Institute of India
Research Report • 2023

The Out-of-Pocket Crisis

Why health shocks remain the leading cause of impoverishment.

Specific Question Answered: Why doesn't Ayushman Bharat prevent catastrophic health spending?

1. Primary Data and Key Figure

Analyzing the core metric reveals a different reality from the prevailing narrative. The most critical number to understand here is 47.1% (Out-of-pocket share of total health expenditure).

Key Finding

Out-patient care (OPD) and diagnostics account for 60% of out-of-pocket expenditure, both of which are largely uncovered by state insurance schemes.

2. Data Analysis

We avoid smoothing curves where structural breaks exist. Utilizing data from our Data Hub, we reconstructed the index series.

Table 1: Key Metrics Comparison
Metric Value
Insurance Coverage41% of population
OOP Share of Total Health Exp47.1%

3. FAQ

Are medicine costs regulated?
While essential medicines are capped, branded generics and diagnostics remain highly unregulated and variable.

4. Next Steps

The data suggests that current interventions are misaligned with the scale of the challenge. Explore our Interactive Tools to model alternative scenarios.