Editorial Notes

[Editorial Notes] Budgetary Health Allocation

Material resources are finite is a fact. When the demand is at its peak amid the pandemic of COVID-19, its time to gauge and use the resources.
By IASToppers
March 24, 2020


  • Introduction
  • Issues
  • Per capita health expenditure
  • Out of pocket expenditure
  • Government initiative by far: Ayushman Bharat and more
  • Way forward
  • Conclusion

Budgetary Health Allocation

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  • National and state health systems need to cope with ever-rising demands — for testing kits, for hospital beds, ventilators, why, even masks and hand sanitisers.
  • In China, the rapidly climbing numbers went far beyond the capacity of the country’s renowned industry (where a hospital was built in record time), and the health systems struggled to cope.
  • Reports indicate that in Italy, which has emerged the hub of the epidemic outside of China, the strain on health systems is massive.
  • With India crossing 100 positive cases, it is impossible to ignore the question about whether the health system is robust enough to meet this emergency.


  • The unexpected demand has traditional production and systems of delivery choking.
  • Health-care resources are also limited and most often, unable to match supply to demand.
  • Only 2.2.% is allocated to healthcare spending as part of GDP.
  • The government remains woefully short of its ambition to increase public health spending to 2.5% of GDP.
  • As per the National Health Profile, 2019, collated by the Central Bureau of Health Intelligence unit of the Directorate General of Health Services, there has been no significant change in health-care expenditure since 2009-2010.

Per capita health expenditure

  • In 2018, the Per capita health expenditure have risen to about ₹1,500 from ₹621 in 2009-10. This amounts to about $20, or about $100 when adjusted for purchasing power parity.
  • A comparison between two large democracies is telling: the U.S.’s health expenditure is 18% of GDP, while India’s is still under 1.5%. The U.S. spends $10,224 per capita on healthcare.

Out of pocket expenditure

  • The expenses that the patient or the family pays directly to the health care provider, without a third-party (insurer, or State) is known as ‘Out of Pocket Expenditure’ (OOP).
  • These expenses could be medical as well as non-medical expenditure.
  • A WHO bulletin of 2018 records that out-of-pocket payments remain common in India, which in 2014, was estimated at 62% of total health expenditure.
  • There is evidence to show that increased public spending on health care has resulted in less financial hardship for communities and better healthoutcomes.

Government Health Initiative by far

  • 1.5 lakh health and wellness centres would be set up under Ayushman Bharat. The mandate of these centres is preventive health, screening, and community-based management of basic health problems.
  • The mandate should include health education and holistic wellness integrating modern medicine with traditional Indian medicine.
  • An estimated ₹250 crore has been allocated for setting up health and wellness centres under the National Urban Health Mission. Under the National Rural Health Mission, ₹1,350 crore has been allocated for the same.
  •  The non-communicable diseases programme of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke has been allocated ₹175 crore, from ₹275 crore.
  •  Allocation to the National Tobacco Control Programme and Drug De-addiction Programme is only ₹65 crore, a decrease of ₹2 crore.
  • The allocation for each of the wellness centres is less than ₹1 lakh per year. This is a meagre amount.

Way forward

  • Spending adequately in health care can reduce out-of-pocket expenditure.
  • Holistic health education in wellness centres can create aware citizens.
  • Quarantine cells at hospitals and self quarantine at home can prevent further COVID-19 spread.


  • Epidemics have impacted economies in history.
  • This time world is dealing with a pandemic whose remedy is still not available.
  • Preventive measures and investment in infrastructure through public private partnership can help to fight unforeseen health worries.
Mains 2020 Editorial Notes

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