necessity, the share of health spending remained stagnant but as high as 11%–12% during the period under consideration”, the report notes.

Comments

Urvashi Devi said…
Why ? Now they have the generic medicines, free dialysis; 5 lacs insurance ; and they also get cover with banking schemes; that I know because we did it for all our staff; reduced price of Valves ; knee operations etc etc ; free treatment for ST Sc health card holders . So I don't understand ?
Ashwin Desai said…
You are absolutely right, God knows when will government make serious & strict policy?

TRENDING

'Enough evidence' in Indian tradition to support legal basis for same-sex marriage

By Iyce Malhotra, Joseph Mathai, Sandeep Chachra*  The ongoing hearing in the Supreme Court on same-sex marriage provides space for much-needed conversations on issues that have hitherto remained “invisible” or engaged with patriarchal locker room humour. We must recognize that people with diverse sexualities and complex gender identities have faced discrimination, stigma and decades of oppression. Their issues have mainly remained buried in dominant social discourse, and many view them with deep insecurities.

Savarkar 'criminally betrayed' Netaji and his INA by siding with the British rulers

By Shamsul Islam* RSS-BJP rulers of India have been trying to show off as great fans of Netaji. But Indians must know what role ideological parents of today's RSS/BJP played against Netaji and Indian National Army (INA). The Hindu Mahasabha and RSS which always had prominent lawyers on their rolls made no attempt to defend the INA accused at Red Fort trials.

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Victim of communal violence, Christians in Manipur want Church leadership to speak up

By Fr Cedric Prakash SJ*  The first eleven days of May 2023 have, in many ways, been a defining period of Indian history! Plenty has happened in a rapid-fire stream of events. Ironically, each one of them are indicators of how crimes and the criminalisation of society has become the ‘new norm’; these include, the May Day rallies with a focus on the four labour codes which are patently against the rights of workers; the U S Commission on International Religious Freedom (USCIRF) released its Annual Report on 1 May stating that conditions for religious freedom in India “continued to worsen in 2022”; the continued protest by the Indian women wrestlers at Jantar Mantar for the expulsion of the chief of the Indian Wrestlers Federation on very serious allegations; the Elections in Karnataka on 10 May (with communalism and corruption as the mainstay); the release of the fake, derogative and insensitive film ‘The Kerala Story’; the release of World Free Press Index on 3 May which places India

Delhi HC rules in favour of retired Air Force officer 'overcharged' for Covid treatment

By Rosamma Thomas*  In a decision of May 22, 2023, the Delhi High Court ruled in favour of petitioner Group Captain Suresh Khanna who was under treatment at CK Birla Hospital, Gurugram, between April 28 and May 5, 2021, for a period of eight days, for Covid-19 pneumonia. The petitioner had to pay Rs 3,55,286 as treatment costs, but the Ex-Servicemen Contributory Health Scheme (ECHS) only reimbursed him for Rs 1,83,748, on the basis of government-approved rates. 

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

Unlike other revolutionaries, Hindutva icon wrote 5 mercy petitions to British masters

By Shamsul Islam*  The Hindutva icon VD Savarkar of the RSS-BJP rulers of India submitted not one, two,or three but five mercy petitions to the British masters! Savarkarites argue: “There are no evidences to prove that Savarkar collaborated with the British for his release from jail. In fact, his appeal for release was a ruse. He was well aware of the political developments outside and wanted to be part of it. So he kept requesting for his release. But the British authorities did not trust him a bit” (YD Phadke, ‘A complex Hero’, "The Indian Expres"s, August 31, 2004)

India joining US sponsored trade pillar to hurt Indian farmers, 'promote' GM seeds, food

Counterview Desk  As many as 32 civil society organisations (CSOs), in a letter to Union Commerce Minister Piyush Goyal on the Indo-Pacific Economic Framework (IPEF) and India joining the trade pillar, have said that its provisions will allow the US to ensure a more favourable regulatory regime “for enhancing its exports of genetically modified (GM) seeds and GM food”, underlining, it will “significantly hurt the livelihoods of Indian farmers.”

Savarkar 'opposed' Bhagat Singh's, Netaji's dream of India, supported British war efforts

By Shamsul Islam* In a shocking development, the student wing of the RSS put the busts of martyrs Bhagat Singh and Subhash Chandra Bose with Savarkar's on one pedestal at the University of Delhi late in the night on August 20, 2019. Bhagat Singh sacrificed his life for a socialist-democratic-secular republic and Netaji raised Azad Hind Fauj (INA) consisting of people of all religions and regions for armed liberation of India.

Undermining law, breastfeeding? Businesses 'using' celebrities to promote baby food

By Rajiv Shah  A report prepared by the top child welfare NGO, Breastfeeding Promotion Network of India (BPNI), has identified as many as 15 offenders allegedly violating the Indian baby food law, the Infant Milk Substitutes Feeding Bottles, and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992, and Amendment Act 2003 (IMS Act), stating, compliance with the law “seems to be dwindling by the day.”