Establishing the relationship between population aging and health care expenditure in India

Purpose - The main purpose of this paper is to examine the role of population aging in determining the health care expenditure (HCE) in India over the period 1981 to 2018. Design/methodology/approach - While establishing the linkage between population aging and HCE, the study has used economic growth, urbanization and CO2 emissions as control variables and used the autoregressive distributed lag (ARDL) approach to cointegration and VECM based Granger causality approach to estimate both the long-run and short-run relationships among the variables. Findings - The results of the ARDL bounds test showed that there is a stable and long-run relationship among the variables. The long-run and short-run coefficients reveal that population aging and income per capita exert a statistically significant and positive effect on per capita HCE in India. The VECM causality evidence shows that there is a presence of short-run causality from economic growth and population aging to per capita HCE, urbanization to environmental degradation and further from aging to urbanization. However, the long-run causality evidence confirms unidirectional causality from population aging to the per capita HCE. Research limitations/implications - The research findings could be improved by considering the changes in mortality rate over time because of other environmental factors such as air pollution, among others as control variables. Various other variables affecting the health of an aged person could be considered for better research outcome which is not included in the present study because of the paucity of data. However, the present research findings would certainly serve effective policy instrument aiming at maximizing health gains that are highly associated with the elderly population and economic growth towards achieving sustainable development in India. Originality/value - The uniqueness of the present study lies in its estimation where the relationship between population aging and HCE is looked at while considering the impact of other environmental factors separately. The causal relationship is shown among the variables using updated econometrics time-series techniques. The study tried to resolve the ambiguity associated with the relationship between aging and HCE at a macro level.