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” syndrome
· 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 language
· 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.
See also: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
Healthy Aging 3: GCOA-EMHN Policy Dialogue in Bangkok, October 24, 2013