UPSC Prelims Practice Questions — Government Health Spending Triples, Households' Out-of-Pocket Expenditure Share Falls Sharply: National Health Accounts 2023–24

Q1. With reference to the classification of household health spending in India's National Health Accounts, consider the following statements: Which of the statements given above is/are NOT correct?

  1. A payment made by a household at a private pharmacy for medicines, not reimbursed by any scheme, is counted as out-of-pocket expenditure.
  2. The premium a household pays to buy a voluntary private health insurance policy is counted as out-of-pocket expenditure.
  3. A hospital bill that a government employee pays first and later gets reimbursed in full by the employer is counted as out-of-pocket expenditure.
  • A. 1 only
  • B. 1 and 3 only
  • C. 1, 2 and 3
  • D. 2 and 3 only

Q2. Consider the following statements: Which of the following is correct in respect of the above statements?

  1. A fall in the share of out-of-pocket expenditure in total health expenditure is treated as progress towards Universal Health Coverage.
  2. Out-of-pocket payments are not pooled, so a household meets the full cost of illness when it occurs, which raises its risk of catastrophic or impoverishing spending.
  • A. Both Statement-I and Statement-II are correct and Statement-II explains Statement-I
  • B. Both Statement-I and Statement-II are correct, but Statement-II does not explain Statement-I
  • C. Statement-I is correct, but Statement-II is incorrect
  • D. Statement-I is incorrect, but Statement-II is correct

Q3. Consider the following statements: Which of the following is correct in respect of the above statements?

  1. In India's National Health Accounts, premiums that households pay voluntarily for private health insurance are counted under Social Security Expenditure on health.
  2. Social Security Expenditure on health includes government-funded health insurance schemes and medical reimbursement to government employees.
  • A. Both Statement-I and Statement-II are correct and Statement-II explains Statement-I
  • B. Both Statement-I and Statement-II are correct, but Statement-II does not explain Statement-I
  • C. Statement-I is correct, but Statement-II is incorrect
  • D. Statement-I is incorrect, but Statement-II is correct

Q4. With reference to the System of Health Accounts 2011 (SHA 2011), which India's National Health Accounts follow, consider the following statements: Which of the statements given above is/are correct?

  1. It is an internationally harmonised framework, which makes health spending comparable across countries.
  2. Country data compiled under it feed the World Health Organization's Global Health Expenditure Database.
  3. It tracks health spending only by the provider delivering care, without recording who finances that care.
  • A. 2 and 3 only
  • B. 1, 2 and 3
  • C. 1 and 2 only
  • D. 1 only

Q5. In a country's health accounts, the share of a financing source in total health expenditure rises from 20% in one year to 30% a few years later. Which of the following correctly describes this change?

  • A. A rise of 10 per cent, which is a 50 percentage point relative increase
  • B. A rise of 10 percentage points, which is a 50 per cent relative increase
  • C. A rise of 50 percentage points, which is a 10 per cent relative increase
  • D. A rise of 10 percentage points, which is a 10 per cent relative increase

Q6. With reference to Total Health Expenditure (THE) and Current Health Expenditure (CHE) as denominators in health financing indicators, consider the following statements: Which of the statements given above is/are correct?

  1. Because both rest on SHA 2011, an out-of-pocket share computed against THE can be compared directly with WHO's out-of-pocket share computed against CHE.
  2. Current Health Expenditure covers only recurrent spending and leaves out capital investment such as building hospitals.
  3. For a given year, out-of-pocket spending expressed as a share of CHE cannot be lower than the same spending expressed as a share of THE.
  • A. 2 and 3 only
  • B. 1 only
  • C. 1 and 2 only
  • D. 1, 2 and 3

Q7. With reference to the constitutional and fiscal basis of public health spending in India, consider the following statements: Which of the statements given above is/are correct?

  1. Public health and sanitation, along with hospitals and dispensaries, is a subject in the State List of the Seventh Schedule.
  2. Government Health Expenditure reported in the National Health Accounts combines health spending by the Union and the State governments.
  3. Where two or more State Legislatures pass resolutions seeking it, Parliament may legislate on a State List subject such as public health for those States.
  • A. 2 and 3 only
  • B. 1 only
  • C. 1 and 2 only
  • D. 1, 2 and 3

Q8. Consider the following assertion: Expanding primary healthcare and providing free or low-cost essential medicines can reduce households' out-of-pocket health expenditure. Which of the following statements support/supports the above assertion?

  1. Medicines and inpatient care are among the largest components of household out-of-pocket health spending.
  2. Government spending on primary healthcare is classified as Social Security Expenditure on health in the National Health Accounts.
  3. Early detection and management of conditions at community level can avert some costly hospitalisations.
  4. Free drugs at public facilities can substitute for medicines that households would otherwise buy at private pharmacies.
  • A. 1, 3 and 4 only
  • B. 1, 2, 3 and 4
  • C. 2, 3 and 4 only
  • D. 1 and 3 only