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Healthcare takes centre stage, finally! 159

low budget allocations for healthcare

5.19 As health is a state subject in India, spending on healthcare by states matters the most
when examining government healthcare spending. According to National Health Accounts,
2017, 66 per cent of spending on healthcare is done by the states. India ranks 179 out of 189
th
countries in prioritization accorded to health in its government budgets (consolidated union &
state government). As Figure 10 shows, this prioritisation of health in India is similar to donor-
dependent countries such as Haiti and Sudan, and well short of its peers in development.

Figure 10: Public Health spend as percentage of total Government
Budget for different countries (centre and state combined)

Source: World Bank and WHO (Global Health Expenditure Data Base)

5.20 The state expenditure on healthcare is highly variable across states and is not fully explained
by the income level of the state. Figure 11 illustrates the same: while healthcare spending per
capita increases with the GSDP per capita, healthcare spending as a per cent of GSDP decreases
with the GSDP per capita. Thus, the richer states are spending a lower proportion of their GSDP
on healthcare.

Figure 11: Healthcare spending across different Indian States