India’s elderly struggle to fend for their health-care expenses

In past 50 years, India’s elderly population has almost tripled and with rise in number of senior citizens’ population, there is also a steep rise in the health-care expense which they bear

India is promoted as rising nation and many initiatives have been introduced by the government to strengthen India’s global economic standing with development as its core agenda.

While on one hand, immense efforts are being made to improve India’s GDP (gross domestic product), which will secure the future of youth, the government machinery has been lagging behind in providing for its elderly population, especially in health-care.

India, which is world’s second most populous country, has experienced a dramatic demographic transition in past 50 years, entailing almost a tripling of population over age 60 years.

With rise in number of senior citizens’ population, there is also a steep rise in the health-care expense which they bear.

It is crucial to be noted that 70 per cent of health care expense is paid by senior citizens themselves and only 30 per cent of the expense is paid by government.

“Though the government has introduced generic medicines for them, which are cheaper than the ones manufactured by other brands, it doesn’t make a difference as elderly health-care expense is increasing by the day,” said Dr Rekha Bhatkhande, Former Dean of Shushrusha Citizens’ Cooperative Hospital.

Bhatkhande believes that introducing proper schemes for senior citizens will help in improving their health-care facilities.

Vanita Kumta, a 68-year-old Mulund resident, lives with her husband and her annual expense is Rs55,000.

“Though we are fit and fine, we have to go for regularly check-ups and basic medicines, which costs us Rs5,000 per month. As retired senior citizens, we do not have so much money to spend. Surely, there is a dire need of schemes for elderly people like us,” said Vanita, adding that there should also be reliable health-care treatment and social security schemes for the elderly.

Not just is the expense a concern, but there is a definite shift in disease pattern too among elderly.

Sailesh Mishra, Founder of Silver Innings, an NGO for senior citizens, observes that there is a definite need to emphasise on the fact that disease and disability are a part of old age and help must be sought to address health problems in elderly.

“Elderly are more prone to non-communicable diseases. It is high time that the health care system is upgraded to meet the growing needs of elderly in an optimal and comprehensive manner. Concept of active and healthy ageing needs to be promoted among senior citizens, which includes preventive, promotive, curative and rehabilitative aspects of health.”

The 60th round of National Sample Survey provides a comprehensive status report on older persons. According to the survey, prevalence and occurrence of diseases as well as hospitalisation rates are much higher in older people than the total population.

Senior citizens heaalth care

“An ageing society should have implications for any government in terms of higher spending on medical or health care and on pensions,” added Mishra.

Kishor Sharma, an 81-year-old Borivli resident, who suffered from brain clot and lost his vision, is perhaps an example on why investment and awareness on health care facilities for elderly is crucial.

Sharma owns a land in his native. He used to grow grass and sell them. Sharma never invested in any insurance scheme and presumed that he would never suffer from any disease. However, one fine day, he lost his sight.

“My monthly expense is over Rs10,000. It is sad that our government has no good scheme for an elderly person like me. I live with my son now and it is very difficult for retired senior citizens to spend huge amount on medicine and health care,” said Sharma.

High-cost medicine for diabetes, multivitamins, blood pressure, cancer, cardiac cases and dementia takes its toll on elders, either they stop taking medicine or buy whenever required. High hospitalisation cost and expert consultancy becomes a curse in old age.

“With hardly any saving, lack of social security and insufficient pension, elders have to either depend on the government’s health care machinery, which is minimal, non-accessible or incompetent, or they have to depend on their children and relatives for financial help,” pointed out Mishra.

According to the Global Age Watch Index 2016, India ranks 71st of 96 nations in elderly, age 60 and above, care. The elderly population in India is projected to rise to 12% of total population by 2020.

The country also ranks in income security domain with only 28.9 per cent pension income coverage. Therefore, under some definitions, India is an ‘ageing population’ and has an estimated 65 per cent of its elderly living in rural areas, with 40 per cent below the poverty line and over 73 per cent illiterate.

Scarily, about 90 per cent of them have no official social security (i.e. no provident fund, gratuity, pension among others).

Dr Manoj Chaddha, Endocrinologist at Hinduja Hospital, said, “Prevention is better than cure. Health care is exorbitant in India, especially for elderly. Seniors who have worked in corporate sector receive the benefit with health insurance schemes, but so is not the case with in rural areas.”

Major health issues among senior citizens for which there is much need for health-care expense:

  • ENT, cardiac cases, blood pressure, diabetes, joint pain, cancer, dementia / Alzheimer’s are usual health issues observed in senor citizens.
  • Around 4% of total elder population, an estimate 4 million (40 lakh) suffer with some form of dementia.
  • Average monthly cost is around Rs30,000 to Rs45,000 per month, depending on severity of dementia.
  • Brain stroke is commonly faced by the elderly population, which requires proper health care and thus adds to the expense.
  • The article is highly informative.It addresses a very pertinent issue of high cost compulsive ageing medication.The suggestion to evolve an effective policy in the interest of elderly confronted with multiplicity of diseases and faced with financial constraints is demand-driven.I personally feel that effort on suggested lines should focus rural elderly who are underrecognized and deservedly qualify for prioritization contrary to their urban counterparts.
    Director
    Institute of Gerontology and Geriatrics,LNMU,Darbhanga, India

  • JC -Ex NB SUB Kuldip Singh Virk

    Sir, very beautifully elaborated article on health care of senior citizens, but the Min of Health is in Slumbers on this issue specially, for the reasons ,best known to them. We are just pointing out ,where in Armed Focrses Tribunal Chandigarh Bench has directed the Govt of India to provide Health Care to The Employees of Department of Post and were on deputation with Army Postal Corps. There are not one , but at least over 40-50 cases , where in AFT Chandigarh Bench has allowed all the effected individuals as Ex Servicemen with an consequence benefits as are available to Ex Servicemen of the Regular Forces, all these personnel have been issued with Ex Servicemen Discharge Book, Ex Servicemen Identity Card from the respective State Goverment, but still the Ex Servicemen Contributory Health Scheme are not complying with the orders of Armd Forces Tribunal , consequentially pensioners, who are also designated as Senior Citizens , but no body cares. The files are moving from one department to other departments , which has taken years together, but still no final decision has been arrived at by the . We have pinned great hopes on change of Central Govt , some positive response will come out of this case. From :- JC 94755N Ex Nb Sub Kuldip Singh Virk Mobile 9417923380
    BSNL land line 0175 2286080
    Kothi No 823, Phase -1,
    Ueban Estate , Patiala -147002