This is the continuation of my earlier article, GCOA-EMHN
Policy Dialogue in Bangkok
last month, on the Global Coalition On Aging (GCOA) - Emerging Markets
Health Network (EMHN) Policy Dialogue on
Aging, held on October 23, 2013 at Plaza Athenee Bangkok, Thailand.
There were about 16 of us from eight different countries.
The resource speaker was Dr. Anindya Mishra, a faculty member of the Indian Institute of Technology
(IIT), Roorke India. He gave a 30
minutes presentation entitled “Social and Economic Challenges of Ageing in
Asia: Special Focus on India.”
Among the points raised by Dr. Mishra in his presentation were the following:
Elderly in India, 8.95% of population in 2011,
108.33 M individuals
Healthcare (HC) for elderly is problematic, no
geriatric specialists, there is shortage of qualified medical staff especially
in rural areas
Most female elderly are widows or without
children, have feelings of social isolation
Government HC programs compete with other
sectors, that HC for elderly are sidelined, there is minimal public spending
There is a cultural expectation that children should
take care of their elderly
Rise of old age homes, but there is not much
choice in Homes for Elderly
Two options for the elderly – be independent
from children, or continue the culturally prescribed care
On cultural expectation, forcing children to
take care of their elderly alienates them
Migration of many young people to the big cities
or other countries leave ageing parents behind, they develop an “empty nest”
Absence of emotional support and caregivers, the
elderly are vulnerable to crimes and abuse by other people
Emigrant elderly, if they join their kids to
their new work elsewhere, difficulty in adjustment with new culture, values and
Active and healthy ageing must be promoted
Market Responses include (a) People saving, preparing for
elderly/ ageing life; (b) retirement communities are growing; middle and upper
class are looking for retirement homes someday, Indian real estate companies now
are slowly developing retirement communities. Estimated demand of 312,000
elderly homes, there is a supply of only 10-15,000 new homes a year.
Key challenge is that the State cannot shoulder the
entire responsibility and hence, civil
society, hospitals and philanthropic organization can step in
An open forum immediately followed.
Among the key messages that arose from the participants were the following:
1. The one-child policy in
China, other government-sponsored population control policies are wrong.
2. Governments healthcare policy of one or single payer
system like in UK is problematic too, not only clouds personal responsibility,
also heavy fiscal burden.
3. Ageing is sometimes used by the government to further intervene in the pricing of private players in the sector. One example is the expanded senior citizens discount under RA 9994, where senior citizens (60 years old and above), rich and poor alike, must be given 20 percent discount in their food purchases in formal restaurants, in their purchases of medicines, vitamins and supplements, hospitalization, and so on.
4. Free market principles and healthcare competition can
better respond to the ageing problem in many countries. Give the adult children
and the elderly more options for their healthcare and retirement. A single
provider system like government will not be able to provide flexible solutions
to emerging problems.
Healthy Ageing 1: The Caregiver Village, February 13, 2012
Healthy Ageing 2: World Congress on Healthy Ageing, March 08, 2012
EMHN 10: Forum on Asia's Ageing Societies, Bangkok, October 08, 2013