Dipak Kurmi
India, a country home to one of the world’s largest populations, is also witnessing a significant demographic shift. A rapidly aging population, with approximately 138 million people aged 60 and above, is creating new healthcare challenges that demand urgent attention. Among these, individuals over the age of 70—more than 10 crore—face an array of pressing healthcare concerns. As the elderly population increases, so do the complexities of addressing their healthcare needs. Chronic diseases, disabilities, and a growing reliance on specialized care are becoming the defining characteristics of this demographic, making the task of ensuring their well-being more pressing than ever before.
The Growing Healthcare Burden
The healthcare needs of India’s elderly are profound and multifaceted. As people age, they become increasingly susceptible to chronic conditions such as hypertension, heart disease, diabetes, and respiratory illnesses. The Longitudinal Ageing Study of India (LASI) reveals that one in every four Indians over 60 reports poor health, with 75% of the elderly living with one or more chronic diseases. Alarmingly, 40% of the elderly experience disabilities, while 1 in 4 suffers from multi-morbidity—compounded by the rising incidence of conditions like diabetes and cancer, especially in urban centers. These health issues contribute not only to declining quality of life but also place a substantial burden on healthcare systems and families alike.
According to the Global Health Estimates of 2019, non-communicable diseases, including ischemic heart disease, stroke, and diabetes, are the leading causes of Disability-Adjusted Life Years (DALYs) lost among individuals over the age of 60. The growing prevalence of these diseases underscores the urgent need for specialized care and long-term treatment options for the elderly. It is not just about the need for routine medical interventions; it is about providing comprehensive, ongoing care that supports the elderly through the trials of aging.
The Economic Strain of Rising Healthcare Costs
Healthcare costs in India are rising at an alarming rate, with medical inflation standing at approximately 14%. This is exacerbating the difficulties faced by the elderly population, whose fixed incomes and often limited financial resources make affording necessary care a major challenge. Rising costs of hospitalization, doctor consultations, and medications place an undue strain on seniors, many of whom struggle to meet even basic healthcare needs.
The sharp rise in medical inflation is particularly burdensome for the elderly, as they are more likely to require frequent medical attention. With the increased cost of medical procedures, insurance companies are now faced with the need to adjust premiums to cover the higher expenses. However, this has led to a steep increase in insurance premiums, further adding to the financial burden faced by senior citizens. For many, the cost of insurance becomes prohibitive, forcing them to either forgo coverage or rely solely on government assistance or personal savings—neither of which offer comprehensive protection.
The Role of Ayushman Bharat and Insurance Coverage Gaps
India has made some progress in addressing the healthcare needs of its elderly population through initiatives such as the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY). This program, aimed at providing health insurance coverage to millions of Indians, has expanded to include 6 crore more individuals from 4.5 crore families, with a particular focus on those aged 70 and above. While the expansion of AB PM-JAY is a positive step, it does not fully address the needs of India’s senior citizens.
One major limitation of the scheme is that it primarily covers inpatient care. Outpatient services, which account for a significant portion of healthcare expenses, are not included. According to research published in the International Journal of Preventive Medicine, outpatient care constitutes between 40-80% of total healthcare expenditures in India. Therefore, while inpatient services may be covered under AB PM-JAY, many elderly individuals will still be forced to bear the costs of outpatient treatments, medications, and routine consultations. This gap in coverage continues to create financial burdens for seniors, despite the improvements made by the scheme.
Moreover, elderly individuals with pre-existing conditions, such as diabetes, cardiovascular diseases, or cancer, face additional challenges. Insurance products available to seniors are often limited, and those that are available come with long waiting periods or outright denials of coverage due to pre-existing conditions. Even when coverage is granted, premiums are substantially higher due to the increased health risks associated with aging. This creates a situation where insurance is either unaffordable or inadequate, leaving many elderly citizens without the protection they need to handle serious health issues.
The Looming Crisis: A Rapidly Aging Population
India’s elderly population is expected to grow exponentially in the coming decades. The United Nations Population Fund (UNFPA) projects that by 2050, India’s elderly population will nearly triple, reaching 320 million. This demographic shift underscores the urgency of reforming healthcare systems to meet the needs of an aging society. As the number of elderly individuals continues to rise, there will be an increasing demand for specialized healthcare services, long-term care facilities, and comprehensive insurance options. While the expansion of PM-JAY is a welcome development, it is not enough to address the broader spectrum of healthcare requirements for the elderly population.
The scheme’s limitations in covering outpatient services, mental health care, long-term care, and rehabilitation remain significant barriers to effective healthcare for senior citizens. In order to meet the needs of India’s aging population, healthcare policies must evolve to include these crucial services. Long-term care, including palliative care and rehabilitation, is essential to ensuring that the elderly can live with dignity and receive the care they require as they navigate the challenges of aging.
Addressing the Gaps: A Comprehensive Approach
To effectively address the healthcare needs of India’s elderly, a multifaceted approach is required. First and foremost, there is a need to expand insurance coverage to include a broader range of services, including outpatient care, long-term care, mental health support, and rehabilitation. These services are crucial to managing the health of elderly individuals who may face ongoing, chronic conditions that require continuous care rather than just short-term hospitalization.
Furthermore, policies should aim to reduce the financial barriers that prevent the elderly from accessing necessary care. This includes lowering the costs of insurance premiums and ensuring that individuals with pre-existing conditions are not excluded or charged exorbitant rates. Additionally, the government must work to provide affordable, accessible healthcare services, particularly for low-income senior citizens who do not have access to private insurance or resources.
Finally, there is an urgent need to invest in the training of healthcare professionals to specialize in geriatric care. With an aging population, India must ensure that its healthcare infrastructure is equipped to deal with the unique challenges of elderly care. This includes providing geriatric training for doctors, nurses, and caregivers to improve the quality of care and ensure that the elderly receive the attention they deserve.
The healthcare needs of India’s elderly population are immense and growing. As the number of senior citizens in the country continues to increase, it is essential that India’s healthcare system evolves to meet their needs. Expanding insurance coverage, reducing medical inflation, and improving access to specialized care are all critical steps in ensuring that India’s elderly can live healthy, dignified lives. By addressing these issues, India can ensure that its aging population is not left behind, but is provided with the comprehensive care and support they need to thrive. The time to act is now, before the healthcare needs of India’s elderly become a crisis that is too great to manage.
(the writer can be reached at dipakkurmiglpltd@gmail.com)
