India needs to expand universal health coverage for rapidly ageing population, maintain growth: ADB report

Tbilisi: India is one of the lowest among the Asia Pacific nations when it comes to health insurance for older people and needs to expand universal health coverage to meet the needs of a rapidly ageing population and sustain growth momentum, a report by ADB said on Thursday.

While the South Korea and Thailand have achieved universal health coverage, others lag behind with India having the lowest health insurance coverage among older people at 21 per cent, a report titled 'Aging Well In Asia' prepared by ADB said.

However, schemes like Ayushman Bharat that provides cashless healthcare to bottom quartile of population has improved health coverage since its launch, ADB senior economist Aiko Kikkawa said here.

Expanding it further will improve the condition and make people aged over 60 years more productive for the economy, she said, adding, silver dividend can be higher for such countries who gainfully employ them.

Besides achieving universal health coverage, she said, it is also critical to extend essential services and interventions that optimize older people's physical and functional capacity.

In Bangladesh, Indonesia and India, more than half of those without access to healthcare are in the bottom two wealth quintiles, it said.

The report further said that economic growth impact due to ageing population during 2031-40 would be lower in the case of India as it would still have high young population.

According to the report, the number of people aged 60 and older in developing Asia and the Pacific is set to nearly double by 2050 to 1.2 billion -- or about a quarter of the total population -- significantly increasing the need for pension and welfare programmes as well as healthcare services.

At the same time, economies have an opportunity to reap a "silver dividend" in the form of additional productivity from older people, which could boost gross domestic product in the region by 0.9 per cent on average, ADB chief economist Albert Park said.

With a view to widen the market and foster adequate protection from healthcare expenses, insurance regulator IRDAI recently removed the age limit of 65 years for individuals buying health insurance policies.

By abolishing the maximum age restriction on purchasing health insurance plans, the Insurance Regulatory and Development Authority of India (IRDAI) targets to foster a more inclusive and accessible healthcare ecosystem, ensuring adequate protection against unforeseen medical expenses.

Talking about financial preparedness for retirement, the report said, it varies across the region.

An individual is considered financially prepared for old age if income, including from assets available for liquidation, meets consumption needs for the expected duration of retirement, it said.

A newly developed financial preparedness index shows the share of financially prepared near-old people -- those within 5 years or so of retirement -- to be as high as 86 per cent in Japan and 73 per cent in India, but somewhat lower at 64 per cent in China and 58 per cent in the Republic of Korea.

"There is a wide rural-urban preparedness gap in China with only 44 per cent of rural residents prepared, barely half of the 82 per cent of urban residents who are prepared. In India, China, and South Korea, 80-90 per cent of financial resources for retirement come from private income and assets, not public pensions or social assistance," it said.

Observing that the life expectancy at age 60 in the region is expected to rise by 3.7 years for women and 4.1 years for men from 2022 to 2050, the report said, adding, this will raise the average regional life expectancy at age 60 from 21.6 to 25.3 years for women and from 18.2 to 22.3 years for men.

"Older women in India will see the greatest increase in life expectancy at 6.4 years, followed by Kazakhstan; Georgia; and Hong Kong, China at 4.6 years. For older men, Armenia will have the highest increase in life expectancy at 6.1 years, followed by India at 5.7 years and Georgia at 5.2 years," it said.

Asia and the Pacific's rapid development is a success story, but it's also fuelling a huge demographic shift, and the pressure is rising, said Park.

"Governments need to prepare now if they're going to be able to help hundreds of millions of people in the region age well. Policies should support lifetime investment in health, education, skills, and financial preparedness for retirement. Family and social ties are also important to foster healthy and productive populations of older people and maximize their contribution to society," he said.

According to the report, 40 per cent of people over age 60 in Asia and the Pacific lack access to any form of pension, with women disproportionately affected, as they are more likely to do unpaid domestic work.

As a result, many older people in the region have no choice but to work well beyond retirement age to survive. Among those still working at age 65 or older, 94 per cent work in the informal sector, which typically doesn't provide basic labour protections or pension benefits.