ECONOMICS OF HEALTH AND HEALTHCARE

1. INTRODUCTION

Health Economics aims to understand the behavior of individual, healthcare

providers, public and government in decision making. It is used to promote healthy
lifestyle positive health outcome- Principal of healthcare economics are supply and
demand, distinction between need and demand, opportunity cost, margins,
efficiency and equity, production. - The study of distribution scare resources
commonly known as goods and services across a population to satisfy human wants
and needs for the care of sickness, promotion, and maintenance.

Historical Background - The Bhore Committee was set up by the Government

of India in 1943 to undertake a health survey by a development committee to assess
the health condition of India. Chaired by Sir Joseph William Bhore, the committee
consisted of pioneers in the healthcare field who met frequently for two years and
submitted their report in 1946. Then in India, the state governments shoulder the
major responsibility of providing health care. After independence, initially a model of
health care delivery based on Bhore Committee recommendations was adopted. It
gave a blueprint for development of a three-tier system of healthcare delivery, which
comprised primary, secondary and tertiary levels of healthcare. Healthcare is provided
by both public and private health care providers at these levels.

Table No: 1

Levels of Healthcare Healthcare providers

Primary Level Healthcare • Community health centers (CHCs)

• Primary health centers (PHCs)
• Sub-centers (SCs)

Secondary Level Healthcare • Sub-district hospitals

Tertiary Level Healthcare • District hospitals

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2. MARKET SIZE

Healthcare has become one of India’s largest sectors, both in terms of revenue and
employment. Healthcare comprises hospitals, medical devices, clinical trials,
outsourcing, telemedicine, medical tourism, health insurance, and medical equipment.
The Indian healthcare sector is growing at a brisk pace due to its strengthening
coverage, services, and increasing expenditure by public as well as private players.

India’s healthcare delivery system is categorized into two major components - public
and private. The government, i.e. public healthcare system, comprises limited
secondary and tertiary care institutions.

India's competitive advantage lies in its large pool of well-trained medical

professionals. India is also cost-competitive compared to its peers in Asia and western
countries. The cost of surgery in India is about one-tenth of that in the US or Western
Europe. The low cost of medical services has resulted in a rise in the country’s
medical tourism, attracting patients from across the world. Moreover, India has
emerged as a hub for R&D activities for international players due to its relatively low
cost of clinical research.

FINANCIAL FIGURES

The Indian healthcare sector is expected to record a three-fold rise, growing at a

CAGR of 22% between 2016–22 to reach US$ 372 billion in 2022 from US$ 110
billion in 2016. By FY22, Indian healthcare infrastructure is expected to reach US$
349.1 billion. In the Economic Survey of 2022, India’s public expenditure on
healthcare stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in
2019-20. In FY22, premiums underwritten by health insurance companies grew to
Rs.73,582.13. The health segment has a 33.33% share in the total gross written
premiums earned in the country. The Indian medical tourism market was valued at
US$ 2.89 billion in 2020 and is expected to reach US$13.42 billion by 2026.
According to India Tourism Statistics at a Glance 2020 report, close to 697,300
foreign tourists came for medical treatment in India in FY19. India has been ranked

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10th in the Medical Tourism Index (MTI) for 2020-21 out of 46 destinations by the
Medical Tourism Association.

The e-health market size is estimated to reach US$ 10.6 billion by 2025.As per
information provided to the Lok Sabha by the Minister of Health & Family Welfare,
Dr. Bharati Pravin Pawar, the doctor population ratio in the country is 1:854,
assuming 80% availability of 12.68 lakh registered allopathic doctors and 5.65 lakh
AYUSH doctors.

3. INVESTMENTS/ DEVELOPMENTS

Between April 2000 March 2022, FDI inflows for drugs and pharmaceuticals sector
stood at US$ 19.41 billion, according to the data released by Department for
Promotion of Industry and Internal Trade (DPIIT). FDI inflows in sectors such as
hospitals and diagnostic centers and medical and surgical appliances stood at US$
7.93 billion and US$ 2.41 billion, respectively.

