Rising Medical Bills in Vidarbha Expose Gaps in Health Protection

thenewsdirt
3 minutes ago
9 min read

In the villages of Vidarbha, an illness can carry a hefty price tag. Families are finding that even a simple fever or minor surgery can strain their finances. Stories abound of farmers selling a portion of their land or taking high-interest loans to pay hospital bills.

Across this region of Maharashtra, households are grappling with rising medical expenses that often force harsh trade-offs.

Treatment for a loved one may mean cutting down on food or education. These everyday struggles are shedding light on a wider problem. The cost of healthcare is climbing beyond reach for many, revealing significant gaps in India’s health protection system.

Medical Bills Squeeze Vidarbha Households

Healthcare in Vidarbha is a paradox of scarcity and expense. Rural areas suffer from a severe shortage of medical facilities and staff in some villages.

A single doctor serves over 30,000 people. A government audit in late 2024 found Vidarbha had the worst shortfall of doctors and paramedics in Maharashtra, with 25 percent fewer doctors and 30 percent fewer paramedics than needed.

This chronic lack of public healthcare forces many residents to travel to cities or turn to private clinics. Even basic diagnostic tests in private labs can cost thousands of rupees, forcing families to dip into savings or incur debt, according to local reports. Daily wage labourers are especially vulnerable to them. Even routine medical expenses can consume a substantial portion of their income.

For Vidarbha’s farming communities, rising healthcare costs have become an added burden on top of agrarian distress. Farmers in Vidarbha have had to mortgage or sell their land to foot spiralling medical bills, as one chronicler of the region noted. Something as common as a viral fever outbreak can leave an entire village in financial ruin, with treatment costs pushing families into debt.

The more serious the illness, the more devastating the impact. One farmer in Yavatmal district recounted that a large part of his borrowings went toward fat healthcare bills from a private hospital. In one recent case in rural Maharashtra, a landless labourer borrowed ₹50,000 for his daughter’s childbirth complications, a loan that plunged the family into a debt trap. Such stories are increasingly common.

While Maharashtra’s government introduced free public hospital care in 2024, many patients in Vidarbha still avoid under-resourced government facilities and opt for private hospitals, hoping for better quality, and they pay dearly for it.

Every illness or injury becomes a potential financial crisis for these households, underscoring how rising medical bills are squeezing those who are least able to afford them.

Gaps in Health Protection Schemes

The hardships in Vidarbha mirror larger gaps in India’s health insurance and protection schemes. The government’s flagship program, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana, was launched to provide ₹5 lakh of health coverage per year to vulnerable families. It has made a dent in the problem.

The latest Economic Survey reported that Ayushman Bharat has saved Indian families over ₹1.25 lakh crore in out-of-pocket medical expenses since 2018.

In fact, greater public spending and insurance coverage have helped lower the share of health costs paid directly by households from about 63 percent of total health expenditure in 2015 to around 39 percent by 2022. But for all its ambition, the scheme leaves many gaps unfilled.

First, Ayushman Bharat primarily covers hospitalisation, not everyday medical needs. Outpatient care, which makes up roughly 63 percent of all healthcare spending in India, is not covered by Ayushman Bharat or most private insurance policies.

This means visits to local clinics, diagnostic tests, and medicines outside of a hospital stay still have to be paid out-of-pocket by patients. Those expenses often pile up.

Medicines alone account for about 43 percent of people’s out-of-pocket health spending in India, a consequence of limited coverage for drug costs. Preventive and primary care also fall through the cracks, leaving families with no financial cushion for these frequent expenses.

Secondly, coverage is far from universal. Ayushman Bharat targets the poorest 40 percent of the population, but that still leaves a huge missing middle without any government health cover. Around 65 percent of Indians, more than 90 crore people, have no health protection scheme at all and are essentially on their own or reliant on costly private insurance.

This missing middle is described by experts as a vast population for whom the government currently has nothing to offer. Many of these are lower-middle-class families who are not poor enough to qualify for Ayushman Bharat and not wealthy enough to comfortably afford private health insurance.

It is noted that it is exceedingly unfair that these households are being pushed to buy commercial health policies, which even carry an 18 percent GST on premiums despite their limited means.

The situation is particularly dire in rural regions like Vidarbha, where fewer people have formal insurance.

These coverage gaps are compounded by low public investment in healthcare infrastructure. India’s government health spending has hovered around only 1.1 percent to 1.3 percent of GDP in recent years, well below the 2.5 percent of GDP recommended by experts and far less than what some neighbouring countries spend. The result is an overstretched public health system.

In Vidarbha’s government hospitals, beds and specialists are limited, and long queues are common. Many primary health centres lack specialists or even basic equipment.

Such shortfalls drive patients to seek private care, effectively negating the financial protection that public facilities are supposed to provide. In theory, insurance schemes like Ayushman Bharat should shield citizens from ruinous expenses, but implementation challenges and exclusions mean many patients in regions like Vidarbha still pay a large share of healthcare costs on their own.

For example, if a farmer under Ayushman Bharat needs monthly follow-up visits and medicines after a surgery, those outpatient needs might not be covered, leading to significant personal spending. Similarly, not everyone eligible for the scheme is enrolled or aware of it.

