India's Government Health Expenditure as a share of GDP remains below the National Health Policy 2017 target despite a threefold nominal rise. Critically examine the reasons and suggest measures for achieving Universal Health Coverage.

Q. India's Government Health Expenditure as a share of GDP remains below the National Health Policy 2017 target despite a threefold nominal rise. Critically examine the reasons and suggest measures for achieving Universal Health Coverage. (15 marks, 250 words)

The National Health Accounts (NHA) Estimates 2022-23 show Government Health Expenditure (GHE) tripling to ₹3.85 lakh crore, yet its GDP share stands at just 1.43%, well short of the National Health Policy (NHP) 2017 target of 2.5% by 2025 — exposing a gap between nominal fiscal effort and structural adequacy [1].

Reasons the GDP target remains unmet - Denominator effect: nominal GHE tripled, but rapid GDP growth over the decade muted the ratio's rise (1.15% → 1.43%) [1]. - Federal fragmentation: health is a State subject; uneven state fiscal capacity limits aggregate GHE despite central schemes. - Low base and competing priorities: GHE forms only 4.89% of General Government Expenditure, crowded out by other demands [1]. - Absorption gaps: weak utilisation and infrastructure deficits blunt spending impact.

Signs of progress toward UHC - OOPE fell sharply from 64.2% to 43.4% of Total Health Expenditure, cutting catastrophic-spending risk [1]. - Social Security Expenditure rose 6% → 9.9%, driven by AB-PMJAY [1]. - Primary healthcare spending doubled to ₹1.4 lakh crore via Health & Wellness Centres [1].

Measures for UHC - Front-load public spending toward the 2.5% goal through higher state allocations. - Deepen primary care and Health & Wellness Centres to pre-empt costly hospitalisation. - Expand PMJAY coverage; strengthen human resources and diagnostics. - Adopt 15th Finance Commission grants to correct inter-state disparities.

Falling OOPE and rising public financing signal a maturing system; sustained, equitable investment aligned with SDG-3 can convert nominal gains into genuine Universal Health Coverage.

(~248 words)

Sources: 1. Union Health Ministry Releases the National Health Accounts Estimates for India 2022-23 (PIB, 27 May 2026) — GHE tripling to ₹3.85 lakh crore, GHE/GDP 1.15%→1.43%, GHE 4.89% of GGE, OOPE 64.2%→43.4%, SSE 6%→9.9%, primary healthcare spending doubling to ₹1.4 lakh crore.