Some of the recent developments in the Indian healthcare industry are as follows:

• As of August 23, 2022, more than 210.31 crore COVID-19 vaccine doses have
been administered across the country.
• As of August 8, 2022, India has exported 24.24 crore vaccine doses.
• In August 2022, Edelweiss General Insurance partnered with the Ministry of
Health, Government of India, to help Indians generate their Ayushman Bharat
Health Account (ABHA) number.
• The healthcare and pharmaceutical sector in India had M&A activity worth US$
4.32 billion in the first half of 2022.
• As of July 2022, the number medical colleges in India stood at 612.
• In July 2022, the Indian Council of Medical Research (ICMR) released standard
treatment guidelines for 51 common illnesses across 11 specialties to assist
doctors,
• In September 2021, Russian-made COVID-19 vaccine, Sputnik Light received
permission for Phase 3 trials in India.

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• In September 2021, Biocon Biologics Limited, a subsidiary of Biocon, announced

a strategic alliance with Serum Institute Life Sciences, a subsidiary of Serum
Institute of India (SII). The alliance is expected to strengthen India's position as a
global vaccine and biologics manufacturing powerhouse.

4. GOVERNMENT INITIATIVES

Some of the major initiatives taken by the Government of India to promote the Indian
healthcare industry are as follows:

1. In the Union Budget 2022-23:Rs. 86,200.65 crore (US$ 11.28 billion) was
allocated to the Ministry of Health and Family Welfare (MoHFW).

2. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) was allocated Rs. 10,000
crores (US$ 1.31 billion)

3. Human Resources for Health and Medical Education was allotted Rs. 7,500 crores
(US$ 982.91 million).

4. National Health Mission was allotted Rs. 37,000 crore (US$ 4.84 billion).

5. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was allotted
Rs. 6,412 crore (US$ 840.32 million).

6. The Government of India approved continuation of ‘National Health Mission’ with

a budget of Rs. 37,000 crore (US$ 4.85 billion).Rs. 5,156 crore (US$ 675.72 million)
was allocated to the newly announced PM-ABHIM to strengthen India’s health
infrastructure and improve the country’s primary, secondary and tertiary care services.

7. In July 2022, the World Bank approved a US$ 1 billion loan towards India's
Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission and technology
development in the health sector, with the aim of improving public health status of the
population of both countries.

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Government Initiatives to Promote Indian Healthcare Industry

Healthcare is one of the major sectors in the country both in terms of revenue and
employment. The major initiatives taken by Government in this regard and
Government’s plan to release additional resources for public health sector enabling it
to get ready for future are as under:

1. Emergency Response and Health Systems Preparedness Package

“Public Health and Hospitals” being a state subject, the primary responsibility of
strengthening public healthcare system lies with the respective State Governments.
However, under National Health Mission (NHM), technical and financial support is
provided to the States/UTs to strengthen the public healthcare system at public
healthcare facilities.

Further, all the States/UTs are provided with necessary financial support under India
COVID-19 Emergency Response and Health System Preparedness Package. Under
the India COVID-19 Emergency Response and Health Systems Preparedness Package
(COVID Package), States/UTs have been provided financial support, besides the
supply of essential materials such as PPEs, N95 masks, ventilators, etc from the
Ministry of Health and Family Welfare (MoHFW).

A Scheme on “India Covid-19 Emergency Response and Health Systems

Preparedness Package - Phase-II” (ECRP-Phase-II) during 2021-22 has been
approved by the Cabinet on 8.07.2021 for an amount of Rs.23,123 crores, to be
implemented in 9 months from 1st July, 2021 to 31st March, 2022. The Scheme is
aimed to prevent, detect and respond to the continuing threat posed by COVID-19 and
strengthen national health systems for preparedness in India. The scheme is a
Centrally Sponsored Scheme (CSS) with some Central Sector (CS) components.

