Paying for treatment out of your own pocket has long been the biggest worry for Indian families when someone falls ill. Fresh government data released today shows that burden is finally easing. The National Health Accounts Estimates for India 2023-24, released by the Union Ministry of Health and Family Welfare on Sunday, say government health spending has tripled in a decade, while the share of total health spending that households pay directly has fallen to 42.7 per cent, the lowest in the series.
For families, the numbers tell a simple story. In 2013-14, nearly two out of every three rupees spent on healthcare in India came straight from a patient’s pocket. Ten years later, that share is down to about 43 in every 100 rupees. The shift did not happen overnight, but the latest figures confirm the trend is holding, and even improving, year after year.
Government spending triples in a decade
Government health expenditure rose from about Rs 1.30 lakh crore in 2013-14 to Rs 4.14 lakh crore in 2023-24, a threefold increase. Per person, government spending on health climbed from Rs 1,042 to Rs 2,959 over the same period, an increase of nearly 2.8 times. The government’s share in total health expenditure rose by 14.9 percentage points across the decade.
Primary healthcare got a large part of that money. Government spending on primary care reached about Rs 1.53 lakh crore in 2023-24, reflecting the expansion of Ayushman Arogya Mandirs, the community health centres that now deliver everyday care closer to home.
Out-of-pocket share down 21.5 points
The headline finding of the report is the fall in out-of-pocket expenditure, the money families pay directly for treatment, medicines and tests. As a share of total health expenditure, it dropped from 64.2 per cent in 2013-14 to 42.7 per cent in 2023-24, a fall of 21.5 percentage points.
The improvement continued in the most recent year too. The out-of-pocket share eased from 43.4 per cent in 2022-23 to 42.7 per cent in 2023-24, showing the decline is not a one-off but a steady trend.
- 2013-14: Out-of-pocket spending was 64.2 per cent of total health spending
- 2022-23: The share had fallen to 43.4 per cent
- 2023-24: It now stands at 42.7 per cent, down 21.5 points in a decade
- Government spending: Up from Rs 1.30 lakh crore to Rs 4.14 lakh crore
- Per person: Government health spending rose from Rs 1,042 to Rs 2,959
Insurance and social security cover more of the bill
Social security spending on health, which includes schemes such as Ayushman Bharat PM-JAY, rose from 6 per cent to 11 per cent of total health expenditure over the decade. That means more treatment is now paid for through pooled schemes rather than by families at the hospital counter.
The ministry said the estimates point to a significant transformation in how healthcare is financed in India. A decade ago, a hospital admission could wipe out a family’s savings. Today, a larger share of the bill is picked up by the government or by insurance and social security schemes.
What the numbers still leave out
The report is about how healthcare is paid for, not about how good the care is. A lower out-of-pocket share is good news, but 42.7 per cent still means families pay more than two-fifths of the country’s health bill directly. For poor households, even a smaller share can mean borrowing or selling assets when a serious illness strikes.
Experts also point out that the data covers 2023-24, so it reflects the system as it was two years ago. The real test is whether the trend continues in the years ahead, and whether the extra government money reaches the clinics and hospitals where people actually go for treatment.
How the estimates are made
The National Health Accounts Estimates for India 2023-24 are the eleventh round of estimates prepared by the National Health Accounts Technical Secretariat at the National Health Systems Resource Centre, under the Ministry of Health and Family Welfare. They follow the internationally recognised System of Health Accounts 2011 framework, which tracks how money flows through a country’s health system, from governments and insurers to households and hospitals.
For now, the message for families is clear. The state is paying a bigger share of India’s health bill than it did ten years ago, and the amount households must find from their own pockets is shrinking. The next round of data will show whether that progress holds.
FAQs
What are the National Health Accounts?
They are official estimates that track how money flows through India’s health system, showing who pays for healthcare: the government, insurers, or households themselves.
How much has government health spending risen?
Government health expenditure rose from about Rs 1.30 lakh crore in 2013-14 to Rs 4.14 lakh crore in 2023-24, roughly a threefold increase.
What is out-of-pocket expenditure?
It is the money families pay directly for treatment, medicines and tests, at the time of care, without reimbursement from the government or an insurer.
How far has the out-of-pocket share fallen?
From 64.2 per cent of total health spending in 2013-14 to 42.7 per cent in 2023-24, a drop of 21.5 percentage points.
What role does Ayushman Bharat play?
Social security spending on health, which includes Ayushman Bharat PM-JAY, rose from 6 per cent to 11 per cent of total health expenditure over the decade.
Source: National Health Accounts Estimates for India 2023-24, Union Ministry of Health and Family Welfare, released 15 November 2026.
