CGHS spends six times as much per person as other populations

The Union government invests over Rs 11,800 per capita on providing comprehensive healthcare to over 34 lakh of its staff and pensioners . The cost of providing only healthcare to the roughly 140 crore population would be about Rs 9.5 lakh crore, or about 4.2 percent of Indias GDP .

According to data from the recently published National Health Accounts, 2018-19, the Union government invests over Rs 11,800 per capita on providing comprehensive healthcare to over 34 lakh of its staff and pensioners, while states and the Centre invest Rs 1,815 per capita on wellness for India's population of nearly 140 crore.According to the reports, the highest per capita expenditure for the Central Government Health Scheme (CGHS was calculated as the total money spent on each scheme in 2018-19 divided by the total number of beneficiaries.The per capita income of other central schemes for providing healthcare, like the Ex-Servicemen Contributory Health Scheme (ECHS), was about 36 lakh beneficiaries, and the Railway Health Service (RHS), which had 68 lakh beneficiaries, was much less, at Rs 8,961 and Rs 6,813 respectively.Though the CGHS and ECHS are contribution programs, over 90% of funding comes from the central government, while RHS is 100% government funded.

Over 34 lakh of its staff and pensioners are served by the Centre, which invests over Rs 11,800 per capita on comprehensive healthcare services.Any health insurance schemes (CGHS and ECHS), as well as Employees State Insurance Corporation (ESIC), are available to employees earning less than Rs 21,000 per month in the organized sector.In its pure sense, ESIC is contributory, since it is made up of employers paying 3.25% of wages and employees contributing 0.75%.ESIC's total funding comes from the Central Government, which is just over 12%.

When the schemes were first introduced in the 1950s, it was predicted that a CGHS-like scheme would be extended to become a national health service that would serve the entire population.Instead, although it extended from Delhi to other parts of the country, it was still restricted to government workers.Unlike Ayushman Bharat, which covers only inpatient costs for a set number of procedures, these programs are a comprehensive list of services for employees, retirees, and their families.It also covers up to Rs 5 lakh in a year, whereas other programs have no fixed cost ceiling.

An estimated Rs 2,400 crore was expended on the project in 2018-19, which translates to Rs 240 per capita, a fraction of the CGHS per capita cost.CGHS pensioners and ECHS pensioners receive lifetime comprehensive healthcare with no upper limit for cost, for annual contributions of Rs 3,000 to Rs 12,000 based on the salary level of serving employees, and for a one-time payment of Rs 30,000 to Rs 1.2 lakh.If we take the average expenditure on RHS, which is the lowest among central government-funded programs, as the minimum required to provide a decent comprehensive healthcare service, the cost of providing only healthcare to the roughly 140 crore population would be about Rs 9.5 lakh crore, or about 4.2 percent of India's GDP.The Centre has set a target of spending 2.5% of GDP on healthcare, including water and sanitation by 2025.

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