New Delhi, January 27: HelpAge India, a not-for-profit working for elder care, in its budgetary recommendations to the Central Government, recommends a set of measures under 3 core areas of – Income & Social Security, Health & Geriatric Care and creating an Enabling Environment for elders.
In view of the consequences of the pandemic the need for increased social and health security are emphasized while adding new areas like encouraging family based care giving and home care, and focus on Digital Literacy for Senior Citizens. These recommendations address the needs of both the rural & urban elder, while focussing on urgent implementation of existing Govt. schemes, beneficial to the elderly.
“The pandemic has brought elder vulnerability to the forefront and the urgency has never been greater for society and government to act, not only to provide relief but also to address systemic inequities towards building back better and leaving no one behind. We appreciate the Government prioritizing elders during its vaccination drive. As admirably done in PMJAY to bring minimum health security for the disadvantaged, we hope the Central Government will take leadership in setting a basic minimum social pension floor of Rs. 3000/ pm for poor elderly across the country, and revise the central contribution from a meagre Rs. 200 (unchanged for 14 years) to at least Rs 1,000/ pm.
Accelerated implementation of National Program for Healthcare of Elderly (NPHCE) with dedicated funds, is another key step needed to bring in comprehensive geriatric care” ” – says Rohit Prasad, CEO, HelpAge India.
There are an estimated 140 million elderly in India. The recently published findings of the Longitudinal Study of Ageing in India (LASI) highlighted the facts of income and health security. Around 70% of the elderly are faced with chronic diseases, while only about 30% of the rural elderly from BPL households are recipients of old-age pension benefits. Just 26% of households are covered by some form of health insurance in India. 36% of the elderly are working—much higher in rural areas (40%) than in urban areas (26%), and mostly in the unorganised sector.
Poverty in old age, is a major challenge that has been further impacted by the pandemic. It has impacted all, poor and middle class elderly in varying degrees. The earlier SECC report of the Ministry of Rural Development had identified 50% of the elderly as poor. Many more could have been pushed under it, due to the pandemic. Therefore, there is an urgent need for a robust pension scheme, health insurance plan, and tax exemptions for the 140 million senior citizens from across the social spectrum.
Income & Social security for the elderly is of critical significance as it is a matter for survival for the poor. The absolute poverty, shrinking earning opportunities and increased cost of living, calls for an increase in the amount of pension to a minimum for decent living. The Central Government may consider increasing the per month contribution per beneficiary to Rs. 1000 for those in 60-79 years and Rs. 1500 for the 80+.
HelpAge India has also sought tax relief on interest income earned by senior citizens of up to Rs. 1 lakh. A tax exemption has also been sought on an annual income of up to Rs. 10 lakh earned by a senior citizen and higher limits to be particularly considered for older women (60+) and all senior citizens in the oldest old segment (80+). Income from bank deposit interest is sometimes the mainstay of the economic security in old age for many. Increase in cost of living affects them too, more so if they have to undergo treatment for non-communicable diseases like cancer, diabetes.
The needs of geriatric care, long term care and palliative care for elderly needs immediate attention. The pandemic has further amplified this need with elders being identified amongst the most at risk. Due to the repurposing of the healthcare delivery systems for the pandemic and movement restrictions, the elderly dependent on public hospitals for treatment of NCDs and free medicines were adversely impacted.
HelpAge strongly recommends an accelerated and prioritised implementation of National Program for Health Care of the Elderly (NPHCE) across the country, along with close monitoring, preferable if the budgetary allocation is done specifically for this unique initiative rather than putting funds in a ‘flexi-pool’. This will cover the cost of outpatient treatment for many poor and not so poor older persons whose families may be constrained to deny them treatment due to economic hardships.
“The government’s National Program for Health Care of the Elderly is an excellent initiative to provide the much needed healthcare assistance required, it now needs to be accelerated across all 740 plus districts” – said Rohit Prasad, CEO, HelpAge India.
At an age when the health insurance need is highest (60 plus/ 80 plus), any insurance policy is prohibitively expensive. Therefore, there is a need for a special drive to enrol older persons particularly elderly women, oldest old and disabled elderly under the national health insurance scheme – Pradhan Mantri Jan Arogya Yojana (PMJAY)and to extend the coverage of PMJAY to all 80 plus elderly.
Under Section 80D for medical insurance, senior and super senior citizens to be allowed a deduction up to Rs.2,00,000 including home care services, for all ailments. Additional exemption for women senior citizens, as women tend to outlive their husbands and need a safety net.
What was interesting to note were also some fresh new recommendations made by the organization to encourage caregiving of elders by their own kin. Apprehending a decline in caregiving of senior citizens by their own family members, HelpAge India also pitched for tax exemptions for family carers, encouraging and giving them a fillip to look after their elderly. It has requested for additional limits beyond the basic tax exemption. An amount of Rs.3.5 lakh (beyond the exemption limit of Rs 2.5 lakh) for those tax payers taking care of parents/in-laws up to 80 years and an amount of Rs 5.5 lakh for taking care of those above 80 years. This can be claimed by any one of the adult members.
“The pandemic has increasingly highlighted the need for elder homecare. We need to encourage and incentivize family caregivers to look after their elderly at home. We hope that this recommendation be seriously considered so care remains within the family fold,” said Anupama Datta, Head – Policy Research & Advocacy, HelpAge India.
Another new recommendation has been made for creating an enabling environment for the elderly by introducing a special scheme on Digital Literacy for elders. Post pandemic, the digital divide has starkly increased for the elders. While all systems (banking, utility, and health, financial and other transactions) are getting digitally enabled under the Digital India/ eGovernance programme, the elderly are left behind struggling. There were also concerns about the isolation and neglect of elderly people in middle-class areas due to their inability to reconnect by digital means.
Considering the unique & varied needs of senior citizens which is also the fastest growing segment of the population, the organization has also requested for a Separate Ministry for Elderly to address these specific immediate needs and plan a better future.