Our elderly population in India is one of the fastest growing in the world. Currently at 110 million, India has the second largest population of ageing citizens and this number is projected to reach 158.7 million by 2025. It’s expected, by 2050, that it will surpass the population of children below 14 years. An analysis of morbidity patterns by age clearly indicates that the elderly experience a greater burden of ailments compared to other age groups, with the most frequent illnesses being cardiovascular illnesses, circulatory diseases, and cancers.
According to a number of surveys across the country, the biggest concerns for senior citizens in India are healthcare costs, lack of financial support and isolation. Also, most of the elderly are not accorded the dignity and quality of the care they deserve. With increasing longevity and debilitating chronic diseases, many elder citizens need better access to physical infrastructure, both in their own homes and in public spaces.
Due to the ever increasing trend of nuclear families, elder care management is getting more difficult, especially for working adult children who find themselves responsible for their parents’ well being. Managing home care for the elderly is a massive challenge as multiple service providers – nursing agencies, physiotherapists and medical suppliers – are small, unorganized players who extend sub-optimal care.
According to a 2011 study in the Lancet medical journal, 39 million Indians are pushed into poverty every year due to medical costs. Eighty-one per cent of health care across India is paid from private funds, mainly individual pockets. Concentrating on the larger picture, the government should look at elder-friendly policies and work to build a better social infrastructure so as to reduce private costs. Currently, less than 4 percent of India’s GDP is allotted to the healthcare sector. In addition, even amongst senior citizens who are eligible, less than 5 percent are covered by the government’s health insurance schemes.
Unlike India, it is almost mandatory in USA that each individual be covered under a health insurance scheme. In USA, health insurance cover includes everything from a visit to the doctor for something as small as fever, to hospitalization for the treatment of more serious diseases and operations. However, in India, health insurance coverage is essentially limited to hospitalization. Healthcare in Switzerland, which is noted to have the best healthcare system in the world, is universal and is regulated by the Federal Health Insurance Act of 1994. Basic health insurance is mandatory for all persons residing in Switzerland (within three months of taking up residence or being born in the country). As a result, 99.5% of Swiss citizens have health insurance, and because they can choose between plans from nearly 100 different private insurance companies, insurers must compete on price and service, helping to curb health care inflation. Moreover, in UK, each of the member countries has a National Health Service that provides public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. Private healthcare companies are free to operate alongside the public one.
The emerging Indian elder care industry is fragmented and offers poor quality services. Speaking in purely economic terms, the demand is a lot greater than the supply, which puts even more pressure on the nascent players. Given the requirements, the quality and quantity of the products offered for healthcare is pitiful with an overdependence on foreign players, especially Chinese products. Most wheelchairs in the western world come with the option to adjust seat height. However, no shower wheelchair in India has this feature, bought either online or offline. In India, only shower chair comes with an option to adjust height, not wheelchairs. This is so, because traders are importers who find it cheap to import from Chinese markets and US/European products, which are of good quality and possess the necessary features cost above $ 1200. This feature of seat adjustment is extremely important, because not only can it allow access over various heights of commode but it also helps in adjusting the height of the wheelchair to match the bed surface thus easing transfers. Development and manufacture of these shower wheelchairs equipped with all necessary features within India itself would reduce the cost of these in the market, facilitating availability for the masses and on the GDP level, it would lead to reduction of imports in the BOP.
India’s demographic dividend of being a ‘young’ country, will soon turn into a demographic nightmare if in house assisted mobility devices and services are not developed fast enough for our ageing population.