In India, there are an estimated 1.5 million hospital beds and nearly half a million large and small health facilities. However, there are imbalances in distribution: an estimated 80 per cent of hospital beds and health care providers are in urban areas; the public sector provides an estimated 20 per cent of outpatient and 40 per cent of hospitalization services; and the private sector has nearly two-thirds of all functional hospital beds and around 85-90 per cent of qualified allopathic physicians.
Although all types of health services are to be provided by the public health sector in India, there is an inadequate mix of promotive, preventive, diagnostic, curative and rehabilitative services. In the absence of sufficient resources, the actual availability of services in the public sector is sub-optimal. The private sector largely focuses on diagnostic and curative services. Moreover, those seeking care often have to go to different facilities to access a range of services required.
Despite being the largest supplier of generic medicines and vaccines globally, access to essential medicines is still elusive to a large segment of the Indian population. Recently, the Government of India has brought 348 drugs in the National List of Essential Medicines using the Drug Price Control Order, 2013 thereby fixing the ceiling price of essential medicines. Despite some decline in out of pocket spending since the launch of the National Rural Health Mission, 60 per cent of total healthcare expenditure, most of which is spent on medicines, is still borne by people out of pocket, one of the highest in the world.
India spends 3.9 per cent of its GDP on health. This is equivalent to per capita health expenditure of US $59 of which only $18.3 (31 per cent) comes from government sources. The global average of per capita health expenditure is $962 which ranges from $14 in Eritrea to $8,987 in Norway. The low government financing of health pushes the costs to its citizens forcing them to meet healthcare costs out of their pockets (OOP). According to estimates, 39 million people fall below the poverty line every year due to catastrophic healthcare expenditure.