The National Statistical Office data on the 80th round of Household Social Consumption: Health, conducted between January and December 2025, have revealed several contradictions that lie at the heart of India’s healthcare system. First, the good news. India’s health-seeking behaviour — it is determined by a combination of factors such as individual perception of illnesses and structural barriers, including distance, cost, services and quality — has improved. The proportion of the population reported ailing nearly doubled from 2017-18 to 2025. Urban areas, which reported a 5.8% increase, have performed slightly better than rural areas (5.4% hike) in this regard. Further, institutional deliveries have increased dramatically, accounting for more than 95% in both urban and rural India. There have been discernible changes in patterns of maladies afflicting the population. For instance, there has been a drop in infectious diseases. Correspondingly, the use of insurance services has expanded. Interestingly, coverage under government-funded health insurance schemes — such as the Centre’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and Bengal’s Swasthya Sathi are prime examples — has increased more than threefold in the past seven years, with rural India, which witnessed an increase from 12.9% to 45.5%, performing better than its urban counterpart, where the increase was from 8.9% to 31.8%.

The gains, however, cannot deflect attention from some challenges that seem to be stiffening. Heightened insurance coverage has not translated into better access to or affordability of hospital care. The median out-of-pocket expenditure stands at Rs 11,285; it has risen sharply, particularly in the private sector, from 2017-18. Institutional deliveries may have risen, but most are taking place in private healthcare institutions: the average hospitalisation expenses in these have jumped by 75%. Those with GFHI schemes are increasingly opting to get treated at private centres; this means that the public healthcare infrastructure remains wobbly. Worse, it is apparent that it is the relatively more affluent who are benefiting from these schemes while the underprivileged — the intended beneficiaries of such welfare programmes — are losing out. Delayed reimbursement, exclusions from coverage and discrimination continue to plague such programmes. In the meantime, non-communicable diseases such as diabetes are exerting pressure on household finances. Taken together, the NSO data show that improved health-seeking behaviour among the people is not being matched by betterment in institutional capacities in the country.