Healthcare Affordability and Accessibility in India

Out-of-pocket expenditure (OOPE) is money that patients pay directly. It does not pass through insurance or a government scheme.

What do the numbers show?

• OOPE was 62.6% of total health expenditure in 2014-15.
• It fell to 39.4% in 2021-22, the pandemic year.
• In 2022-23 it was 43.4%, a rise from the year before.
• The earlier National Health Accounts series began at 64.2% in 2013-14.

What is the memory hook?

Think “62.6 down to 39.4, then up to 43.4”. Down, then a small bounce.

Ayushman Bharat PM-JAY gives health cover to eligible families. It covers secondary and tertiary hospital care.

What are the key facts?

• The cover is Rs 5 lakh per family per year.
• A Rajya Sabha written reply gave 12.69 crore cashless admissions authorised as of 30 June.
• Those admissions were worth Rs 1.92 lakh crore.
• The scheme works through 37,413 public and private hospitals.

What is the memory hook?

Think “5 lakh cover, 12.69 crore admissions”. The money figure is claims, not savings.

Government health expenditure is the second half of the story. India set itself a target for it.

What are the figures?

• The National Health Policy aims for government health spending of 2.5% of GDP by 2025.
• The National Health Accounts put government spending at 1.48% of GDP in 2022-23 on the new GDP series.
• On the older series it is 1.43%.
• A parliamentary panel’s report also cited around 1.43% of GDP.
• Both figures are below the 2.5% goal.

What is the memory hook?

Think “2.5 wanted, under 1.5 spent”. Always check which year and source.

The health committee presented its 176th report in August 2026. The report is on affordability and accessibility of healthcare in the public and private sectors.

What are the key facts?

• It contains 368 recommendations.
• It was presented in the Rajya Sabha and laid in the Lok Sabha on 7 August 2026.
• It covers public hospitals, private hospitals, insurance and medicine costs.
• It said government health spending is below the 2.5% target.

What is the memory hook?

Think “176th, 368, 7 August”. Three numbers.

Another committee looked at the National Pharmaceutical Pricing Authority (NPPA). It was the Standing Committee on Chemicals and Fertilizers. It presented its report on 6 August 2026.

What did it find?

• Trade margin rationalisation limits what distributors and retailers can add to a drug’s price.
• A pilot has run for certain anti-cancer medicines and COVID-19 devices.
• Hospitals and retailers give discounts of 20% to 60% on MRP.
• About 82% of the market is non-scheduled medicines, which can rise by up to 10% a year.
• Rs 8,526 crore of overcharged amounts remained unrecovered as of 2025.

What is the memory hook?

Think “82% outside price control”. Most of the market is not scheduled.

CDS-I 2020 asked about the scheme’s features.

What was the question?

The key is option (d). The real cover is Rs 5 lakh per family per year. View the 2020 paper.

What is the memory hook?

Think “5, not 10”. One number swap makes the false option.

Four mix-ups come up often.

What are the traps?

• Which OOPE series? 62.6% to 39.4% covers 2014-15 to 2021-22. The 2022-23 value is 43.4%.
• Claims or savings? Rs 1.92 lakh crore is the value of authorised admissions.
• Goal or outcome? The goal is 2.5% of GDP. Reports give about 1.43% to 1.48%.
• Two committees. Health and Family Welfare made the 176th report. Chemicals and Fertilizers reviewed the NPPA.

What is the memory hook?

Think “series, claims, goal, committee”.