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Introduction
An ageing population is increasingly growing globally, which results from decreasing fertility and increasing life expectancy. It is projected that by the year 2030, more people will have developed chronic diseases, ill – health and increased dependence. These are usually associated with older people. According to the World Health Organization (2011), by the year 2050, two billion people will be above the age of 60 years. Out of this number, 80% of them will be living in developing countries (U.S. Bureau of the Census, 2016). An important question to ask therefore is ‘‘how the needs and desires of an individual including older people are properly addressed in this changing health care environment? ’ Currently, the elderly group of people are largely white; however, there are projections that the black elderly people will soon overtake the whites shortly.
Comparison of healthcare coverage for the elderly in America and Kenya
The population of the U.S. is ageing, and healthcare needs are also dynamic. It is projected that by the year 2050, adults with 65 years and over will make 20% of the U.S. population (U.S. Bureau of the Census, 2016). This demographic shift has caused serious financial and policy challenges in the country. The ageing population will indeed put more stress on the healthcare system, resources, and families. Just like in many other countries, lack of adequate personal savings for long – term care and institutionally dependent delivery method is a threat to the health and quality of health services offered to the ageing Americans. Meeting the healthcare needs for elderly Americans is just about to be unsustainable due to the high cost of health coverage and as well as increasingly declining access to quality healthcare (Wiener & Tilly J., 2002).
On the other hand, the Kenyan elderly population is not as high as the American because of the high mortality rate. Although, the government of Kenya is trying extremely hard to take care of the older people both financially and health-wise, there are several challenges, including access to quality healthcare. Up to date, the government of Kenya has not come up with a conclusive healthcare coverage system for the older people except the only available system the National Hospital Insurance Fund (NHIF). The NHIF cover is the only hospital cover which is used by everyone in the country but with no special benefits to the elderly citizens. Since there is no direct and conclusive system to address elderly healthcare in Kenya, the country
Merits of the American Healthcare system over the Kenyan Healthcare system in serving the elderly people
In the United States, there is no single healthcare system. However, health insurance is provided by both private and public agencies. The most common and recent public medical plans include Medicare and Medicaid. Medicare plans provide insurance cover for the elderly as well as some disabled no – elderly. In contrast, Medicaid plan offers insurance assistance for poor women and children under the age of 65 years. The insurance for Medicare coverage which caters for the inpatient is paid by the young at a percentage of 2.9 payroll tax, half paid by the employer, and the remaining half by the employee. Besides, the outpatient care under Medicare is catered for through supplementary medical insurance (Center for Studies on Aging, 2010). However, almost half of the Medicare beneficiaries are covered by privately owned medical policy rather than the public ones.
The government of the United States spends twice the amount spent by the rest of the developed countries in the world. Precisely, about 18% of the United States’ GDP goes to support the healthcare system. However, it is important to note that the Medicare system for the elderly focussed on the older people who are over 65 years and those who have worked for the government for at least ten years. It is, therefore, unfortunate for those who have never worked for the government since they will have to dig deep into their pockets to pay for their medical insurance covers. The United States healthcare system is at least offering support to the older people as compared to the focus that the Kenyan government health system is giving the elder people. In Kenya, the government offers very little support to elderly healthcare. In this case, the health insurance cover stops immediately one retires as a public servant. However, at the beginning of 2019, the government of Kenya, through the president, came up with an initiative to support the vulnerable people through the provision of Universal Health Coverage (UHC). The Universal Health Coverage was aimed at providing health coverage for free through the insurance cover provided by both public and private agencies. The UHC was a collaboration between the county governments and the national government.
Interestingly, the program has just hit a snag at the piloting stage because of inadequate funding or lack of funds from the two levels of government. On the other hand, the National Hospital fund provided by the government of Kenya is majorly unaffordable to many people because it is individually contributed so long as one is not a government employee. However, all employers are required under law to submit their employee’s contributions to the National Insurance Fund as part of their contributions for the cover. For the retirees, the law requires that for one to continue enjoying the health services free, you must again constantly update your NHIF status.
Some of the disadvantages presented in the United States healthcare system include unaffordability of health insurance, lack of proper policies to strengthen the system, low public knowledge of health insurance. These disadvantages are replicated in the healthcare systems in many developing countries, including Kenya. It is also important to note that the American system is marred with inequality were some African – Americans are not getting full support from the coverage offered by the government institutions (World Health Organization, 2010). In Kenya, the healthcare system is not strong because of the many persistent problems. The problems range from poor services to inadequate insurance premiums. Inadequate funding of the free Universal Health Care (UHS) is almost making this wonderful initiative to go down. Besides, the healthcare coverage in Kenya is marred by a lot of corruption whereby the government finds itself paying for ghost consumers. Most health facilities in Kenya, especially in rural areas, are understaffed with medical staffs which lead to reduced quality of care. Healthcare coverage in Kenya and especially any developing countries leads to reduced motivation in providing innovation in the health sector. Lastly, there is a big problem with all free health coverage in all the countries, offering it that people can sometimes become careless with their health.
In the United States, reports indicate that the sickest persons benefit a lot from healthy persons’ contributions. This is possible because healthy people regularly contribute as needed. Still, it can take them some times to seek treatment while their contributions are used to treat those with perennial health problems and may need constant clinics and hospital admissions.
In conclusion, the Universal Healthcare Coverage (UHC) started by the Kenyan government was a viable project which could be adopted and fully implemented. The healthcare system provided an opportunity for vulnerable communities to access health services irrespective of their ethnic and social status. Kenya’s healthcare system for the elderly must be changed to cover the elderly persons from the age of 55 years and not from 65 years. Additionally, the limit of cover should be increased so that the elderly can get quality services from across the hospitals, including level 4, 5, and private hospitals. The National Hospital Insurance Fund can also be incorporated within the Universal Healthcare Coverage so the health cover can be financially strengthened and older people to get covered under the system. The health cover will only be effective if the health facilities are improved and more staff recruited with better remuneration; otherwise, better and quality services are an illusion.
References
U.S. Bureau of the Census. (2016). Current Population Reports, Series P25–1130.
Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050. Washington, D.C.: U.S. Government Printing Office.
World Health Organization. (2010). U.S. National Institute of Aging. Global health
and aging. Bethesda, Maryland: National Institutes of Health; 2011 (NIH Publication no. 11-7737).
Center for Studies on Aging. (2010). Chronic disease and aging in the Eastern
Mediterranean Region: from research to policy and practice. Policy brief 3. Beirut, Lebanon.
Wiener J, Tilly J. (2002). Population ageing in the United States of America: implications
for public programmes. Int J Epidemiol, 31(4):776–81.