These cracks in the system ensure that, despite bold policies, health coverage in practice remains patchy and families often fall through the gaps when they need help most.

When Healthcare Costs Drive Poverty

The consequence of these gaps is a heavy out-of-pocket burden on households, one that pushes many into debt or poverty. Even with recent improvements, Indians still pay nearly 40 percent of all medical expenses from their own pocket, a proportion that ranks among the highest in the world.

This reliance on personal funds for healthcare has a very human cost. According to health experts, about 39 million Indians are pushed into poverty each year due to catastrophic medical expenses.

Put another way, medical bills drive roughly the population of a large country into financial ruin annually. Another analysis by an international NGO found a similar trend, estimating that around 63 million people are impoverished every year by healthcare costs in India. The exact figures may differ, but they underscore the same reality. Millions of families slide below the poverty line because someone fell ill and needed treatment.

Families employ various coping strategies, most of which are financially harmful. Government data and surveys show that a significant share of households resort to borrowing money or selling assets to pay for healthcare. In one national survey, nearly 18 percent of families said they had to borrow funds or dispose of property to meet hospital expenses for their young children.

Many others rely on contributions from relatives or neighbours. These desperate measures are hallmarks of what researchers call hardship financing. By one estimate, roughly 13 out of every 100 Indian households experience such financial hardship from medical costs in a given year.

Those in rural areas and those with chronic illnesses are at higher risk. In Vidarbha’s agrarian communities, the burden of healthcare often adds to existing debts from farm loans, creating a vicious cycle. Social workers note that rising costs for healthcare, along with essentials like education and food, have far outpaced rural incomes, worsening the income expense gap for farmers.

Unlike salaried employees who get yearly raises to adjust for inflation, farmers and informal workers have no such cushion, as veteran farm activists in the region point out. So when medical bills climb, these families have little slack in their budgets to absorb the shock.

Another fallout of high out-of-pocket costs is that people may delay or forego treatment. Healthcare experts observe that families often wait until a condition becomes unbearable, hoping to save money, which can lead to more severe health problems.

A recent report noted that 71 percent of Indians feel medical expenses have risen significantly, and about 19 percent admitted they have postponed or skipped treatment due to cost, even among those who have some form of health insurance.

This indicates that many insurance plans, either government or private, do not fully cover expenses, or patients fear the outlays they might still incur. Skipping early care can turn minor ailments into emergencies that are far more expensive to treat, perpetuating the cycle of cost and illness.

The out-of-pocket spending pattern in India shows where the money goes. Aside from hospital fees, the largest chunk is spent on medicines from pharmacies, which make up almost half of out-of-pocket expenditure. Other significant costs include private hospital charges, diagnostic tests, and even transport to medical facilities.

These are exactly the areas where public support or insurance coverage is lacking. When a needed drug is not available for free at a government clinic, a villager might have to buy it at full price from a market pharmacy.

If the nearest X-ray machine or specialist is in a city, the patient must pay for travel and often for private service. Each step carries a price tag that the family must cover. For low-income households, such costs quickly become catastrophic, defined as spending more than 10 percent of their total household budget on health.

By that definition, millions of Indian families face catastrophic health expenditures each year. In Vidarbha, health activists link these medical expenses to the region’s persistent poverty. They note that in many cases, the road to bankruptcy or extreme hardship for a rural family can start with an illness.

Healthcare debt has quietly become a contributor to agrarian debt. A medical emergency, coming on top of crop losses or low prices, can tip a family into despair. It is a grim calculus some end up choosing between paying for treatment and risking their livelihood.

The cumulative effect of these trends is a growing awareness that health costs are a societal challenge.

Rising household medical expenditure is now recognised as both a cause and a consequence of poverty and inequality. For every family in Vidarbha that is pushed to the brink by hospital bills, there are likely many more across the country in similar straits.

Their struggles illustrate why closing the gaps in health protection is crucial not only for individual well-being but for broader economic and social stability.

The plight of families in Vidarbha confronting rising medical bills shines a spotlight on the critical gaps in India’s health system.

It is a situation that speaks to more than just healthcare. It touches on fairness, development, and the role of the state in safeguarding its citizens.

When a mother in a village postpones her treatment to save money for her children, or a farmer takes on crippling debt to pay for a life-saving surgery, it becomes clear that health costs are not merely personal expenses but a test of the system’s safety nets. India has set its sights on achieving universal health coverage and ensuring that no one is denied care due to cost. Yet, the experiences in Vidarbha show how distant that goal remains for many on the ground.

The rising household medical expenditure here is a microcosm of a national challenge. Quality healthcare is advancing, but access and affordability are lagging. Until those gaps are bridged, families will continue to live one illness away from financial ruin.

The numbers and policies tell one side of the story, but it is the voices from Vidarbha’s villages and towns of loans taken, assets sold, treatments delayed, and hopes dimmed that truly underscore the urgency of this issue.

They serve as a stark reminder that health and economic well-being are inextricably linked, and that protecting citizens from the devastation of medical debt must be a priority in the journey toward Health for All.