Rising cost of healthcare: The challenge of managing health-related expenses in old age

Source: Live Mint

One of the major worries for most senior citizens is deteriorating health. In the face of steep premiums for health insurance and rising healthcare costs, managing health-related expenses can be really challenging. We asked experts how senior citizens can plan their finances.

The Indian healthcare ecosystem is evolving slower than the spiralling medical inflation. This has put to risk the elderly, many of whom don’t have health insurance nor have they put aside money to cater to medical needs. Also, the increasing complexity of the healthcare space puts them at a loss to decide the best quality for care.

It’s always good if one gets health insurance early (before 40 years of age) before your age and pre-existing disease profile makes it more expensive or worse not possible to get insurance. Post 40 years, it would be prudent to evaluate every 5 years if your cover is appropriate and increase it regularly to reflect increasing healthcare costs. You can increase the cover on your existing policy or buy another policy without discontinuing your earlier policy as your chances for claim approval is higher on earlier policies, including for existing diseases which have come in later.

Having said that, health insurance would not take care of all your needs like day-to-day care (OPD needs). Even if your cover is enough for hospitalisation, various components do not get paid by insurance companies. Therefore, you need to put aside some money for your healthcare needs as you approach age of 50 years.

Unfortunately, many of the elderly don’t have health cover and probably out of range for getting one because of their profile. They can explore if they can get covered as dependants of their children’s corporate health plans.

Dr D.S. Chadha, Director-internal medicine, Fortis Hospital, Vasant Kunj

Increased life expectancy, rapid urbanisation and lifestyle changes have led to the emergence of varied problems for the elderly in India. The elderly population suffers high rates of morbidity and mortality due to infectious diseases. Unattended chronic disease, unaffordable medicines and treatment and malnutrition are part of old age life in India as there is no system of affordable healthcare.

Insurance cover that is elderly-sensitive is virtually non- existent in India and, when provided, it’s very costly, limited to hospitalisation and with many exclusions. With the emerging prevalence of nuclear family set-ups in recent years, the elderly are likely to be exposed to emotional, physical and financial insecurity in the years to come. Pension and social security is also restricted to those who have worked in the government or public sector or the organised sector of the industry.

They are less vulnerable in rural areas as compared to their urban counterparts due to the joint family system in rural areas. The concept of geriatric care has remained a neglected area of medicine in the country.

Healthcare system for elderly in India is extremely bad and very costly which many can’t afford as compared to developed countries where government schemes and healthcare system look after their senior citizens.

S. Premkumar Raja, Co-founder and secretary, Nightingales Medical Trust

One of the biggest challenges that elders face is financial instability. Being financially stable plays an important role, especially in meeting the increased cost of healthcare requirements as elders are more prone to multiple diseases. Unlike in developed countries, where the social security systems and health services take care of the retired elderly, the resources in India, both from the government and the private sectors, are very limited.

In India, only 10% of retired employees get pension from the government/former employers and the other 90% are forced to survive on their savings which often get exhausted within a few years of retirement. Thus, post-retirement, elders often end up depending on their children or others for financial help and neglect their health. This lack of economic independence leads to distress within the family, stealing dignity and independence from the aged.

Inaccessible and unaffordable healthcare services, absence of geriatric care, unorganised home care providers and lack of elder friendly insurance schemes are the major issues that senior citizens face in healthcare.

It’s important for elders to make a conscious effort to remain active and engaged. Everyone should plan their post-retirement and finances as early as 40 years of age.

Dr Naresh Trehan, Chairman and Managing Director, Medanta

In present times, people typically live longer but a long life is worthwhile only if it is disease-free. India faces a rapidly growing healthcare crisis. In addition to cyclical diseases like dengue, we have chronic lifestyle-related ailments such as diabetes. This is compounded by one of the fastest growing geriatric populations in the world: by 2050 we will have 240 million elderly. Failure to address this will create an unbearable and unmanageable healthcare burden with vast ramifications. Unless we co-opt our population into the national health agenda as informed, proactive and participative agents, we will be unable to meet the looming healthcare crisis.

The focus has to be on promoting wellness and preventing disease. A second necessity is detection as early detection of disease is extremely important to contain it. Regular health check-ups are necessary. Their importance only increases as we grow older. Comprehensive treatment of disease and its thorough management and control is the third important aspect. Factoring these into our life maps will ensure a healthy old age.

One must remember that healthcare is incrementally expensive as we age. It is necessary to secure oneself with adequate health insurance. Wellness through healthy living is the key to all healthcare. While no one can reverse or prevent ageing, anyone can optimise opportunities for a fine quality of life in old age.

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