India is in the whirlpool. Millions of Indians are getting sucked into this crippling condition called diabetes. Unfortunately diabetes does not remain just a healthcare challenge. It confronts the individual and the family – physically, emotionally, professionally and very importantly financially. Over its lifetime, it morphs itself from a marginal healthcare expense initially into something massive and completely Herculean.

In India, 85-95% of the all healthcare costs are borne by individuals and their families. This is because a vast majority of our population is either not insured, not insured appropriately or under-insured. This money is pulled out from the anyway limited household income. Now if one has to appreciate the various financial implications and more importantly plan for these, then understanding the following are important:

There are 5 layers of costs that surround diabetes. They may materialize sequentially or come in groups depending on which stage of diabetes you are in, which more or less translates into how badly or well have you treated your body. These are:

  1. Prevention costs
  2. Cost of routine care
  3. Direct costs
  4. Indirect costs
  5. Intangible costs

A recently published article in one of India’s leading newspaper pegs the various costs of diabetes as below.

Cost of routine care:

Type of diabetic / income levels / tenure Expenditure
Low income family with a diabetic adult 20% of the household income
For a family where a child is diabetic 35% of the household income
5 years into diabetes Cumulative INR 1.5 lakhs
10 years into diabetes Cumulative INR 4.0 lakhs
20 years into diabetes Cumulative INR 15 lakhs

 

Direct costs:

            Nature of expense       Cost incurred
Physician, diagnostics, medicine, insulin and home testing INR 36,000 – 1,00,000 / annum
Health insurance costs Higher premiums with every passing year
Hospital admissions for long term complications such as heart, kidney, eyes, foot etc. Expenses going into lakhs for one such hospitalization
Foot complications INR 19020 / month
Renal complications INR 12690 / month
Heart & cardiovascular complications INR 13135 / month
Retinal complications INR 13922 / month

 

Indirect costs include:

  1. Shortened careers and reduced productivity
  2. Loss of income

Intangible costs include:

  1. Pain, anxiety and fear
  2. Making do with a not-so-sensitive and intolerant society
  3. Discrimination at workplaces
  4. A roadblock to marriage – especially for the diabetic girl child (the beti bachao, beti padhao movement will soon have a new parameter to include)

While the purpose of this blog is to make you financially aware, there are unfortunately no absolute solutions for situations like these. It will finally be your own understanding and planning thereof that will help you. But there are a few hints that I can share:

  1. Focus on prevention – if you have a family history or any other factor that even remotely correlates you to diabetes, do everything in your capacity to prolong and prevent. This will include a change in lifestyle with respect to food, exercise, sleep patterns and management of stress levels.
  2. The financial blow if you realise is a double whammy. A truncated or a not so productive career which will result in a huge loss of income over years and the need to have an increased pool of money just for yourself and your family for the future. This is where health and other forms of insurance step in. I myself have a 10 lakh medical insurance from Max Bupa.

The nuances of various forms of insurance and the long-term benefits of investing in mutual funds via the SIP route with healthcare as a ‘goal’ (despite the introduction of the short term capital gains tax) are worth an elaboration. But that clearly is a topic for my next blog in this segment.