India’s aging population will surge rapidly by 2050, a new UN report says, calling for stronger regulations to help this vulnerable population better manage and finance their healthcare. There is. As of July 1, 2022, there were approximately 149 million people aged 60 and over in the country, representing 10.5% of the population. According to the India Aging Report 2023, that proportion will double to 20.8%, and the absolute number will reach 347 million by 2050.
India’s aging population will surge rapidly by 2050, a new UN report says, calling for stronger regulations to help this vulnerable population better manage and finance their healthcare. There is. As of July 1, 2022, there were approximately 149 million people aged 60 and over in the country, representing 10.5% of the population. According to the India Aging Report 2023, that proportion will double to 20.8%, and the absolute number will reach 347 million by 2050.
This means that by 2050, one in five Indians will be elderly.
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This means that by 2050, one in five Indians will be elderly.
Health insurance is most needed in old age, but insurance companies deny this coverage to seniors due to their loss-making portfolios. In 2009, the Insurance Regulatory and Development Authority of India (Irdai) took a small step by enacting rules to allow people to join the health insurance scheme up to the age of 65. Insurance companies were required to record the reasons for denying elderly insurance coverage.
Later, insurance companies were also allowed to increase premiums based on the insured’s age. The rules include disclosing premiums charged by seniors upfront, resolving claims within 30 days, and giving consumers the option to move from one health insurance company to another. It included: But regulators have been inundated with complaints from consumers who have been denied this coverage.
Of course, more efforts need to be made to strengthen policyholder protection, increase competition, lower prices and improve the quality of service.
More importantly, insurance companies and health care providers can quickly join the National Health Claims Exchange, a gateway for exchanging claims-related information among stakeholders for faster claim resolution. Irdai must ensure that. This will go a long way in addressing the many hassles faced by policyholders, especially the elderly.
Additionally, unifying hospitals, medical service providers, third-party aggregators, and insurance companies on a single platform to ensure a seamless exchange of data and information will aid in smart underwriting practices. This is because insurance companies only want to underwrite insurance policies when the price is realistic.
There is also much to be gained from encouraging young people, the largest group of the population, to get insurance early. That way, you can minimize the risk of not being able to get insurance as you get older.
But what about the majority of older adults whose incomes are too low to afford health care or health insurance? Who will pay for their medical care?
Out-of-pocket expenses can exacerbate financial insecurity, impede access to health care, and, in worst cases, push people into poverty.. A study on publicly funded health insurance for older people (PFHI) has reportedly raised concerns about increased out-of-pocket costs for the poor. The main limitation of PFHI policy appears to be its over-reliance on the poorly regulated private sector.
In such a case, the inevitable remedy would be to strengthen regulations and strictly enforce them. This is particularly the case when the quality of public health services remains poor. Governments need to leverage the private sector in tertiary care and use digital platforms, technology, data and processes to improve overall outcomes, but there is no substitute for a well-run public health system.
Second, purely traditional insurance models suffer from the well-known incentive conflict. Private hospitals constantly try to drive up costs by forcing patients to undergo avoidable and unnecessary surgeries, procedures, and tests, which insurance companies naturally want to minimize. . payment.
Aligning incentives for insurers, providers, and patients will require implementing new models in which providers agree to provide specialized care to groups that receive an upfront per capita fee. That fee is calculated by an actuary used by the insurance company.
These medical providers will monitor the insured’s health and provide treatment in case of illness. In such a model, there is actually no incentive for care providers to drive up costs because the per capita premium is paid directly by the insurance purchaser.
The government should foot the bill for the poor. Low-income groups can pay a prorated amount based on their income. Safeguards can be built in in the form of strong regulations to keep health care providers in check.
Irdai should quickly develop a blueprint for the regulatory framework such a model will require for an aging population.
