India has amongst the countries with highest out of pocket expenditure for healthcare. While elucidating the reasons for the same, critically examine the government efforts towards this.

Published: September 18, 2017

One of the peculiar characteristics of India’s healthcare system is that, globally, India has one of the highest out of pocket expenditure for healthcare the world over. There are various reasons for it. One of the major reason is that public health infrastructure is poor. Because of the inability of the public sector to provide treatment and medicines, the majority of health services are delivered by the private sector. Therefore the treatment in private healthcare leads to high out of pocket expenditure.
Another major issue is the lack of adequate and comprehensive health insurance coverage, leading to additional expenditure on treatments and uncovered procedures. Another reason behind high out of pocket expenditure is the lack of proper regulations due to which private hospitals in some cases charge exorbitant prices and refer patients for unnecessary tests. For example, as per National Family Health Survey-4 private hospitals perform more than thrice the number of cesarean deliveries as compared to government hospitals.
The government has taken various initiatives to reduce out of pocket expenditure. For example, the government made it mandatory for hospitals to publicly display the number of C-section and normal deliveries, this is to reduce the abnormally high rate of C Section deliveries.
Cost of medicines constitutes a major chunk of out of pocket expenditure. In order to reduce expenditure on medicine, through Drug Price Control Order(DPCO) government put price controls on drugs, stents and now on orthopedic implants. Jan Aushadhi Scheme is another initiative to ensure quality generic medicines at affordable prices to all, especially the poor through Jan Aushadhi Stores (JASs).
The quality of public healthcare needs to be improved in order to reduce the burden of out of pocket expenditure. Therefore government should increase public health expenditure. Along with that focus should be on awareness generation regarding health insurance.

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