NEW DELHI: In a stark indicator of India’s shifting healthcare landscape, individual health insurance premiums have now exceeded the combined central government allocation for the Department of Health and Family Welfare and the Department of Health Research.An analysis of annual reports from the Insurance Regulatory and Development Authority of India and corresponding Union Budget documents shows that while insurance premium collections briefly dipped in the immediate post-pandemic years (2021–22 and 2022–23), they have since surged past the national health budget. Even when related spending by other ministries—such as Defence and Labour—is taken into account, India’s total public health expenditure remains low: just around 2% of the Union Budget and 1.5% of GDP, falling short of the 2.5% target set by the National Health Policy.This trend signals more than a budgetary shift—it reflects a structural transformation in how healthcare is accessed and funded in India. Increasing reliance on private insurance points toward a market-driven model where care is increasingly linked to ability to pay, raising serious equity concerns, particularly for the uninsured and underinsured.Critics argue that insurance-based healthcare, especially when not backed by strong public infrastructure, can exacerbate inequalities. A large share of India’s workforce remains in the informal sector and lacks access to comprehensive insurance. Public health facilities, meanwhile, continue to be underfunded and overstretched.
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