Health Care Spending
Health is a State subject under the Indian Constitution, making States/UTs primarily responsible for healthcare expenditure.
Growth in Healthcare Spending
- States/UTs : Healthcare allocation rose from ₹2.3 lakh crore (2019-20) to ₹5 lakh crore (2024-25), with a CAGR of 16.8% .
- Central Government : Allocation grew from ₹62,397 crore to ₹87,656 crore, with a CAGR of 7% .
- State share in total healthcare expenditure increased from 79% (2019-20) to 85.2% (2024-25) .

State-wise Variations
- High spenders (2023-24) : Bihar (3.4% of GSDP), Odisha (3%), Chhattisgarh (3%).
- Low spenders : Tamil Nadu, Karnataka, Punjab (0.9% of GSDP).
- FY25 allocations:
- Increased : Odisha (+26%), Karnataka (+19.3%), Rajasthan (+17.3%).
- Decreased : Bihar (-37.4%), Maharashtra (-26.2%), Uttarakhand (-15.3%).
Challenges Highlighted
- Inadequate health security despite rising expenditure due to:
- Low public health spending (24.66% of total healthcare expenditure).
- High out-of-pocket expenditure and rising costs.
- Political dynamics : Populist schemes and freebies divert funds from healthcare in some States.

Global Health Journal Findings
- India’s government healthcare spending is lower than countries with similar per capita GDP.
- Administrative and political factors hinder effective health financing.

Practice Questions for Mains
- Q: Evaluate the role of political and administrative structures in shaping India’s healthcare policies.