The global health care industry estimated at $ 5 trillion, is one of the world's largest and fastest growing industries. India’s healthcare industry, has grown from $4 Billion in 1990:91 to almost $45 billion by the end of 2013, which accounts for less than 1 % of the global healthcare industry, but has to address the healthcare needs of 17% of the global population (over 1.2 billion), thereby registering an impressive growth. The Indian health sector therefore faces severe resource constraints to deliver health services. India spends about 5% of GDP on healthcare compared with 10-12% of GDP on healthcare spending by developed countries. The government’s share in the total healthcare expenditure in India has remained around 1-4 % of GDP over years, and therefore the private sector has become a dominant player in health service delivery. (K.V.Ramani, 2014) (Government of India, 2011)
The total health expenditure in India is accounted for 4.6 % of its GDP. Of the total expenditure, around 20% was public/governm (Insurance Regulatory and Development Authority)ent expenditure, 77.4 % was private expenditure and remaining 2.3 % external support. Over all, the per capita health expenditure is around Rupees (Rs.) 1021 (equivalent to approximately $17). The sources of financing healthcare are as follows: the Central Government contributed Rs. 67,185 million (6.4 %) while the contribution of state governments and local governments (Urban Local bodies and Panchayat Raj institutions) was Rs. 132,709 million (12.6 %) and Rs. 14,496 million (1.3 %) respectively. (Government of India, 2011)
In private expenditure, the household funds or the out of pocket expenditure incurred by households for availing health care services is around 700,000 million Rs. which accounts for approximately 77 % of total health expenditure in India. The total expenditure incurred by firms in public and private sector for providing medical care benefits to employees and their dependents is around 50,000 million Rs. The contribution of NGOs at Rs 800 million is mainly through donations from Indian philanthropic organizations and from their own resources in the form of interest from deposits and rent from buildings etc. The total external aid received for providing health activities is around 24,000 million Rs., most of which has been routed through the grants and material aid to the Central governments, grants to the State government and through NGO’s. Health care providers mainly comprise of hospitals, nursing and residential care facilities, out patient care centers, laboratory and ambulance services, health education and research, retail sale of medical goods, health insurance facilities etc. In the total health expenditure of the country for public providers is accounted for a share of 22.9 % as against 69.6 % by private providers. Share of providers from NGOs sector were 1.9 %. (Government of India, 2011)
Out of the entire 1.2 billion population of India, only 25% is covered by some form of health insurance, which is growing significantly due to liberalization of economy and general awareness. The health insurance is popularly known as mediclaim policy. There are private health insurers along with government sponsored health insurance providers. Health insurance in India typically pays for only inpatient hospitalization and for emergency treatment at hospitals in India. The outpatient services are not covered by the insurance policies. These policies can be broadly be categorized into hospitalization plans, hospital daily cash benefit plans and critical illness plans through various individual and family plans. There are two payment options under the health insurance. Under direct payment or cashless facilities, the insured can undertake treatment from those hospitals approved by the insurer and the insurer pays directly to the hospital. Under reimbursement payment option, at the end of the hospital stay the patient can