Under CSS components of ECRP-II, support is provided to the States for provision
for establishing District Pediatric Units (42 or 32 bedded units including Oxygen
Supported beds and ICU beds) in all the Districts of the Country. Besides, support is
also provided to increase the availability of ICU beds in Medical Colleges, District

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Hospitals, Sub District Hospitals and Community Health Centres. Further, taking into
consideration, the recommendations of Empowered Group -1, support is extendedto
create pre-fabricated structures for establishing 6 bedded units at Sub Health Centres
and Primary Health Centres and 20 bedded units at Community Health Centres for
meeting the requirement of hospital beds in rural, peri-urban and tribal areas. Besides,
support is provided to prove vision of required drugs and diagnosticsfor COVID
management, including maintaining a buffer stock for essential medicines required
for effective COVID-19 management. Further, support is extended to establish Field
Hospitals (100-bedded or 50-bedded units) wherever required.

Further, the ECRP-II has also a CS component of Central Procurement of essential

medicines (including the emerging drugs, based on the needs) for effective
management of COVID-19

Also, to fast-track the availability of Medical Oxygen in rural and peri-urban areas, it
is planned to provide 1 lakh Oxygen Concentrators to the CHCs, PHCs, and SHCs
including HWCs in the country so as to bring medical management closer to people
and ensure the availability of critical resource of Oxygen closer to the public. This
support is over and above the routine oxygen support available at such facilities
through other sources (like state governments, NHM, ECRP, etc.).

Accordingly, so far, more than 18,000 Oxygen Concentrators have been allocated to
various States. All these interventions will lead to the promotion of the healthcare
industry, as a whole, and increase the employment opportunities.

2. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)

Launched on 23rd September 2018, Ayushman Bharat PM-JAY is the largest

Government funded health assurance/insurance scheme in the world. PM-JAY is a
centrally sponsored scheme. It is entirely funded by Government and the funding is
shared between Centre and States as per prevailing guidelines of Ministry of Finance.
PM-JAY is an entitlement-based scheme. The households included are based on the
deprivation and occupational criteria of Socio-Economic Caste Census 2011(SECC
2011) for rural and urban areas respectively. Over 10.74 crore poor and vulnerable

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entitled families (approximately 50 crore beneficiaries) are eligible for these benefits.
However, the beneficiary base under the scheme has been expanded bythe 33
States/UTs implementing AB PM-JAY. In case of expansion of beneficiary base
beyond eligible SECC families, States have to bear the financial burden
corresponding to additional families.

PM- JAY has been designed to provide financial risk protection against catastrophic
health expenditure that impoverishes an estimated 6 crore people every year. It
provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care
hospitalization across public and private empanelled hospitals in India. PM-JAY
provides cashless access to health care services for the beneficiary at the point of
service, that is, the hospital.

Current Implementation status of PM-JAY

As on 15th July 2021, the progress under AB PM-JAY since inception is as follows.
Table No: 2

SERIAL PARAMETER ACHIEVEMENT

NUMBER

1) States/UTs implementing AB PM-JAY 33 STATES

2) Beneficiary cards issued 16.09 CRORES

3) Count of authorized hospital admissions 1.94 CRORES

3. Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)

PMSSY Scheme Announced in 2003 and Launched in 2006

Objective -to correct regional imbalances in the availability of tertiary healthcare

services and to augment facilities for quality medical education in the country. It has
two components:-

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A. Setting up of new AIIMS like institutes

B. Upgradation of existing Govt. Medical Colleges (GMCs)

A. Setting up of new AIIMS :

1. 750/960 beds

2. 18/17Speciality/Super-Specialty departments

3. 100 MBBS/ 60 Nursing seats

4. Focus on PG Education

B. Upgradation of GMCs: -

1. Creation of Super-Specialty departments – ranging from 8 to 10

2. Additional 150-200 beds

3. Around 15 new PG seats

4. Average cost: Rs. 200 crore - shared 60:40 between Centre and States (90:10 in
case of NE and hilly states)

5. HR and running cost to be provided by the State Govt.

Pradhan Mantri Swasthya Suraksha Yojana – Progress

1. Setting up of 22 new AIIMS and upgradation of 75 GMCs sanctioned so far.

2. Six AIIMS out of the sanctioned AIIMS are functional and upgradation of 50
GMCs completed

3. .9 more AIIMS to be made functional by August, 2022 (cumulative 6+9 = 15 new

AIIMS)

