Hospitalisation more privatised, costlier in India despite wider govt insurance coverage

HOspitalisation has suit sir thomas more privatised and expensive in bharat betwixt 2017-18 and 2025 even out as more Indians are being covered by government-sponsored health insurance programmes, government data released on Monday showed.An average non-childbirth hospitalisation in India required an out-of-pocket (OOP) spending of ₹34,604 in 2025. This number, about 1.64 times an average Indian household’s monthly spending in 2023-24, underlines the potential economic shock that a family could face from an emergency health spend.These numbers are from the report on Household Social Consumption: Health, released by the National Statistical Office (NSO) on Monday, which is based on a survey of 139,732 households in the calendar year 2025.There are three key takeaways in the data. The share of people seeking treatment at private hospitals has increased in India. The cost of private healthcare has increased at a much greater pace than of public health care; and the growth in OOP spending on hospitalisation exceeds both the overall, and health inflation component of the Consumer Price Index (CPI).Also Read | Why India’s health care problem begins before the hospitalThe average OOP spending on medical costs – it includes costs of doctor’s fee, diagnostic tests, bed charges, appliances, blood, oxygen, etcetera, but not transport and food – for a treatment was ₹34,604 for hospitalisation (excluding childbirth), ₹14,755 for childbirth and ₹861 for non-hospitalisation cases.These headline numbers hide a large divergence between the costs of availing government and private healthcare in the country. The private hospital-public health facility ratio of OOP spending on hospitalisation (excluding childbirth) was 7.6 in 2025 as against 6.8 in 2017-18 ( according to the same survey conducted in July 2017-June 2018). Similarly, for outpatient treatment, the ratio of private hospitals and private doctor/clinic with public health facilities was 5 and 3.3 in 2025, respectively, compared to 3.4 and 1.9 in 2017-18.Private hospitalisation grows as public share drops in rural, urban IndiaNot only did private hospitalisation become more expensive, it also became more widespread. The share of hospitalisation cases (excluding childbirth) at public health facilities decreased from 45.7% in 2017-18 to 39.2% in 2025 in rural areas; and from 35.3% to 32.2% in urban areas.To be sure, non-hospitalisation treatment in public facilities saw a marginal rise from 33% to 35% in rural areas but a fall from 26% to 25% in urban areas during this period.The result of private hospitalisation becoming more expensive and widespread has been OOP spending outpacing not just overall but also health inflation in the country between 2017-18. OOP spending on hospitalisation excluding childbirth, childbirth and non-hospitalisation treatments increased by 1.88, 2 and 1.42 times between 2017-18 and 2025. Health spending as seen in the 2011 CPI series increased by 1.52 times while overall CPI increased by 1.43 times during this period.The disproportionate rise in OOP spending –reimbursements from insurance are subtracted to arrive at this number – has happened despite a big growth in people covered by health insurance or schemes. The proportion of people covered by health insurance/financing schemes increased from 14.1% in 2017-18 to 47.4% in rural areas; and from 19.1% to 44.3% in urban areas. Most of this growth was due to government-sponsored schemes. The share covered by government sponsored schemes increased from 12.9% in 2017-18 to 45.5% in rural areas; and from 8.9% to 31.8% in urban areas.