National Health Accounts Report – Key Findings

National Health Accounts

National Health Accounts Latest News

  • The latest National Health Accounts (NHA) Estimates for FY23 show a rise in out-of-pocket healthcare expenditure and a decline in government health spending in India.

National Health Accounts in India

  • The National Health Accounts (NHA) is an official framework that tracks the flow of funds within India’s healthcare sector. It provides estimates of:
    • Total health expenditure in the country. 
    • Government spending on healthcare. 
    • Household out-of-pocket expenditure. 
    • Private sector and insurance contributions. 
  • The NHA estimates are prepared by the National Health Systems Resource Centre (NHSRC) under the Ministry of Health and Family Welfare using internationally accepted accounting standards developed by the World Health Organisation (WHO) and the Organisation for Economic Co-operation and Development (OECD).
  • The report helps policymakers assess whether healthcare financing is becoming more accessible, equitable, and affordable. It is also important for monitoring progress toward Universal Health Coverage (UHC).

Key Indicators in Health Financing

  • Government Health Expenditure (GHE)
    • Government Health Expenditure refers to the amount spent by the Union and State governments on healthcare services, infrastructure, medicines, and public health programmes.
    • Higher public expenditure generally improves healthcare accessibility and reduces financial burdens on households. India’s National Health Policy, 2017, had proposed increasing government health expenditure to 2.5% of GDP by 2025.
  • Out-of-Pocket Expenditure (OOPE)
    • Out-of-Pocket Expenditure refers to direct payments made by individuals for healthcare services at the time of treatment. It includes spending on Medicines, Hospitalisation, Diagnostic services and Doctor consultations. 
    • High OOPE is considered a major challenge because it can push vulnerable families into poverty and discourage timely healthcare access.
    • India has historically recorded high out-of-pocket spending compared to many developing and developed countries.

Findings of the Latest National Health Accounts Report

  • According to the latest National Health Accounts Estimates for FY23, India witnessed a rise in household spending on healthcare.
  • Out-of-pocket expenditure increased sharply from around 39.4% of total health expenditure in FY22 to nearly 44% in FY23. This marks a reversal of the declining trend observed in recent years.
  • At the same time, the share of government health expenditure reportedly declined by around 11% in FY23 compared to the previous year.
  • The report highlighted that:
    • Public spending growth slowed after the pandemic period. 
    • Household financial burden in healthcare increased again. 
    • Private expenditure regained a larger share in overall health financing. 
  • This change assumes significance because India had witnessed improvements during and immediately after the COVID-19 pandemic due to increased government health spending and emergency public health investments.

Reasons Behind Rising Out-of-Pocket Spending

  • Several factors may have contributed to the rise in OOPE in FY23.
  • Decline in Pandemic-Era Public Spending
    • During the COVID-19 period, governments substantially increased expenditure on hospitals, vaccination, testing, and emergency care. As emergency allocations reduced in FY23, public spending also moderated.
  • High Dependence on Private Healthcare
    • A significant proportion of Indians continue to rely on private healthcare facilities because of concerns related to overcrowding, infrastructure gaps, and specialist shortages in public hospitals.
    • Private healthcare generally involves higher treatment costs, leading to increased household expenditure.
  • Rising Medicine and Diagnostic Costs
    • Spending on medicines and diagnostics continues to constitute a large share of household healthcare expenses in India. 
    • Even relatively minor medical treatments can impose financial stress on low-income families.

Government Measures to Reduce Healthcare Burden

  • The Government of India has launched several initiatives aimed at reducing financial hardship in healthcare.
  • Ayushman Bharat Scheme
    • The Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides health insurance coverage of up to Rs. 5 lakh per family annually for secondary and tertiary healthcare.
    • It targets economically vulnerable households and aims to reduce catastrophic medical expenditure.
  • Expansion of Health Infrastructure
    • The government has also increased investments under schemes such as:
      • PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)
      • Establishment of new AIIMS institutions 
      • Strengthening of Health and Wellness Centres
    • These measures aim to improve access to affordable public healthcare services.
  • Promotion of Generic Medicines
    • The Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) promotes affordable generic medicines through dedicated Jan Aushadhi Kendras across the country.
    • This initiative seeks to reduce medicine-related out-of-pocket expenses.

Source : PIB | IE | PIB

National Health Accounts FAQs

Q1: What are National Health Accounts (NHA)?

