Smaller states beat richest on healthcare spending

NEW DELHI: Several northeastern and other smaller states are spending proportionately more on healthcare than richer states such as Maharashtra, Karnataka and Telangana, reveals National Health Accounts 2022-23 data. Manipur health expenditure as a proportion of its GSDP was the highest in the country at 5.5%, up from 4.6% in 2021-22.

Meghalaya spent 4.4% on health, while Nagaland’s spending rose from 3.4% to 3.6%, and Mizoram reported 3.2%, shows the report released by the Union health ministry. Some of India’s largest and richest states spent less than 1% of GSDP on health. Karnataka spent 0.7% of its GSDP on health in 202223, down from 1.1% in 2021-22.

Maharashtra’s spending declined from 1.2% to 0.8%, while Tamil Nadu’s fell from 1.3% to 0.9%. Telangana reported 0.8% and Punjab 0.9% spending in 2022-23.


Among UTs with a legislature, Puducherry reported one of the highest health spending shares at 5%. Experts said 2021-22 remained an exceptional spending year because of Covid vaccination drives, emergency healthcare expenditure and pandemicrelated infrastructure expansion, which pushed health spending ratios sharply higher across states. The figures have been made public at a time when states face a rising burden of non-communicable diseases, ageing populations and healthcare costs.

The report also showed major differences in per capita public health spending across states. Among states and UTs with a legislature, Puducherry recorded the highest per capita govt health expenditure at Rs 10,675, followed by Mizoram at Rs 9,800, Sikkim at Rs 7,400, Manipur at Rs 7,040 and Meghalaya at Rs 6,843. Among UTs without a legislature, Chandigarh reported the highest per capita govt health expenditure at Rs 20,985, followed by Lakshadweep at Rs 10,594 and Andaman & Nicobar Islands at Rs 8,888. Among larger states, Kerala reported one of the highest per capita public health expenditures at Rs 3,592, though lower than Rs 4,338 reported in 2021-22. Karnataka’s per capita spending also declined, from Rs 3,259 to Rs 2,333 over the same period.

Uttar Pradesh reported one of the lowest per capita govt health expenditures among major states at Rs 1,419, followed by Jharkhand at Rs 1,536 and Madhya Pradesh at Rs 1,827. Despite low per capita spending, UP recorded the country’s highest total govt health expenditure at Rs 33,352 crore because of its massive population base, followed by Maharashtra at Rs 30,537 crore and Tamil Nadu at Rs 21,517 crore. The report showed that West Bengal allocated 8.5% of its total govt expenditure towards health, one of the highest among major states, while Kerala allocated 8.3% and Uttarakhand 8.2%.

Experts say the figures reflect deep interstate inequalities in healthcare priorities. The data also underlines continuing dependence of larger states on private healthcare systems despite rising demand for stronger public health infrastructure.