From Borrowing to Contributions: The Financial Landscape of Elderly Healthcare in Haryana

Abstract

This study investigates the financing of out-of-pocket health expenditures (OOPHE) for the elderly in Haryana, India, highlighting the significant economic challenges faced by households. Utilizing data from a household survey conducted in 2020-21, the research reveals that a staggering 76.2% of total OOPHE for the elderly is financed through contributions from family members, borrowings, and the sale of physical assets. Specifically, contributions account for 52.5% of OOPHE, with the highest reliance observed among the wealthiest households (83.1%) and those with uneducated elderly members (77.5%). Borrowings emerge as a critical source of financing, particularly among Scheduled Caste (SC) households, where 60.6% resort to loans for healthcare expenses. The study also indicates that 23.8% of OOPHE is financed through the sale of assets, with this figure rising to 52.4% among elderly individuals with higher secondary education or above. Alarmingly, more than three-fifths of the total OOPHE (41.1%) is borne through borrowings and asset sales, underscoring the desperation and deprivation faced by these households. The findings highlight the limited role of insurance and reimbursements, which are often negligible due to inadequate coverage and reporting challenges. This reliance on distressed financing mechanisms raises concerns about the sustainability of healthcare access for the elderly and calls for urgent policy interventions to universalize healthcare facilities. The study emphasizes the need for comprehensive health policies that protect vulnerable populations from the economic burdens of healthcare, ensuring equitable access to necessary medical services for the elderly in Haryana and beyond.