NSO 80th Round: India’s Healthcare Revolution as Insurance Coverage Hits Record Highs

NEW DELHI— India is witnessing a “health-seeking revolution.” According to the latest National Statistical Office (NSO) 80th Round survey released on Wednesday, the proportion of Indians reporting ailments has nearly doubled since 2017-18. This trend, experts say, is not a sign of a sicker nation, but of a population that is increasingly aware of its health and more confident in seeking medical care.

The Awareness Jump: PPRA Statistics

The Proportion of Population Reported Ailing (PPRA) has seen a sharp uptick across both rural and urban India.

Region	2017-18 (PPRA)	2025 (PPRA)
Rural India	6.8%	12.2%
Urban India	9.1%	14.9%

The report attributes this rise to better early diagnostic care and the availability of free drugs and diagnostics at the primary level.

The Ayushman Bharat Effect: Insurance Triple-Fold

One of the most striking findings is the rapid expansion of financial risk protection. Coverage under government-financed health insurance schemes (like PM-JAY) has skyrocketed.

• Rural Surge: Insurance coverage jumped from 12.9% to 45.5%.
• Urban Growth: Coverage rose from 8.9% to 31.8%.
• Institutional Deliveries: India has almost achieved universal institutional births, reaching 95.6% in rural and 97.8% in urban areas.

Out-of-Pocket Expenditure (OOPE): The Public Sector Win

The survey highlights the success of public health facilities in reducing the financial burden on citizens.

• Zero Cost Outpatient Care: For non-hospitalization (outpatient) care, the median out-of-pocket expenditure in public facilities is ₹0.
• Affordable Hospitalization: While the overall median expenditure for hospitalization stands at ₹11,285, half of all cases in public health facilities incurred only ₹1,100.
• High-Cost Cases: The NSO noted that while “average” costs might seem high, they are pushed up by a small number of specialized, high-cost cases. For the majority, healthcare remains affordable.

Shifting Disease Burden: From Fevers to Lifestyle

The 80th Round survey also confirms a major epidemiological transition in India:

1. Declining Infectious Diseases: Cases of traditional infections are on a downward trend.
2. Rising NCDs: There is a growing prevalence of Non-Communicable Diseases (NCDs), specifically Diabetes and Cardiovascular conditions.

Why Public Healthcare is Winning

There is an increasing trend of citizens heading back to public hospitals. Utilization for outpatient care in rural areas has increased from 28% in 2014 to 35% in 2025. This is largely due to:

• Expansion of Comprehensive Primary Healthcare Services.
• Emphasis on preventive and early diagnostic care.
• Robust scaling-up of State-sponsored health insurance schemes.