Estimating funds required for UHC within Indian States

Area of Science:

• Health Economics
• Public Health Policy
• Healthcare Financing

Background:

• Universal Health Coverage (UHC) is a global Sustainable Development Goal.
• Indian states exhibit significant variation in per capita Government Health Expenditure (GHE).
• No Indian state currently provides UHC, despite varying spending levels.

Purpose of the Study:

• To estimate the financial requirements for achieving UHC in Indian states.
• To compare these estimates with current GHE across states.
• To identify factors hindering UHC provision in India.

Main Methods:

• Utilized secondary data to estimate UHC financing needs.
• Employed four novel approaches: Outside-in, Actuarial, Normative, and Inside-Out.
• Compared estimated UHC costs with existing state-level GHE.

Main Results:

• Most methods estimated UHC costs between 1302 and 2703 per capita, with 2000 as a reasonable point estimate.
• No significant variation in UHC cost estimates was found between states.
• The Inside-Out approach, assuming current system optimality, yielded different results.

Conclusions:

• Several Indian states may possess the financial capacity for UHC if waste and inefficiency in current health spending are reduced.
• Some states may be further from UHC than GHE/GSDP ratios suggest.
• States like Bihar, Jharkhand, Madhya Pradesh, and Uttar Pradesh may need to more than triple health budgets to achieve UHC.