Ans: National Health Accounts track the flow of funds and expenditure patterns within the healthcare sector.

Q2: What is Out-of-Pocket Expenditure (OOPE)?

Ans: OOPE refers to direct healthcare payments made by households at the time of treatment.

Q3: Why is high OOPE a concern?

Ans: High OOPE can push families into poverty and reduce access to timely healthcare services.

Q4: Which ministry releases the National Health Accounts Estimates?

Ans: The Ministry of Health and Family Welfare releases the National Health Accounts Estimates.

Q5: What is the objective of Ayushman Bharat PM-JAY?

Ans: It aims to provide financial protection and affordable healthcare coverage to vulnerable families.

Retrospective GST Ruling Threatens Online Gaming Sector: Impact Explained

Online Gaming Sector

Online Gaming Sector Latest News

  • The Supreme Court upheld the constitutional validity of the government's retrospective 28% GST levy on online gaming companies — delivering what could be an existential blow to a sector already reeling under a government ban imposed in 2025. 
  • A bench of Justices JB Pardiwala and R Mahadevan dismissed petitions filed by several gaming companies and industry bodies challenging the GST regime and retrospective tax demands. 
  • The verdict revives tax demands of nearly ₹2.5 lakh crore against gaming firms, fantasy sports platforms, and casinos.

Background — The GST Dispute

  • The GST Council approved a 28% GST rate on online gaming with effect from October 1, 2023. 
  • Following this, the govt began issuing retrospective tax demand notices — covering revenue earned even before October 1, 2023. 
  • Gaming companies challenged this, arguing that the 28% rate should apply only prospectively — from the date the new rate came into effect.

Two Core Questions Before the Court

  • Question 1 — Prospective or Retrospective?
    • Gaming companies argued the 2023 GST amendments were new law and could only apply going forward. 
    • The Supreme Court sided with the government, treating the 2023 amendments as clarificatory in nature — meaning they simply clarified what the law always was, thereby allowing retrospective application.
  • Question 2 — Tax on GGR or Full Face Value?
    • Gaming companies argued GST should be levied only on their Gross Gaming Revenue (GGR), not on the full face value of bets and contest entry amounts deposited by users. 
      • GGR is the actual revenue a gaming platform earns — typically the commission or platform fee charged for hosting games, not the total money deposited by all players.
    • Taxing the full pooled amount, they argued, was commercially unsustainable and unfair for skill-based games. 
    • The Court also said that for GST purposes, real-money games involving uncertain outcomes will be treated like betting or gambling, even if skill is involved.

Scale of Tax Demands — Companies Impacted

  • Dream11 - ₹40,000 crore (show cause notice for evasion)
  • GamesKraft - ₹21,000 crore (Karnataka HC relief now overturned)
  • Delta Corp - ₹23,204 crore (multiple notices for short-payment)
  • Total (Sector-wide) – Nearly ₹2.5 lakh crore
  • The ruling overturns the relief earlier granted by the Karnataka High Court to GamesKraft, which had challenged its ₹21,000 crore GST notice.

The PROG Act, 2025 and Its Impact on Online Gaming Sector

  • Even before this verdict, the government had already dealt a severe blow to the sector through the Promotion and Regulation of Online Gaming (PROG) Act, 2025 — which placed a strict ban on online gaming companies operating in India, citing national security concerns including:
    • Use of digital wallets and cryptocurrencies for money laundering and illicit fund transfers.
    • Platforms serving as communication channels for terror organisations.
    • Offshore entities circumventing Indian tax and legal obligations.

Key Provisions of the PROG Act

  • Complete ban on any person offering online games in India.
  • Imprisonment up to 3 years and penalty of ₹1 crore for violations.
  • Social media influencers promoting such platforms face 2 years' jail and ₹50 lakh penalty.
  • Banks and financial institutions prohibited from facilitating transactions on such platforms.
  • Applies to all online money gaming — regardless of whether the game is one of skill or chance — a distinction the industry had lobbied hard to preserve.
  • The sector was projected to become a $9 billion market by 2029 before the PROG Act effectively shut it down.

