V R Muraleedharan IIT Madras-PHFI consortium Presented on UHC Day – Advancing UHC in India

1. Improving Efficiency in Public Spending on Healthcare: Some empirical observations from select states in India V R Muraleedharan IIT Madras-PHFI consortium Presented on UHC Day – Advancing UHC in India Delhi 11 December 2017 I

2. Health care expenditure: India in comparison with BRICS and Asian neighbours Source: WHO NHA data base

3. How much money is spent on health? (As % of GSDP), 2013-14 Authors’ estimates, SHA database

4. How much money is spent on health?Per capita expenditure (INR) 2013-14 Authors’ estimates, SHA database

5. What is the extent of financial protection? Who Pays? NPISH, 1.6 Enterprises, 2.4 How resources are mobilised? VHI, 3.6 Social Insurance 2.9 What is the extent of risk pooling? Authors’ estimates, SHA database

6. Comparison of costs in public and private sector: per hospitalisation episode (INR) Source: PHFI Estimate based on State Health Accounts Study

7. Cost per outpatient episode (INR) Source: PHFI Estimate based on State Health Accounts Study

9. Average per Child birth total expenditure (Rs.) in health centres, public and private hospital in TN and All India, 2013-14

10. Conclusion: Enormous scope for reducing cost of OP care per visit by strengthening health sub-centresand PHCs; Enormous scope for reducing cost of IP care by investing in higher level public facilities; What is saved could therefore be invested in expanding the range of services offered in sub-centres/PHCs/higher level facilities and through improving quality of care; Combine this approach with strategic purchasing at higher levels of care, as is done in CMCHIS with UIIC playing the role of purchaser on behalf of the Govt. Thank you.

11. Thank You