Public Health Spending and Out of Pocket Costs in India

India's health financing architecture shows, over the decade examined, a shift toward increased public financing and a lower recorded OOPE share of Total Health Expenditure, evidenced by the near tripling of nominal Government Health Expenditure. Reading this alongside the caveats above (nominal reporting, the COVID 19 window, and mixed scheme level evidence on PM JAY), we treat this as a documented association rather than an established causal effect. To meet the National Health Policy targeet of 2.5 per cent of GDP and to approach genuine Universal Health Coverage, the evidence here points to three priority areas for future policy: •                      Extend scheme coverage to include outpatient consultations and prescription drugs, rather than concentrating public insurance benefit packages on inpatient hospitalization alone. •                      Increase fiscal allocations from state governments, which reportedly finance a majority of public health spending, to reduce inter state disparities in per capita public health investment; this figure should be independently verified against the same NHA release before final submission. •                      Integrate primary health centre workflows with digital health records (e.g., the Ayushman Bharat Health Account, ABHA) to reduce diagnostic duplication and strengthen continuity of care between primary and referral levels.

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