The global population is ageing. It is estimated that by 2050, older people will constitute more than one-fifth of the world’s population. In the populace statistics prediction, the proportion of world’s population over 65 years will double, the number of people worldwide aged over 80 will quadruple to 400 million and for the first time in history, there will be more people over the age of 65 years than under the age of 14 years.
Eighty per cent of those over 65 years will live in current low or middle-income countries. Hence, the greatest increase will be in Africa. Recent data shows that the median age in Kenya is 19 years so by 2050, our nation will be approaching a mass retirement. But is our healthcare system prepared for this demographic transition to guarantee a lifetime of quality life and dignity?
The Covid-19 pandemic laid bare the shortcomings of our healthcare systems particularly the mismatch between needs and available care. Those who are poorer or uninsured are unlikely to access quality healthcare or the care could push them to poverty due to the huge bills. Other problems exposed by the pandemic include unequipped under-staffed facilities and a great extent of mismanagement of funds and resources in the healthcare space.
Our nation has a lot to learn from developed nations and even middle-income countries, including South Africa. For example, we could borrow from South Africa’s older persons’ care system that is sensitive to their personal needs like nutrition and access to healthcare.
The State must invest in efforts to support long-term care which is rare in Africa despite our average life expectancy of 70 years. This includes research, planning, partnerships and subsidised costs for care homes so that older people can access them affordably. As the workforce gets busier, there is an urgent need to lessen the elderly care burden on families, which is both unsustainable and impractical in the long run.
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Another touchpoint is medical insurance for senior citizens. Although we have come a long way in popularising NHIF, Kenya needs to move quickly into propagating the need for the State universal healthcare for pensioners as well as private post-retirement medical funds. These special funds allow members to either make additional voluntary contributions or set aside a portion of their accrued benefits for medical care. Upon retirement, they have the option of purchasing a medical cover or using the amount to offset outstanding medical bills.
The medical funds were, in 2018, exempted from the retirement benefits levy in a bid to spur the growth of this sector. However, there is an urgent need for further legislation to entice new uptake, grow contributions by members, and guarantee benefits adequacy. Key attention needs to be paid to the informal sector which is already struggling with low pension penetration.
Findings of a recent survey by Strathmore University and Enwealth Financial Services showed that about 41 per cent of retirees pay for medical bills out of pocket. The data showed that a third of pensioners have private medical insurance, with a fifth relying on the National Health Insurance Fund. Additionally, only 1 per cent of them had invested their pension payout in buying a post-retirement medical cover upon retirement, a time when they are highly vulnerable to diseases.
Healthcare is critical. Older people face an increased risk of degenerative and non-communicable diseases such as cardiovascular ailments, diabetes and kidney diseases. Unfortunately, our system is ill-prepared to attend to the increasing demand for health care from older people as the people are financially unprepared for unforeseen medical bills. This is true in both preventive and curative services. Simultaneously, we are ill-prepared to provide long-term care for older people.
Older adults are not simply passive recipients of support, but active contributors to families, communities and societies. Tailored responses must, therefore, not be seen as philanthropy but rather as part and parcel of overall national development efforts. If we do this, there’s a flicker of hope that old age will not mean deprivation and neglect.
Ms Wamugo is Assistant Manager, Underwriting, Enwealth Insurance Brokers.
