Health Insurance Scheme for Seniors Hinges on Better Infrastructure
Health Insurance schemes for senior citizens in many countries has come under scrutiny due to the inadequate healthcare infrastructure available to cater to this vulnerable population. Despite well-meaning efforts by governments and insurance companies to provide affordable health coverage for seniors, the lack of robust medical facilities, especially in rural and underserved areas, is a critical bottleneck. Improving the infrastructure of hospitals, clinics, and related services is essential for any senior health insurance scheme to succeed. Without addressing this, insurance alone cannot fulfill its promise of accessible and affordable healthcare for seniors.
Background
According to the World Health Organization’s (WHO) World Report on Ageing and Health
(2015), the percentage of people worldwide who are 60 or older is expected to nearly
double between 2015 and 2050, from 12% to 22%, with significant ramifications for socioeconomic structures and healthcare systems. As the population ages at an increasing rate,countries worldwide recognise the need to change their perspective on ageing and shift their focus to the needs of older adults.
In India, senior citizens, i.e. people aged 60 years and above, currently comprise a little
over 10% of the population, translating to about 104 million. The United Nations Population Fund (UNFPA) projects that this population, which will make up 158 million people by
2025, is the one that is ageing at the fastest rate. By 2050, the elderly population is
projected to rise to 319 million (19.5% of the total population), as shown in figure below.
Further, the total dependency ratio, which stood at 56.92 in 2020, is projected to decrease
steadily till the 2025 due to the rise in the percentage of the working-age population; but
it is expected to rise again to touch 61.22 by 2050.
In India, the challenges associated with population ageing are further exacerbated by the lack of
affordable healthcare services, shifting disease burden, evolving nuclear family structures, and
altered consumption patterns.
India will have 319 million older adults by 2050, accounting for 20% of the total population,
putting additional strain on India’s already overburdened healthcare system. Nearly one-half
(45%) of India’s disease burden is projected to be borne by older adults in 2030, when the
population age groups with high levels of chronic conditions will represent a much greater share
of the total population.
Further, neuro-degenerative diseases like dementia mostly affect older adults, though it is not
a part of normal ageing. According to the WHO, there are approximately 50 million people
worldwide, who are living with dementia, and this number is expected to triple by 2050. In India,
an estimated 4 million people are living with dementia, and this number is projected to increase
to 13.4 million by 2050. The burden of dementia on healthcare systems is substantial, with global
costs estimated at US$1 trillion annually. In addition, there is a need to address mental health
concerns such as depression and anxiety as well as issues related to mobility and independence,
such as fall prevention, assistive technology, and accessible transportation.
Growing Healthcare Needs of Seniors
The senior population, typically defined as individuals aged 60 and above, is rapidly increasing worldwide. In many countries, the demographic shift is significant, with seniors accounting for a substantial portion of the population. The rising life expectancy rates, thanks to advances in medicine and healthcare, have resulted in more people living longer, but also facing complex medical conditions such as chronic diseases, mobility issues, and cognitive impairments.
These conditions often require frequent medical attention, long-term care, and specialized treatments, putting tremendous pressure on healthcare systems. Health Insurance schemes designed for seniors often aim to alleviate the financial burden of healthcare costs. However, without the necessary infrastructure to support quality care, these schemes risk being reduced to little more than paper promises.
Inadequate Healthcare Infrastructure
In many developing countries, healthcare infrastructure remains inadequate. Hospitals and clinics, particularly in rural and semi-urban areas, often lack the essential facilities, trained staff, and medical equipment required to deliver quality healthcare. Even in more developed regions, the challenge of healthcare infrastructure for seniors can be overwhelming, particularly in specialized areas such as geriatrics, long-term care, and rehabilitation services.
For example,Health insurance schemes might promise coverage for surgeries, diagnostics, and treatments, but if the local hospital doesn’t have the necessary equipment or skilled personnel to perform these tasks, the insurance becomes irrelevant. The absence of skilled geriatric care professionals further exacerbates this problem, as seniors require specialized treatment and care that goes beyond standard medical practice.
The Role of Technology in Bridging the Gap
One potential solution to address the infrastructure challenge is the integration of technology in healthcare. Telemedicine services, for instance, can help provide timely consultations for seniors, particularly those living in remote areas. With the help of digital platforms, healthcare providers can monitor the health conditions of elderly patients, offer virtual consultations, and provide guidance on medication and lifestyle management.
However, the widespread adoption of such technology requires significant investment in digital infrastructure and training, especially in rural areas where internet connectivity may be poor. Additionally, seniors need assistance and training in using these technologies, as many of them may not be technologically adept. Health Insurance schemes can consider covering the costs of digital consultations, wearable health monitoring devices, and telemedicine platforms to ensure that seniors have access to timely healthcare.
Conclusion
The success of health insurance schemes for seniors is inextricably linked to the quality and availability of healthcare infrastructure. While Health insurance plays a vital role in reducing out-of-pocket expenses for seniors, it cannot replace the need for strong medical facilities, trained personnel, and innovative solutions such as telemedicine. Governments, insurers, and the healthcare sector must work together to build the infrastructure required to support the growing healthcare needs of the elderly. Only with a robust foundation of healthcare services can senior health insurance schemes truly deliver on their promises, providing affordable, accessible, and quality care to the aging population.