Impact of the Supreme Court Verdict

  • Existential Crisis
    • The ruling creates an "immediate, steep financial burden that cannot be passed on to consumers" and companies must "recalibrate financial structures" immediately. 
    • Survival will require rapid business model adaptation and aggressive cost-rationalisation.
  • Recovery of Dues — A Practical Impossibility
    • Ironically, despite the legal victory for the government, experts question whether the tax demands can actually be recovered. 
    • With the complete ban on online money gaming, most companies have either shut down or pivoted to other businesses. 
    • Any attempt at recovering such massive GST demands may not practically yield results since the GST amounts demanded are several times higher than cumulative revenues ever earned by these companies.

Conclusion

  • This case raises several important questions at the intersection of taxation, technology regulation, and constitutional law. 
  • The retrospective taxation aspect — where a law is applied to past conduct — is a deeply contested area of tax jurisprudence, as it violates businesses' legitimate expectation of legal certainty. 
  • The skill vs chance distinction in gaming has important constitutional dimensions — since games of skill have historically enjoyed greater legal protection than games of chance. 
  • The verdict settles this debate by treating all real-money gaming with uncertain outcomes as gambling for GST purposes — regardless of the skill element involved.

Source: IE

Online Gaming Sector FAQs

Q1: Why does the Retrospective GST Ruling Threatens Online Gaming Sector?

Ans: The Retrospective GST Ruling Threatens Online Gaming Sector because companies may face massive tax demands for past years, significantly increasing financial liabilities.

Q2: How did the Supreme Court interpret the law in the Retrospective GST Ruling Threatens Online Gaming Sector case?

Ans: In the case where the Retrospective GST Ruling Threatens Online Gaming Sector, the Court held that the 2023 GST amendments merely clarified existing law and could apply retrospectively.

Q3: Why is the tax base important in the Retrospective GST Ruling Threatens Online Gaming Sector issue?

Ans: The Retrospective GST Ruling Threatens Online Gaming Sector because GST is levied on the full value of player deposits rather than only platform commissions.

Q4: What impact could the Retrospective GST Ruling Threatens Online Gaming Sector have on businesses?

Ans: The Retrospective GST Ruling Threatens Online Gaming Sector by increasing compliance burdens, reducing profitability, discouraging investment, and threatening the viability of smaller firms.

Q5: Why is the Retrospective GST Ruling Threatens Online Gaming Sector significant for policymakers?

Ans: The Retrospective GST Ruling Threatens Online Gaming Sector highlights the challenge of balancing tax collection, regulatory certainty, innovation, and growth in the digital economy.

Consent and the Revival of Sedition: Understanding the Supreme Court’s Clarification

Revival of Sedition

Revival of Sedition Latest News

  • A three-judge Supreme Court Bench headed by CJI Surya Kant clarified that courts may proceed with trials, appeals, and proceedings under Section 124A of the now-repealed Indian Penal Code (IPC) — the colonial sedition provision — if the accused raise no objection. 
  • This has partially revived the paused sedition provision for consenting accused persons, triggering significant constitutional and legal debate.

Background — The May 2022 Order and Vombatkere Case

  • In May 2022, the Supreme Court ordered all ongoing and future proceedings under Section 124A to be kept in abeyance — effectively pausing the sedition law across India. 
  • This came in the context of S.G. Vombatkere vs Union of India — a group of writ petitions challenging Section 124A as unconstitutional for violating fundamental rights. 
  • The court had expressed its "hope and expectation" that the government would not register fresh FIRs or take coercive action under Section 124A while the constitutional challenge remained pending. 
  • The Vombatkere petitions remain pending before the Supreme Court — meaning the constitutional validity of Section 124A has still not been decided.

What Triggered the Recent Clarification

  • The clarification arose from a Special Leave Petition filed by one Kamran — anxious about his nearly decade-old appeal against conviction under the UAPA, Arms Act, and IPC including Section 124A. 
  • He and his co-accused were sentenced to life imprisonment by a Sessions Court in Madhya Pradesh in February 2017. 
  • Their appeal before the State High Court had been stuck in limbo since the May 2022 Supreme Court order. The High Court appeared "reluctant" to hear the appeal while the stay was in force. 
  • Kamran submitted that he was willing to let the High Court hear the full appeal — including the sedition component. 
  • The Supreme Court relented and passed a general direction .

