World Health Organization (WHO) projections suggest that by 2030 India’s cumulative number of deaths due to cancer as of this year will number 13.1 million. This is a considerable figure and will place a vast strain on the healthcare expenditure of the country, as a large portion of expenditure is out of pocket. The financing of cancer care is often left to the patient.
As life expectancies rise, cancer has become more prevalent in India. An estimated 12.5 lakh (1.25 million) new cases are diagnosed each year, with an average of around 28 lakh (2.8 million) patients living with the condition at any given time. This is a massive strain on the healthcare system in terms of both resources and funding.
Public expenditure on cancer care in India is less than $10 USD per person (as a total of the whole population, not just those with cancer). This is compared to a much higher figure of an excess of $100 USD in high income countries. Out of pocket payments for cancer care in India account for three quarters of cancer expenditure according to a paper published in The Lancet.
The implication is that due to low funding provided for cancer patients, the vast majority of the expenditure in India is provided by the patients and their families. This, as with many cases of out of pocket medical expenditure, places a patient in a situation where they could be faced with either the worsening of their condition, or poverty.
India faces a vicious cycle in which poverty exacerbates the conditions in which an NCD such as cancer may arise through factors such as poor diet or lack of prior medical access. The treatment of these NCDs then pushes many further into poverty. 55 million Indians were pushed into poverty due to health expenditures in the 2011-2012 period. More still paid for medical treatments with bank assistance, this can create a huge amount of debt that, due to interest rates, may never be paid back.
This is a situation that may only be resolved by an increase in government healthcare expenditure. Estimates currently place the burden of NCDs and the cost they will incur in India to be $6.2 trillion USD over the 2012-2030 period, cancer forms a large portion of this sum. Without a suitable increase in government expenditure, this burden falls to the patients.
In the 2017 Union budget, an increase in health spending was promised: a rise to 2.5 percent of GDP (a full percentage higher than current spending levels). Even with the proposed increase, health spending levels would still be lower than the global average. NCDs are on the rise in India, and unless properly addressed could spiral out of control and put an extreme burden on both Indian hospitals and the patient’s finances in the years to come.
