Daily News Analysis ‘Out-of-Pocket Expenditure (OOPE) on Health in India’ : 18 September

Meaning of OOPE:

• Out-of-Pocket Expenditure (OOPE) means the money that people pay directly from their own pockets for health care.
• It includes payments for doctor fees, medicines, hospital charges, tests, and transport.
• It does not include costs paid by the government or insurance.

OOPE in India:

• In India, households mainly pay for health care through OOPE.
• Families often use savings, sell assets, or borrow money when someone falls ill.
• The poor are forced to skip care or face deeper poverty.
• This creates a cycle of ill-health and poverty.

NHA Estimates:

• The National Health Accounts (NHA) track health spending by households, government, and others.
• NHA 2017-18 reported OOPE fell from 64% in 2013-14 to 49% in 2017-18.
• NHA 2021-22 shows OOPE further down to 39% of total health spending.

Concerns Raised:

• The decline may reflect less reporting of illness and hospital use, not cheaper health care.
• The Consumer Expenditure Survey (2022-23) shows OOPE share in household budgets rising (rural 5.5% → 5.9%, urban 6.9% → 7.1%).
• This suggests that healthcare is becoming more expensive, not cheaper.

Why in News?

• Recent analyses have questioned the official decline in OOPE reported by NHA, pointing out gaps in data coverage and the non-reflection of COVID-19 costs.