Key Constitutional Concerns

  • Trial Under a Law Whose Validity Is Undecided
    • The recent clarification raises a fundamental question: can courts continue trials under a law whose constitutionality is still under judicial scrutiny?
    • Since the challenge to Section 124A remains pending before the Supreme Court, lower courts may be required to decide guilt under a provision that could eventually be declared unconstitutional.
  • Violation of Equality Before Law
    • The clarification creates a visible disparity in the application of Section 124A. Those who consent — perhaps out of desperation for closure or confidence in their innocence — will face trial. 
    • Those who do not consent will wait in indefinite limbo until the Supreme Court finally decides the Vombatkere petitions – a clear violation of Article 14.
  • Passed Without Hearing Vombatkere Petitioners
    • The May 21 direction was passed in the unconnected Kamran case — without issuing notice to or hearing the petitioners in the Vombatkere group of matters. 
    • This raises serious procedural concerns about the validity of a general direction that effectively modifies the scope of the 2022 order without hearing those directly affected by it.
  • Practical Problems in Co-Accused Scenarios
    • The clarification creates practical problems for lower courts — if one accused consents to be tried under Section 124A while a co-accused does not, the court faces a legally untenable situation with different legal standards applying to different accused in the same case.

Historical and Legislative Context of Sedition

  • The offence of sedition has been traced to the Statute of Westminster 1275 — enacted when the King was considered the holder of Divine right. 
  • Section 124A of the IPC was a colonial tool used to suppress political dissent — most famously invoked against Bal Gangadhar Tilak and Mahatma Gandhi.
  • Even after Independence, sedition has been viewed with suspicion. PM Nehru described Section 124A on the floor of the Provisional Parliament in 1951 as "highly objectionable and obnoxious."

Kedar Nath Singh vs State of Bihar (1962)

  • The Supreme Court "read down" Section 124A — holding that a citizen has the right to criticise the government in speech or writing, so long as it does not incite violence or create public disorder. 
  • This remains the foundational judicial interpretation of sedition in India.

Documented Misuse

  • The Attorney General in 2022 shared glaring instances of misuse — including the case where an independent MP and her husband were booked under Section 124A for threatening to recite the Hanuman Chalisa outside the private residence of a former Maharashtra Chief Minister.

Section 152 BNS — The Successor Provision Also Under Challenge

  • Section 152 of the Bharatiya Nyaya Sanhita (BNS) — considered the successor to Section 124A — is itself under challenge in the Supreme Court for its ambiguity and potential chilling effect on free speech. 
  • Critics argue it retains the same essential character as the old sedition law while using different language — making the fundamental constitutional questions unresolved regardless of which provision is used.

The Broader Constitutional Framework — Fundamental Rights Are Interconnected

  • The current challenges to sedition provisions urge the Supreme Court to apply post-Kedar Nath precedents — including R.C. Cooper, Indira Gandhi vs Raj Narain, and I.R. Coelho — which established that fundamental rights do not reside in isolated silos. 
  • A charge under Section 124A or Section 152 that curtails free speech also necessarily affects the right to life and personal liberty under Article 21. 
  • Each fundamental right animates the others — making sedition not just a free speech issue but a comprehensive fundamental rights question.

Conclusion

  • The real solution lies not in temporary clarifications but in a final judicial determination on the constitutionality of sedition laws. 
  • Until then, citizens remain caught between prolonged uncertainty and prosecution under a provision whose legality is yet to be settled.

Source: TH | TH

Revival of Sedition FAQs

Q1: What does Consent and the Revival of Sedition mean in the recent Supreme Court context?

Ans: Consent and the Revival of Sedition refers to the Supreme Court allowing pending sedition proceedings to continue if the accused voluntarily agrees to face them.

Q2: Why has Consent and the Revival of Sedition generated constitutional concerns?

Ans: Consent and the Revival of Sedition raises questions about equality before law, due process, and continuing prosecutions under a provision whose validity remains under challenge.

Q3: How is Consent and the Revival of Sedition linked to the 2022 Supreme Court order?

Ans: Consent and the Revival of Sedition emerged after the Court’s 2022 stay on sedition proceedings was partially relaxed through consent-based continuation of cases.

Q4: What are the criticisms of Consent and the Revival of Sedition?

Ans: Critics argue Consent and the Revival of Sedition creates unequal treatment among accused persons and revives legal uncertainty surrounding a controversial colonial-era law.

Q5: Why is Consent and the Revival of Sedition significant for civil liberties?

Ans: Consent and the Revival of Sedition is significant because it affects free speech protections, judicial process, and the broader debate on balancing state authority and individual rights.

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