Asians are living longer and flocking to cities. Their diets have changed and sedentary lifestyles are increasingly common, leading to obesity and chronic diseases. China and India have the world’s largest diabetic populations. Yet healthcare expenditure in the region is too low.

All Asian markets apart from India have seen growth in healthcare spending outpace GDP growth since 2000. But China’s recent spending on healthcare goods and services is only about 5 per cent of GDP compared with 11 per cent in Japan and 17 per cent in the US – and India’s is just 4 per cent.

Government healthcare expenditure has risen 9 per cent a year since 2000 in Asia, excluding Japan, while private spending rose just 6 per cent. The state share, 42 per cent In 2000, is now 52 per cent but that means a significant burden still falls on households.

Most ASEAN countries rely on private contributions. In the Philippines, India and Bangladesh, private expenditure is at least 70 per cent of the healthcare total – mostly from individuals rather than corporate health plans.

Asia is ageing – especially north Asia. By 2050, the average Japanese women will live to 91, men to nearly 89. Already only 12.5 per cent of Korea is aged under 14 – half the OECD average. Japan’s median age of 48.4 years is the oldest globally and expected to reach 52.1 by 2030 with Korea and Taiwan catching up quickly. However, India’s 28.4 median gives it the world’s largest youth population.

But older people have to spend more on healthcare than the young. And while incomes rise as people move to cities, their diets change: they consume more meat, sugar, dairy and alcohol. Chronic degenerative diseases – cancer, diabetes, cardiovascular – are more prevalent in urbanised centres.

China has 116m diabetics, more than any other country; India has 77m. And by 2045, China’s total is expected to grow by 27 per cent and India’s by 74 per cent. The US has 31m, but Malaysia and Pakistan now have a higher prevalence of diabetes than the US.

About 1 in every 4 new cancer cases worldwide is in China and 10 per cent of Indians are estimated to get cancer in their lifetime.

This all means that spending on healthcare needs to rise much faster than economic growth.

In some countries – including China, Indonesia, Korea, Singapore, Japan and Thailand – households are relatively better able to pay for healthcare. However, many can’t afford it in countries with burdensome out-of-pocket expenditures, especially India, Pakistan, Bangladesh and the Philippines. That not only squeezes the sick but also has economic implications, weighing on worker productivity and growth.

However, Asians are becoming increasingly health conscious, partly because they are getting richer and want to live longer. And COVID-19 is likely to have a lasting impact on Asia’s health awareness as people focus on healthy lifestyles – keeping fit, plus cleanliness and hygiene.

The pandemic has accelerated the adoption of online medical services in China, especially among those with chronic diseases, but there is also a move back to time-tested methods for health products, such as traditional herbal products.

First published 11 August 2020.

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