Make prevention the focus of health policy

The government’s move to expand the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) to cover those above 70 years of age recognises a key need of the health care architecture in India — ensuring access to health care for the elderly by making it affordable for them to also seek it in the private sector. It is a significant shift given the elderly are likelier to face more frequent and greater health care needs than the younger population while being devoid of regular income. With rising medical costs and public health care well short of saturation in terms of reach and infrastructure, this expansion could make a significant difference to the lives of the country’s elderly — more so since it will complement the recent removal of the 65-years cap on health insurance by the insurance regulator.

That said, there will be pressures on the fiscal side. While the government has estimated an initial cost of ₹3,437 crore, this will need to be expanded in the years ahead given the scheme is demand-based. The fact is that longevity in India is rising, as is the burden of non-communicable diseases, many of which are chronic. As the ageing of the population accelerates in the coming decades, the pressure from funding health care will rise in tandem.

To mitigate this, the need is now for a focused approach on healthy living, geared towards preventive and pre-emptive medical attention. While the elderly are the immediate catchment for this, there has to be concurrent efforts to also include the younger generations for accumulated effects on health later in life. Parallelly, the government must work on improving the reach and quality of public health care to provide affordable health care to all sections of the population, including the elderly.

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