India is going through a demographic shift – the country is seeing a steady increase in its senior population over the last few decades. Forecasts indicate that the number of elders will surge to 173 million by 2026, amounting to over 12% of the estimated total population.
The Longitudinal Ageing Study in India states that about 40% of the country’s senior population have some form of disability, and as high as 20% are suffering from mental health issues. Also, 27% of this population group has multi-morbidities, which translates to roughly 35 million people.
All this means that this is a key part of the demographic that we cannot ignore.
In the 2011 census report, people above 60 years accounted for 8.6% of India’s population – that is roughly about 103 million elderly people. Let us account for a 3% increase in this number annually, as people are now living longer. A report by CII estimates that the number of elders in India will increase to over 300 million by 2050.
While these are validated figures, what is crucial to understand is that our country is not equipped to manage these numbers. The ongoing pandemic situation has made us understand that it is critical to plan for preventive and ongoing healthcare for seniors, as they are a vulnerable segment of the country. Even stepping out for groceries is not safe for them during these testing times. We have miles to go to ensure that we have the right systems and infrastructure in place to take good care of our elders. There is barely any government regulation, quality control or any insurance.
In mature markets like Europe and the Americas, the government has laid out a robust care plan that addresses the financial aspect, insurance, facilities and the different stages of care (preventive, home care and transitional care). We must work towards building a solid infrastructure in India as well to ensure a healthy and happy senior population.
Insurance: Extending insurance cover for new age health services such as step-down facility care & home care for the elderly. This will ensure improved quality care and thus reducing readmissions & hence reduce the burden on tertiary care. Currently, a few pre and post hospitalisation costs are covered which are insufficient. It is suggested that Insurance schemes cover the cost of services rendered at specialized centres such as assisted, memory & palliative care centres, hospice, and centres for PWD & special needs.
Interest rates, Income tax & GST: It is recommended that a higher rate of interest be provided on deposits by Senior Citizens than what is prevailing now. Deposit linked insurance scheme should be formulated which will provide peace of mind to the elderly. Necessary changes to be introduced to safeguard the deposit of seniors in banks, mutual funds, or any other approved funds and in the event of default by these institutions the Government shall make good these losses of seniors.
Reduction or ‘nil rate’ of GST on rentals of care facilities: Health care services are exempt from output GST. Any input taxes paid by care providers is a cost to the entity and they do not avail any offset benefits. Rentals especially in metros are very expensive and GST of 18% adds to the burden. Considering this if the GST on such rentals is made ‘nil’ or reduced rate, it will help the care providers and pass the benefit to the older patients and make it affordable.
Income tax concessions for older persons to be considered. Income tax can be abolished for older persons on their earned income (pension & interest on deposits of their earned monies). This will put extra monies in their hands to be used for their health and welfare.
Organisation’s employing citizens above the age of 60 shall be suitably incentivized including additional tax rebate, exemption from labour laws for that group of people etc.
Infrastructure, Community health initiative: It is suggested to encourage State Governments to implement Community health initiative specifically targeting the geriatric population in a PPP model with private players. CSR funds from corporates can be deployed for this purpose. This will allow access to quality geriatric care to the under privileged.
- Introduce Care Giving as a specialization in Nursing colleges and promote the same extensively. Subsidize the fees for such students.
- Evolve special labour law codes for home-based care providers.
Separate Ministry: It is suggested to establish a separate ministry for senior citizens or an exclusive department under the relevant ministry which will oversee the policy implementation by collaborating with various bodies & state governments. It will also act as a nodal body to address grievances.
Senior Care shall be recognised as a separate industry to ensure that adequate importance is attached to the same.
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