India, April 23 -- A new consumption survey by the government has found that, between 2017-18 and 2025, the rise in out-of-pocket (OOP) spending on hospitalisation outstripped overall consumer price index (CPI) inflation and its health inflation component. This points to the worrying possibility of health care becoming unaffordable for hundreds of millions in the country. While insurance and government cost support schemes such as Ayushman Bharat defray some costs for a section of the population, more than half the population in both urban and rural areas has no such cover to rely on. This situation can have drastic implications. Those unable to access health care without either eroding savings or incurring crushing debt - given India's complex consumption matrix across its several income classes - may avoid necessary interventions, imposing heavy costs on the economy in terms of disease burden. This is more so for households where health awareness is low - where treatment is delayed because the less severe, initial symptoms of complex but treatable diseases are mistaken for routine ailments and ignored - which translates into higher chances of incurring large health spends. The rise in costs at private facilities compounds the problem. The long-term solution is to increase spending on public health and expand the public health network in the country. States have an uneven record on this front - southern states, particularly Tamil Nadu and Kerala, have built a robust network stretching from primary health centres to medical colleges, while the poorer states in the north lag behind. The government is increasingly leaning on the private sector to address the gap by encouraging expansion of insurance coverage. Another survey finding - uptake of services at private health care facilities has been growing - suggests that with insurance/government support, households could be choosing private health care facilities over government-run ones where these are available. One reason could be the inadequate infrastructure in public health care facilities (a lack of enough beds, critical equipment, etc.): The Indian Public Health Standards say each community health centre (CHC) must serve up to 80,000-120,000 persons, whereas many CHCs are forced to serve tens of thousands more. Another reason why patients could be privileging private facilities over public ones is the poor quality of services (a result of inadequate staffing, inattentive staff, and a lack of cleanliness, among others). In the immediate future, the government will have to expand both insurance coverage and public-sector health care facilities....