On April 7, earmarked as World Health Day, the World Health Organization (WHO) focused on the theme ‘Prevent. Treat. Beat Diabetes’, highlighting the importance of fighting the global epidemic. The first WHO global report on diabetes stated that the number of adults living with diabetes has almost quadrupled to 422 million in 2014 from 180 million in 1980. While China has the largest number of cases, India has moved to the second spot with 69.1 million people living with this health issue.
Our internal analysis of health insurance claims shows that claims with diabetes hovered around 20% during 2012-15. In a clear case of concern, claims with diabetes in the age group of 26–45 years contributed to 20–22% of the claims.
Uncontrolled diabetes increases the risk of ailments affecting multiple organs. Delay in detection and control of ailments as well as conditions such as hypertension, can lead to co-morbidity, which can aggravate other life threatening critical diseases. Adults with diabetes have a 2-3 fold increased risk of heart attacks and strokes. The overall risk of premature death among people with diabetes is at least double the risk of their non-diabetic counterparts.
Due to its chronic nature and the severity of complications, diabetes is a costly disease. Studies in India estimate that for a low-income Indian family with an adult diabetes patient, as much as 25% of the family income may be devoted to diabetes care. Apart from the financial burden, it curtails one’s ability to work effectively. Intangible costs (pain, anxiety, inconvenience and generally lower quality of life) also impact the lives of patients and their families.
But diabetes can be prevented or the complications can be delayed through daily exercise and healthy diet. Early diagnosis through regular blood sugar testing and timely intervention in terms of blood glucose control can enable one to live well, even if diagnosed with diabetes. In countries such as the UK and China, governments and their agencies are working towards preventing diabetes and reducing its consequences by creating a weight control programme. The approach involves multiple elements, including creating awareness about a healthy lifestyle, working with food industry towards making healthier foods, screening for diabetes and providing counselling on diet, exercise and medications, and patient management.
In India, policymakers are working towards diabetes control by introducing interventions as well as focusing on awareness and behavioural changes by promoting screening and early diagnosis of people with high risk followed by treatment. The recent discussions pertaining to imposing a cess on sugar sweetened beverages is in line with the WHO recommendation to governments to levy taxes on sugar-sweetened beverages to reduce childhood obesity. Several countries, including the US, France, Hungary, Mexico and Finland, have already taken measures on this front and early indicators point to the desired behavioural change in terms of consumption.
For India, it makes sense to take faster steps in this direction, considering that the annual per capita consumption of sugar sweetened beverages has increased significantly from 2 litres a person to 11 litres a person between 1998 and 2014. Further, there are added benefits to this in terms of water conservation when production of such beverages is brought down.
Insurance companies, too, are taking multiple initiatives to reduce incidence rates. Insurers are moving beyond their role of being risk financers to become risk managers by offering wellness solutions covering diet and nutrition consultation, fitness therapy and more. Insurers are also introducing indemnity-based outpatient department (OPD) products that enable customers to avail insurance benefits for consultation, diagnosis as well as pharmacy. These initiatives should motivate customers to become more responsive towards maintaining their health.
While diverse stakeholders work towards addressing the diabetes issue, it is ultimately in the hands of each one of us to take charge of our health. No incentive or penalty can substitute one’s resolve to lead a healthy life. Further, as medical treatments become expensive, it is important to stay protected against financial impact of medical expenses by availing of a comprehensive health insurance policy at an early age. As a society, we need to collaborate and ensure that we successfully prevent, treat and beat diabetes.
Bhargav Dasgupta is managing director and chief executive officer, ICICI Lombard General Insurance Ltd.