kochi the per capita health expenditure is the highest in kerala at rs 9871 almost four times the national average of rs 2100 indicating that the cost of healthcare in the state is significantly higher than the other states the national health account nha estimates report for 201819 of the union health and family welfare ministry released on monday puts himachal pradesh rs 6946 in the second placekeralas figures were twice as much as the other south indian states with karnataka at rs 4878 tn at rs 4311 telangana at rs 4130 and andhra pradesh at rs 4967 besides it has gone up from rs 9264 the previous year 201718 the nha estimates are the sixth consecutive report it is prepared using an accounting framework based on the internationally accepted standard of system of health accounts 2011 developed by who the report shows that outofpocket expenditure in kerala remains exceedingly high with twothirds or 69 of health expenditure being paid from personal savings or borrowings or other sources against national average of 53the data show that people are paying 25 times more than those in other southern states for healthcare facilities in kerala said mysore sanjeev convenor project jeevan raksha an initiative of proxima consulting focusing on advocacy analytics and awareness in healthcare on the other hand kerala is spending 11 of its gross state domestic product gsdp on health expenditure which is marginally higher than other southern states this indicates that the state government is paying more for healthcare products and services consumed under various healthcare schemes he said