Arun K Aggarwal
Financial Protection, as measured by Catastrophic Health Expenditure (CHE), is an important arm of Universal Health Care Coverage (UHC) and is an important outcome parameter of Health systems. Global discourse revolves around increasing the share of government spending as percentage of Gross Domestic Product (GDP) to avert CHE and Out of Pocket Health Expenditure (OOPE). Fundamental questions for health financing are: a) can the funding from donor agencies solve this problem? b) where is the gap; less % Total Health Expenditure (THE) or less spending by government as % GDP? c) How valid is the claim of the national governments for increased spending on health? d) What are the contributors to health spending? What level of care? What expenditure heads? Which clinical department? Through the analysis of various case studies and secondary data, we have discussed all such issues in this article. We have done comparative analysis of India (Tamil Nadu) and Srilanka and shown that at both these places significantly high UHC coverage was obtained at less % GDP expenditure compared to other nations. Comparison of Tamil Nadu data of 2004 with National Health Account (NHA) data of 2014 shows that during ten years period, there has been increase in THE by Rs. 100/- per capita per year, increase in Government Health Expenditure (GHE) by Rs. 61/- per capita per year and decrease in OOPE by Rs. 9/- per capita per year. Substantial Health Expense occurs on Pharmacy. Renal Transplant Department, Cardiology and Orthopedic departments were found to be top three departments with huge OOPE. Article gives insight to better design future financial protection schemes.