Nearly 80% of the money on healthcare in an individual’s lifetime is spent in the last five years of his/her life. While a host of private healthcare providers and investors have rushed in to cater to the needs of India’s rapidly rising senior population, which is projected to be equal to the population of the US by 2050, it’s been an uphill battle as the demand has far outstripped the supply. What adds to the problem is an almost-broken public healthcare system.
Universal healthcare system
Experts say even within a universal healthcare system, there are marked disparities in access to care among older adults, with distance to healthcare facility posing a critical barrier. According to a Lancet study in 2024, for two-thirds (67%) of the urban older adults, an availed outpatient facility is within 10 km. However, for their rural counterparts, who form 70% of the elderly population in India, the same is 28.3 km. This grows disproportionately for in-patient care where the distance and time taken are two times higher for a senior in rural areas than his urban counterparts.
But healthcare access in urban areas comes at a steep cost. According to Mercer Marsh’s Health Trend report, the cost of healthcare services, including doctor’s fees, medicines, hospital charges, and diagnostic tests, grew at 14% in 2024, the highest in Asia.
Prasun Chatterjee, chief of geriatric medicine at Artemis Hospitals, said that given that 60% of the admissions in intensive care units (ICUs) are people over 60 years of age, the healthcare infrastructure is already burdened with elderly care. He expects this number to go up further as India’s young demography begins to age. “The prevalence of cancer in senior population is growing fast and it is going to increase strokes and heart-related illnesses. Dementia is going to be another pandemic. It’s beyond doubt that India is staring at a silver tsunami in the coming years. However, seniors are not fully prepared to deal with most non-communicable diseases (NCDs) which leaves huge scope for healthcare companies to focus on preventive healthcare,” he said.
Apart from the lack of awareness in general about specialised senior healthcare facilities, Chatterjee pointed out the distorted patient-doctor ratio in India. There are just about 200 geriatric doctors in India for an elderly population of about 120 million. “It’s an upcoming branch of medicine that requires attention from investors because the existing hospitals don’t offer specialised elderly services,” he said.
NITI Aayog report and experts POV
As per a February 2024 NITI Aayog report, the challenges associated with population ageing in India are exacerbated by the lack of affordable healthcare services, shifting disease burden, evolving nuclear family structures, and altered consumption patterns.
Aakangshita Dutta, director at Confederation of Indian Industry (CII), however, strikes an optimistic tone. Recent innovations in the digital space, especially on the delivery of healthcare services, have paved the way for easy access and affordability for seniors, she said, adding that with the emergence of healthcare at home services and e-pharmacies, the needle has moved.
Sujay Shetty, global health industries advisory leader at PwC, agrees. He said while India is adequately covered to handle the medicine-related requirements for the senior citizens, the delivery of care remains an issue, which is why the companies providing healthcare services at home are flourishing. “Going forward, more innovative models are going to emerge to cater to the large section of seniors who are financially strong,” he said.
Experts said that the government needs to step up its allocation towards the healthcare sector, which has been in the range of 1.2-1.9% for the past 10-odd years. They believe that higher allocation would result in the launch of effective programmes. One such example is the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), which is a government initiative aimed to address the growing burden of NCDs. The initiative has already seen a lot of private specialised clinics coming up to treat diabetes, a lifestyle problem affecting about 36% of senior population in India.
“Backed by the government policies, there will be many such opportunities for private service providers in the future,” CCI’s Dutta said.
Experts also say the government’s move to expand the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) to include a special provision for senior citizens aged 70 and above is a welcome move. Under this scheme, eligible individuals can access up to Rs 5 lakh in free medical treatment annually. The initiative, led by the National Health Authority (NHA), allows beneficiaries to receive cashless treatment at both public and empanelled private hospitals across the nation.
Lancet has an interesting recommendation on reducing the distance barrier in healthcare. Future research, the study says, must develop and demonstrate how community-based transport service can be embedded within as a model for implementation for geriatric care. Given the rising number of ageing populations who are home-bound, a shift from clinic-based out-patient care to home-based primary care merits consideration through a mix of mobile medical van, digital healthcare and inclusive social support. There is a need to design and formulate strategies on how existing Ayushman Arogya Mandir (Community based primary care centre) can be strengthened to meet the comprehensive healthcare needs of growing geriatric, the study added.