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Pradhan Mantri Swasthya Suraksha Yojana - 6 functional AIIMS

1) All 6 AIIMS of phase I are functional – Bhopal, Bhubaneswar, Jodhpur, Patna,

Raipurand Rishikesh

2) Envisaged bed strength i.e., 5,760 (960*6) fully functional

Dedicated COVID facilities operational in all
Pradhan Mantri Swasthya Suraksha Yojana – Status of remaining 16 AIIMS

A. MBBS classes & OPD started in 7 AIIMS:

a. Raebareli, Uttar Pradesh, Mangalagiri, Andhra Pradesh, Nagpur, Maharashtra,
Kalyani, West Bengal, Gorakhpur, Uttar Pradesh, Bathinda, Punjab,
Bibinagar, Telangana.
B. Only MBBS classes started in 5 AIIMS: (Guwahati, Assam, Bilaspur, Himachal
Pradesh, Deoghar, Jharkhand, Samba, Jammu and Rajkot, Gujarat –all from
temporary campus, except at AIIMS, Bilaspur)

4. Medical Education

• There are three Centrally Sponsored Schemes under Medical Education, namely.
• Establishment of new Medical Colleges attached with existing district/referral
hospitals.
• Upgradation of existing State Government/Central Government medical colleges
to increase MBBS seats in the country.
• Strengthening and upgradation of State Government Medical colleges for starting
new PG disciplines and increasing PG seats.

5. Efforts of Ministry of AYUSH

The rapid growth of the AYUSH Sector, scientific cultivation of medicinal plants,
expansion of AYUSH Education and health infrastructure, Skill upgradation and
global acceptance of Yoga and Ayurveda have opened up new opportunities for
revenue and employment. As estimated by IMARC (2021), the Ayurveda market is
expected to grow by around 15 per cent during 2020-2025. The initiatives taken by
the Ministry of AYUSH to promote AYUSH systems of medicine and for
combating the challenges of COVID-19 are as under:

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• The Ministry of AYUSH is implementing a Centrally Sponsored Scheme of National

AYUSH Mission to provide cost-effective AYUSH Services by upgrading AYUSH
Hospitals, Dispensaries and AYUSH educational institutions, setting upnew AYUSH
hospitals and teaching institutions and also operationalization of 12,500 AYUSH
Health & Wellness Centers.
• The Government of India has approved the continuation of Centrally Sponsored
Scheme of National AYUSH Mission (NAM) from 01-04-2021 to 31-03-2026 with a
financial implication of Rs 4607.30 Crore (Rs 3000.00 Crore as Central Share and Rs
1607.30 Crore as State Share).

Objectives of Ministry of AYUSH :-

• To encourage private investors to invest in the AYUSH sector through the

Establishment of World Class, State of the Art Super Specialty Hospitals/Day
Care Centers.
• To develop AYUSH specific skilled human resources.
• To promote Export of Services
• Digitization of data.
• Financial outlay
• The total financial outlay is Rs 769 crore for five years
• Rs.514 crore for central sector scheme for the establishment of AYUSH Super
Specialty hospitals/ day care centres
• Rs. 155 crores For Central Sector scheme for Skill Development.
• Rs. 100 crores For Central sector scheme for the establishment of AYUSH Grid.
A mega digital platform for connecting all AYUSH related institutions/ hospitals
to generate various types of data for the requirement of Information gathering,
sharing and further processes.
• To support the industries and healthcare systems of India, under Drug Policy
Section, Ministry of AYUSH the central sector scheme for augmenting the quality
of AYUSH drugs’ is being implemented with following objectives.
• To strengthen regulatory frameworks at the Central and State levels for effective
quality control, safety monitoring and surveillance of misleading advertisements
of AYUSH drugs.

