Government health spending at 1.4% of GDP, 80% shortfall in rural specialist doctors

Who it concerns: Ministry of Health and Family Welfare; the general public, particularly those in rural areas, patients relying on private healthcare, and beneficiaries of government health schemes like AB-PMJAY.

What the committee found

• Committee flagged that government health expenditure of 1.4% of GDP is inadequate compared to the 2.5% target set by the National Health Policy, 2017, and recommended a time-bound roadmap to reach 2.5% and then 5% over five years.
• Committee noted that 30% of the demographic lacks structured financial health protection and recommended introducing a voluntary contributory insurance model for them.
• Committee recommended expanding Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) coverage to include outpatient consultations, diagnostic tests, and medicines, and increasing the annual family coverage limit from Rs 5 lakh to Rs 10 lakh.
• Committee recommended establishing Jan Aushadhi Kendras (government-run generic medicine pharmacies) in all district hospitals, community health centres, and private hospitals under government schemes, and enforcing price controls on life-saving and over-the-counter drugs.
• Committee identified an imbalance in health allocations (51% to primary care vs. 28% secondary and 11% tertiary) and low public sector bed density (0.79 per 1,000 population), recommending expanded capital investment and a dedicated Healthcare Capital Expenditure Fund.
• Committee flagged over-commercialization and excessive billing in the private sector, recommending a legally binding framework to standardize rates for common procedures, essential treatments, and diagnostic tests, and mandating nationwide adoption of the Clinical Establishments Act, 2010.
• Committee noted an 80% shortfall of specialist physicians in rural community health centres despite a 151% increase in MBBS seats, and recommended a geographically responsive deployment policy and state-level Health Recruitment Boards.
• Committee identified gaps in neonatal and senior citizen care, recommending national policies for senior care, extending AB-PMJAY to all children under five, and mandating local governments to allocate a fixed budget percentage for senior citizen care.

Also in the document

• Government health expenditure is currently at 1.4% of GDP, significantly lower than the 2.5% target set by the National Health Policy, 2017.
• Outpatient costs are estimated to be five times higher in private facilities than in public facilities.
• There is an 80% shortfall of specialist physicians in rural community health centres.
• Pharmaceutical expenditure accounts for nearly 30% of India’s current health expenditure.