Background and Context
The National Health Accounts (NHA) are the account of the total spending on health in the country: how much the government spends, how much families spend from their own pockets, how much from insurance. This account is built on the international framework "System of Health Accounts 2011". "Out-of-pocket expenditure" (OOPE) is what a patient pays directly at the time of treatment; the higher it is, the greater the economic burden on families and the risk of falling into poverty because of treatment is considered to be.
Why in the News
According to PIB, the Union Health Ministry released the NHA estimates 2022-23 for India on 27 May 2026. This is the tenth report of the National Health Accounts Technical Secretariat (NHATS), National Health Systems Resource Centre (NHSRC).
Key Facts and Figures
| Report | NHA estimates 2022-23, tenth report; NHATS, NHSRC, Health Ministry; framework: SHA 2011; PIB, 27 May 2026 |
|---|---|
| Government health expenditure (GHE) | Total amount rose from ₹1.30 lakh crore in 2013-14 to ₹3.85 lakh crore in 2022-23 ("threefold" in PIB's headline). |
| Share in GDP | GHE's share in GDP from 1.15% (2013-14) to 1.43% (2022-23); 1.48% as per the new GDP series of base year 2022-23. |
| Share in general government expenditure | GHE's share in general government expenditure from 3.78% to 4.89%. |
| Per person | GHE per person from ₹1,042 to ₹2,786, that is about 2.7 times. |
| Shares in total health expenditure | GHE's share from 28.6% to 43.7%; the share of out-of-pocket spending (OOPE) from 64.2% to 43.4%; social security expenditure (including Ayushman Bharat PM-JAY, reimbursement of government employees and social health insurance) from 6% to 9.9%; private health insurance from 3.4% to 9.2%. |
| Primary health care | The government's spending on primary health care from about ₹0.5 lakh crore in 2013-14 to ₹1.4 lakh crore in 2022-23, that is more than double. |
| The COVID period | According to PIB, in 2021-22 GHE rose to 1.84% of GDP and the share of out-of-pocket spending that year stayed at 39.4%. PIB links this to the one-off higher spending on COVID management. |
How to Read the Figures
Share versus amount: the share of out-of-pocket spending falling does not say that families paid fewer rupees. If total health expenditure has grown, the amount can rise even as the share falls. PIB has not given the amount of out-of-pocket spending, so we give no conclusion about it.
The effect of COVID: in 2021-22 government expenditure rose unusually and the share of out-of-pocket spending fell to 39.4%; in 2022-23 it is at 43.4%. That is, the 2022-23 figure is of the year after COVID's unusual year, and PIB's statement comparing from 2013-14 should also be read with this eye.
The role of insurance: social security expenditure includes government insurance (such as PM-JAY), whose share went from 6% to 9.9%. The share of private insurance went from 3.4% to 9.2%. The two together appear to raise insurance-based financing.
Why This Topic Matters
Universal health coverage: the share of out-of-pocket spending falling is an indicator in the direction of the goal of universal health coverage. PIB describes this as the "right direction"; that is the government's assessment.
The largest share is still from private pockets: in PIB's figures, the share of out-of-pocket spending is 43.4%, which is roughly equal to the share of government expenditure (43.7%). That is, despite the fall, it remains a large source of health financing. This is our reading from the figures.
Points of Debate and Cautions
An old year: this estimate is of the financial year 2022-23 and was released in May 2026. It does not have the position of the years after it. On 18 October 2026, 2022-23 appears as the newest report in NHSRC's NHA list.
The tone of a government release: the PIB release is in the tone of achievement. We have not opened the original NHA report; all figures are in quoted form from PIB.
Sources and limits: we read the PIB release (https://www.pib.gov.in/PressReleasePage.aspx?lang=1&PRID=2265816®=3) and saw NHSRC's report list (https://nhsrcindia.org/national-health-accounts-records). The report's full text, state-wise figures and the amount of out-of-pocket spending we have not seen.
Difference from a prior article: we found no article on pcsmantra.com on National Health Accounts (searches: "National Health Accounts" in Hindi and in English).
Way Forward
Read this article's figures as of the 2022-23 year and the position of the release of 27 May 2026. The picture can change when the next NHA report comes.
Difference in Concepts
Keep four things separate: (1) figures quoted in PIB; (2) PIB's assessment ("right direction"); (3) the effect of COVID's unusual year; and (4) our interpretations.
Mains Perspective
GS-II: health and social-sector policies; GS-III: public finance. In the answer, write the difference between share (%) and amount clearly.
Answer Outline: introduction: NHA and OOPE; the rise in government expenditure; the falling share of out-of-pocket spending; the role of insurance; the context of the COVID year; limitations; conclusion.
Sources
- PIB, the Health Ministry released NHA estimates 2022-23 (27 May 2026)
- NHSRC, National Health Accounts report list (viewed on 18 October 2026)
The figures are from the PIB release; NHSRC's list was viewed only to check the newest report's status.
Remember: according to PIB, in NHA 2022-23 government health expenditure stayed at 1.43% of GDP, its share in total health expenditure went from 28.6% to 43.7% and the share of out-of-pocket spending from 64.2% to 43.4%. These are shares (%); the release says nothing about the amount of out-of-pocket spending.
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