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• To encourage building up synergies, collaborations and convergent approaches for

promoting standards and quality of AYUSH drugs & materials.
• Ministry of Commerce and Industry approved for setting up an Export Promotion
Council (EPC) for AYUSH products.

5. PUBLIC EXPENDITURE ON HEALTHCARE

Public Expenditure data has been sourced from the State Budget documents,
Detailed Demand for Grants of MoHFW and other Central
Ministries/Departments. This document provides actual expenditure, Budget and
Revised Estimates (BE & RE) under the different schemes/programs in the
health sector. Budgetary accounting presents these data under different Heads-
Major, Sub-Major and Minor Heads representing functions, sub-functions and
the program. In the case of health expenditure, the relevant Major Heads are
2210 – Revenue Expenditure on Medical and Public Health, 2211 - Revenue
Expenditure on Family Welfare, 4210 - Capital Expenditure on Medical and
Public Health and 4211- Capital Expenditure on Family Welfare. For the
year 2015-16, Public Expenditure figures have been taken from the Demand for
Grants of 2017-18 for State and Central Ministries and these figures have been
validated with the figures provided in the respective Annual Financial

It also includes all other expenditure heads appearing under Ministry of Health
& Family Welfare, the Demand for Grants of Health and Family Welfare
departments of State Governments and the expenditure on medical
reimbursement or treatment of employees of the Central and State Governments.
Additionally for the Central Government, medical expenditure incurred by the
Ministries offense, Posts, Railways, Science & Technology, Mines and Labour &
Employment have been covered as these Ministries contribute a significant
proportion towards health spending.

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FIG-1 Component wise breakup of medical and public

health expenditure 2015-2016

Per Capita Public Expenditure on Health In States.

Table No:- 3

States 2006- 2007- 2008- 2009-

2007 2008 2009 2010

MajorStates

AndhraPradesh 74 96 95 100
Bihar 43 68 75 96
Gujarat 65 89 95 112
Haryana 42 33 44 80
Karnataka 49 70 92 110

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Kerala 44 90 95 81
Madhya pradesh 95 133 107 104
Maharashtra 23 76 81 100
Rajasthan 83 123 136 155
TamilNadu 72 85 97 108
UttarPradesh 61 72 89 108
WestBengal 51 58 69 80

Others

ArunachalPradesh 521 594 500 560

Assam 137 275 240 253
Chattisgarh 131 112 108 98
JammuKashmir 36 94 100 143
Jharkhand 80 65 98 57
Manipur 142 355 319 290
Meghalaya 155 168 186 306
Mizoram 613 844 644 663
NCTDelhi 34 50 59 58
Nagaland 439 403 386 422
Puducherry 69 225 57 150
Sikkim 210 328 903 600
Tripura 160 195 228 248
Uttarakhand 45 104 135 148

Per Capita Public Expenditure on Health in States (incurred by Central

Government),2006-07 to 2009-10 at current prices (Rs.)

These figures are from the years 2006-2010. The latest figures are not updated yet on
the official websites. The Indian healthcare sector is expected to record a three-fold
rise, growing at a CAGR of 22% between 2016–22 to reach US$ 372 billion in 2022
from US$ 110 billion in 2016.

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BREAKUP OF MEDICAL AND PUBLIC HEALTH OF 2021

FIG-2 WISE BREAKUP OF MEDICAL & PUBLIC COMPONENT

HEALTH OF 2021

6. WHO INITIATIVES IN HEALTHCARE SECTORS

1) Providing guidance to countries on institutionalizing Health Technology

Assessment

The WHO provides guidance to countries to institutionalize HTA mechanisms. In

response to World Health Assembly resolution WHA67.23, WHO is increasingly
supporting countries to develop HTA mechanisms to support decision-making. A
2021 report from WHO details in five chapters the “How To” steps needed for
institutionalizing HTA. These are:

