Government expenditure on health dropped from 1.35% of the gross domestic product in 2017-’18 to 1.28% in 2018-’19, data from the National Health Estimates showed on Monday.

India’s real gross domestic product prices in 2018-’19 stood at Rs 139.75 lakh crore – a 6.1% growth from the previous year.

Meanwhile, out-of-pocket expenditure on health also declined from 1.62% of the gross domestic product in 2017-’18 to 1.52% in 2018-’19. Out-of-pocket payments are borne directly by a patient where insurance does not cover the full cost of health services.

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The National Health Policy, 2017 claims that government health expenditure will be 2.5% of the gross domestic product by 2025.

Per capita government expenditure on health increased from Rs 1,753 in 2017-’18 to Rs 1,815 in 2018-’19. Per capita out-of-pocket spending also increased in absolute numbers from Rs 2,097 in 2017-18 to Rs 2,155 in 2018-19.

The data showed that out-of-pocket spending as a percentage of total health expenditure declined substantially from 69.4% in 2004-’05 to 48.2% in 2018-’19. On the other hand, the figure for government spending on health increased from 22.5% in 2004-’05 to 40.6% over 15 years.

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Total health expenditure includes spending by governments, citizens, insurers and donors.

Data from the National Health Accounts also showed that total health expenditure as a percentage of gross domestic product declined from 4.2% in 2004-’05 to 3.2% in 2018-’19.

State-wise figures

The National Health Estimates show that the Arunachal Pradesh government spent the highest percentage (4.5%) of its gross domestic product on health in 2018-’19. The figure was the lowest (0.7%) Haryana, Karnataka, Maharashtra and Telangana.

Meanwhile, the total per capita health expenditure is highest in Kerala (Rs 9,871) and the lowest in Bihar (Rs 1,517). The out-of-pocket expenditure per capita in Kerala in 2018-’19 was Rs 6,772, while the figure for Bihar was Rs 811.