Feeble growth in Maharashtra healthcare spend

MUMBAI: The share of Gross State Domestic Product (GSDP) allocated by Maharashtra government to healthcare has grown only marginally over the past few years, underlining how political regimes have failed to make it a priority.
Data from the National Health Accounts (NHA) Estimates for India 2019-20 indicates Maharashtra's spending on healthcare was barely 0.8% of its GSDP, a slight increase from the previous four-year average of 0.7%.Data showed total healthcare expenditure was Rs 77,501 crore of which government's contribution was just 27% (Rs 20,606 crore).
The state has done poorly compared to the national average, which showed an upward trend in government expenditure as a proportion of total health expenditure—from 29% in 2014-2015 to 41.4% in 2019-20. The Centre is spending 1.35% of the GDP on health.
According to Soumitra Ghosh from the School of Health Systems Studies at TISS, allocating at least 2.5% of GSDP to healthcare would be ideal as per the National Health Policy. However, states fail to even allocate 1% of their GDP to healthcare. "When governments neglect investments in healthcare, it is the people who suffer the most. They either cannot access healthcare at all or drop midway."
The data shows that bigger states like Tamil Nadu, Karnataka, Andhra Pradesh, and Gujarat are all spending in the range of 0.8-0.9% of their GDP on health, whereas smaller ones like Goa, Himachal Pradesh, Chhattisgarh, Sikkim have managed to take it to around 1.2-1.4%. Northeastern states Mizoram and Arunachal Pradesh spend the most, almost 3.4% of their GSDP in health. Dr Abhay Shukla of the public health movement Jan Arogya Abhiyan said despite being ranked seventh on per capita income among states, Maharashtra is at the bottom in terms of state spending on healthcare. "Hence, the high degree of privatisation and out-of-pocket expenses remain,” he said.
As per the NHA report, the state spent Rs 1,675 per capita on healthcare in 2019-20, only a slight increase from the Rs 1,120 spent in 2015-2016. By comparison, Himachal Pradesh spent Rs 3,829, Kerala Rs 2,590, Uttarakhand Rs 2,273 and Tamil Nadu Rs 2039. Bihar and UP were among the poorest spenders, allocating Rs 701 and 951 per capita.
Dr Shukla said the trend could show significant changes following onset of the pandemic. However, much of the spending would have been emergency-based and whether it translates into long-term shifts in expenditure patterns remained to be seen, he said.
The only positive development in the NHA was that out-of-pocket (OOP) expenditure for healthcare appeared to have declined from 58.9% in 2015-16 to 44.1% in 2019-20. Nationally too, there’s been a steady decline in OOP expenditure as a percentage of total health expenditure from 62.6% in 2014-15 to 47.1% in 2019-20.