• Establishing a Mandate
• Legal Considerations: Reviewing or Establishing the Legal Framework
• Establishing Institutional and Governance Arrangements
• Processes and Evidence Required for Assessment and Appraisal
• Monitoring and Evaluation

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HTA mechanisms across the globe include a range of functions, from horizon
scanning to scoping, topic selection, technology assessment and appraisal, supporting
decisions on coverage, to price negotiation, guideline development and setting quality
standards. A long-term strategy should be developed for the HTA mechanism to
encompass the increasing strength of the health system and the fiscal space available
for health, which may change the mandate of the HTA mechanism, and the
complexity of the methods used. WHO’s approach is to provide guidance for all
member states with various levels of capacity for HTA development and refinement.

2) Strengthening collaboration on Health Technology Assessment

WHO enables collaboration to share Health Technology Assessment information and

best practices. Such collaboration also supports capacity building for Health
Technology Assessment. WHO collaboration formats include:

• International HTA networks

• Regional HTA networks
• WHO collaborating centers
• Discussion groups

Regional HTA networks and international HTA networks foster knowledge on HTA
among national policymakers and other stakeholders. WHO collaborating centers
support activities in the field. They facilitate the exchange of methodologies and
information, build capacity and provide training and mentoring activities. WHO
coordinates and participates in HTA discussion groups. Such groups aim to
technically support Member States (MS) in the development of their own national
HTA programs, connect national and regional champions, and seek political and
financial commitments needed to establish/strengthen national HTA programs

3) Accelerating impact of innovations for health

“The scale-up of effective, quality health innovations require a better understandingof

barriers to implementation and uptake to reach the most vulnerable populations. It
also requires support in linking the health demand and supply of innovations in
countries. WHO will apply a new collaborative approach to scaling innovations in

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health (‘the WHO Innovation Scaling Framework’), aimed at linking the health
demand in countries with the supply of mature, assessed innovations.

WHO will also support research to address barriers to health impact, strengthen
primary health care systems, and innovate delivery of interventions to achieve
universal health coverage. WHO will also examine the ethical, social, and public
health aspects of emerging technologies.

4) Prioritizing medical devices

Medical devices are indispensable tools for quality health care delivery, but their
selection and appropriate use pose a significant challenge in many parts of the world.
Medical devices include from a syringe, catheters and surgical mask, to complex
devices like pacemakers and prothesis to magnetic resonance.

WHO global lists of priority medical devices help improve access to suitable medical
devices, increase safety, support quality of care and strengthen health care systems.
These lists facilitate decision-making for health professionals in the areas of health
policies, strategic planning, health technology assessment, resource allocation,
procurement, biomedical engineering, regulation and facility assessment. Under the
Priority Medical Device Project, WHO is continuously updating this list of priority
medical devices needed for the management of high-burden diseases, such as cancer
and COVID-19, and for specific populations such as older adults, pregnant women
and newborns. Key medical devices are identified in the lists based on their
appropriateness and use to prevent, diagnose or treat a disease. The lists are meant to
assist countries in developing or updating their national essential or priority lists, to
promote their availability to support universal health coverage. The lists should be
adapted to the countries.

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7. GLOBAL HEALTHCARE SYSTEM STATS

Health care is integral to a country’s well-being. Most high-income, developed

countries provide or mandate universal health coverage for its people. This usually
means that at least 99 percent of the population has health insurance, and some
countries provide it free at point-of-service with no co-payments, like the National
Health Service in the UK. Generally though, cost-sharing is a part of the coverage to
discourage unnecessary treatment and overuse of health care. Nevertheless, out-of-
pocket health spending is normally restricted, such as the 385 Euro (429 U.S. dollars)
deductible a year in the Netherlands. This is much less than the average deductible for
an employer-sponsored single coverage plan in the U.S., which was 1,670 U.S. dollars
as of 2021. That is what an average person must spend a year before their insurance
kicks in and that is on top of the high premium they paid for their health insurance. It
is no wonder the U.S. public believes the biggest problem the health care system in
the U.S. is facing is the cost of accessing treatment.

