Bihar Spends Lowest, HP Highest on Healthcare

While the central government is moving towards handing over more autonomy to states to maneuver their health spending, it is pertinent to note wide ranging differences on how states spend behind healthcare. Bihar spends the lowest of all at Rs 348 per individual on health. Also, hardly 6.2% of it's total population is covered under health insurance. The data is derived from National Sample Survey Organisation's 2014 round and was analysed by researchers at Brookings India in New Delhi.Bihar also has the largest shortfall of Community Health Centres (CHCs) at 91%, according to data derived from National Rural Health Mission (NRHM). CHC is a larger referral centre for paediatrics, gynaecology and surgery requiring patients. Ideally, there must be one CHC for a population of one lakh persons.Jharkhand and Uttar Pradesh spend barely Rs 428 and Rs 488 respectively behind an individual.The state health spending of Himachal Pradesh (HP) is over five times more than Bihar on it's population. HP government spends maximum per capita on healthcare at Rs 1,831. While in Bihar almost 80% health expenditure is borne out-of- pocket by the population, in HP the share of out-of-pocket expenditure is 55%.

"With very low state spending and predominance of private healthcare sector, the household out-of- pocket expenditure spending is nearly 80% of all health spending in the state," said Shamika Ravi, lead author of the analysis.

Andhra Pradesh (AP) is one of the better of states as far as providing healthcare is concerned. It not only spends Rs 1,022 behind each individual but also has an enviable population of upto 62.8% covered under insurance. The Aarogyasri scheme of insuring families below poverty line which was started in AP in 2007 has been emulated by many states including Maharashtra which started Rajiv Gandhi Jeevandayee Arogya Yojana in 2011. In spite of emulating the scheme, Maharashtra has a paltry 7.2% population covered under insurance. Moreover, Maharashtra spends Rs 674 per capita on healthcare.