Context: According to the National Sample Survey (NSS)’s 75th round of survey on household consumption related to health has brought out startling facts on the state of healthcare and morbidity among Indians.
About NSS 75th Survey

• The survey was conducted from July 2017 to June 2018.
• It covered over 0.55 million people in both rural and urban areas.
• The survey, conducted periodically, is done to assess expenditure on health-related activities, access to private and public health facilities and above all, the level of morbidity in the country.
• The first full-scale NSS health survey was conducted in the 28th round of NSS (1973-74). Since the 1990s there have been four health surveys.

Key highlights of the survey

• 80 % Indians don’t have health expenditure coverage.
• Among, 85.9 % of rural Indians and 80.9% of urban Indians don’t have any health expenditure coverage.

Concern
The low insurance coverage is a cause of concern for two reasons:

• First, more and more people are accessing private healthcare that is relatively more expensive than public facilities;
• second, to make access to healthcare affordable, the government has been pursuing universal insurance coverage.

Choosing Private/Government hospitals

• 55% of Indians continue to depend on private healthcare facilities. Only 42 % of the population went to government hospitals.
• In rural areas, 52 % people went to private hospitals while 46 % opted for government hospitals.
• In urban areas, only 35 % people opted for government hospitals.
• Government schemes covered just about 13 % of rural and 9 % of the urban population. The survey didn’t cover the flagship Pradhan Mantri Jan Aarogya Yojana (PMJAY) as it was launched on September 23, 2018.

Medical expenditure for hospitalisation

• Average annual Medical expenditure for hospitalisation in Rural household: Rs 16,676 and Urban Household: Rs 26,475
• Average medical expenditure for hospitalisation in government hospitals in Rural Areas Rs 4,290 and Urban Areas: 4, 837
• Average medical expenditure for hospitalisation in private hospitals in Rural Areas: Rs 27,347 and Urban Areas: Rs 38,822

Dependence on saving/borrowing

• In absence of health insurance coverage and high expenditure, Indians are digging into their savings or borrowings to bear household medical care bills.
• Rural areas: 80 % households depended on savings to fund medical expenditure while 13 % people borrowed from various sources.
• Urban areas: 84 % people depended on their savings while 9 % borrowed to pay for medical expenditure.