Having adopted the conviction that old people do not climb Mt. Kilimanjaro, I came to a startling realisation a few years ago that I am considered an elder – a label made clear when a salesperson abruptly ended a call upon learning my age, even after I had listed a health insurance package they only offered those under 60. At first, I found this a convenient way to escape annoying sales calls. But it soon struck me that I, like many older Tanzanians, was facing age-based discrimination – a quiet yet serious infringement of our basic human rights.
While the National Health Insurance Fund (NHIF) doesn’t exclude older people outright, its system penalises age with steeply increasing premiums – akin to a punishment for simply living longer. This reflects a broader issue: a blind adoption of foreign health policies that ignore our own cultural values. In traditional Tanzanian society, elders were honoured and revered, having earned their place through raising children and guiding generations. Today, that respect is being replaced by exclusions, driven by policies out of step with our realities.
The thinking that older people might claim their premiums because they fall ill more often and use medical services more frequently. That may be understandable from a business standpoint, but it is not justifiable from an ethical one.
On paper, the Universal Health Insurance Act of 2023 promises equal healthcare access for all, regardless of age. In practice, however, older Tanzanians still face higher premiums simply for being older.
Tanzanians aged 60 and above make up only 4.51 per cent of the population. If insurance truly aimed to spread health risk rather than maximise profit, the economically active majority could absorb the cost, making it possible to offer a flat rate for all—regardless of age.
Elders have paid their dues to society—through years of direct or indirect tax contributions and more importantly, by raising and nurturing the very generation now deciding they must pay more for healthcare. Their lifetime of service should earn them protection, not penalties.
On paper, the Universal Health Insurance Act of 2023 promises equal healthcare access for all, regardless of age. In practice, however, older Tanzanians still face higher premiums simply for being older. A fair system would provide equal coverage on equal terms—without age-based discrimination.
I’ve noticed that those persistent insurance sales calls have stopped. It’s a small relief, but also a stark reminder that healthcare is treated as a business—if you don’t promise profit, you’re considered worthless.
We must hold policymakers accountable and insist that healthcare is a right, not a privilege. Growing old should not come with punishment; senior citizens deserve care, not higher costs, simply for having lived longer.
