Who pays when an Indian family falls sick?

When you fall sick in an Indian home, the first question is where to go. The next one is what it will cost. The family has to pick a door: one leads to a government hospital, where care costs far less; the other leads to a much more expensive private hospital.

That gap is now before Parliament. A Rajya Sabha Standing Committee on Health and Family Welfare said the cost of private care is pushing vulnerable families into "catastrophic debt". In a report presented on August 7, it asked the government to cap what private hospitals charge for essential treatment.

Government data shows how wide the gap is, and how much public money goes to health.HOW EXPENSIVE IS PRIVATE?

Having a baby in a government hospital cost Rs 2,299 out of pocket in 2025, according to the National Statistics Office's health survey. This is the data used by the standing committee. The same was Rs 37,630 in a private hospital that year. That’s roughly sixteen times as much as a government facility.

Out-of-pocket means what the family paid itself, after any insurance payout. It leaves out travel and food.

As the survey shows, the gap runs through all care. A hospital stay cost Rs 50,508 out of pocket in a private facility and Rs 6,631 in a government one, nearly eight times as much. Treating an illness without a hospital stay cost Rs 1,447 at a private hospital and Rs 289 at a government facility. At least half of such treatments at government facilities cost the family nothing.

The survey counts private hospitals that treat patients under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, the government's health insurance scheme, as private.WHERE IS THE GAP WIDEST?

In Tamil Nadu. A family there paid Rs 1,357 for a stay in a government hospital and Rs 74,168 in a private one, nearly 55 times as much. Goa came next, at 39.1 times.

In 10 of the 30 states and Union Territories compared, a private stay cost at least 10 times a government one, India Today's Data Intelligence Unit found. We left out six small Union Territories from our calculations because their samples are likely too small. Himachal Pradesh had the narrowest gap, at 2.4 times, the survey shows.

A wide gap can mean cheap government care as much as costly private care, as in Tamil Nadu. Figures for small states such as Sikkim, where a private stay averaged Rs 1,44,555, rest on smaller samples, according to the survey.HOW MUCH DOES THE GOVERNMENT SPEND?

India's government spent Rs 3,85,332 crore on health in 2022-23, according to the National Health Accounts, the Health Ministry's official count. That covers the Union, the states, and local bodies together. That works out to Rs 2,786 a person for the year, or about Rs 232 a month, which is less than Rs 8 a day.

Government health spending was 1.48 per cent of gross domestic product, according to the new GDP series. The committee pointed out that the target was 2.5 per cent.

During the Covid-19 pandemic, in 2021-22, the government bore about 60 per cent of people’s healthcare bill. However, following the global crisis, people again had to foot a major part of the bill themselves. In 2022-23, households’ share of healthcare expenses was 43.4 per cent.

After inflation, households spent between Rs 2,657 and Rs 2,771 a person every year from 2017-18 to 2022-23, a DIU calculation from the accounts shows, in 2022-23 rupees. Government health spending rose to Rs 3,358 a person in 2021-22, up 26 per cent in one year, and fell back to Rs 2,785 in 2022-23.

Because families pay for much of them directly, the standing committee said in the Rajya Sabha. Pharmacies took Rs 1,62,511 crore in 2022-23, about one in every five rupees of India's day-to-day health spending, according to the National Health Accounts.

All medicines together make up nearly 30 per cent of that spending, the committee said, adding that this cost is "disproportionately financed directly by households rather than through insurance or government schemes".

Outpatient care "remains the segment least protected by existing insurance architecture", the committee said, asking the government to widen PM-JAY to pay for doctor visits, tests and medicines.

The committee made 368 recommendations in its 176th report. It also asked for a plan to lift government health spending from 1.43 per cent of GDP to 2.5 per cent. For now, however, the price of a birth still depends on which door you pick.- EndsPublished By: Pathikrit SanyalPublished On: Sep 23, 2026 10:47 IST