Health systems ranking

The latest health systems ranking produced by the Commonwealth Fund scored
Norway’s health system as number one overall out of eleven high-income countries. Second
and third places went to the Netherlands and Australia, while Switzerland, Canada,
and the United States took the last spots. In the previous ranking in 2017, the United
Kingdom was rated as number one, but has since dropped to fourth place. The ranking
is based on five performance categories including access to care, care procedure,
administrative efficiency, equity, and health outcomes. The United States was ranked
last in four of the five categories, except for care procedure. Here the U.S. performed
well on measures of preventive care, care safety, and coordinated care.

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(FIG -3 ) Health expenditure as a percentage of gross domestic product

(GDP) in selected countries in 2020

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8. SUMMARY & CONCLUSION

India’s healthcare sector is extremely diversified and is full of opportunities in every

segment, which includes providers, payers, and medical technology. With the increase
in the competition, businesses are looking to explore the latest dynamics and trends
which will have a positive impact on their business. The hospital industry in India is
forecast to increase to Rs. 8.6 trillion (US$ 132.84 billion) by FY22 from Rs. 4 trillion
(US$ 61.79 billion) in FY17 at a CAGR of 16–17%.

India is a land full of opportunities for players in the medical devices industry. The
country has also become one of the leading destinations for high-end diagnostic
services with tremendous capital investment for advanced diagnostic facilities, thus
catering to a greater proportion of the population. Besides, Indian medical service
consumers have become more conscious towards their healthcare upkeep. Rising
income levels, an ageing population, growing health awareness and a changing
attitude towards preventive healthcare is expected to boost healthcare services
demand in the future. Greater penetration of health insurance aided the rise in
healthcare spending, a trend likely to intensify in the coming decade.

The Government aims to develop India as a global healthcare hub, and is planning to
increase public health spending to 2.5% of the country's GDP by 2025.

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9. REFERENCES

1. Introduction regarding the financial figures (INDIAN BRNAD EQUITY

FOUNDATION) WEBSITE- www.ibef.org
2. World health organization international websites (WHO INITIATIVES)
WEBSITE-www.who.int

3. Varkey RS, Joy J, Panda PK (2020) Health infrastructure, health outcome and
economic growth: evidence from Indian major states. Journal of critical reviews
ISSN-2394-5125, Vol. 7, Issue 11.
4. GOVERNMENT INITIATIVES REGARDING HEALTHCARE WEBSITE-
pib.gov.in
5. Ansari, M. Athar. “Health care waste – A public health problems,” Yojana,
Vol.48, no.1, Jan.2004, pp.66-67
6. FINANCIAL FIGURES IN SELECTED COUNTRIES WEBSITE-

data.worldbank.org

7. Cohen D. Marginal analysis in practice: An alternative to needs assessment for

contracting health care. British Medical Journal 1994; 309: 781–784.

8. Ramesh Bhat and Nishant Jain, (2006). “Analysis of Public and Private
Healthcare Expenditures,” Economic and Political Weekly, vol. XLI, no.1, pp.
57-68.
9. Per Capita Public Expenditure on Health in States. WEBSITE-www.nipfp.org.in

10. HEALTH SECTOR FINANCING WEBSITE-https://main.mohfw.gov.in

11. Garg, C., and Karan, A. (2009). ‘Reducing out-of-pocket expenditures to reduce
poverty: a disaggregated analysis at rural-urban and state level in India’. Health
Policy and Planning, 24(2): 116– 128.

12. Health expenditure as a percentage of gross domestic product (GDP) in selected

countries in 2020WEBSITE-Statista.com/statistics/268826/health-expenditure-as-
gdp-percentage-in-oecd-countries/

13. Berman, P (2010). ‘The Impoverishing effects of health Care payments in India:
New methodology and findings’. Economic and Political weekly 27(16): 65-71.

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14. Ministry of Health & Family Welfare, Gol (1991).

15. O’Donnell, O., van Doorslaer, E., et al. (2007). ‘The incidence of public spending
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