The lockdown due to the COVID-19 scare had a significant impact on the GDP however, over the last few months, macroeconomic indicators are showing signs of recovery. However, an area that has always been ignored is that of healthcare for the elderly. Every fourth Indian above the age of 60 and every fifth above the age of 45 reported poor health in a recent Union ministry survey. I urge the government to focus on this segment to ensure that our elderly are well taken of. Some ways of doing this are:
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, thus reducing re-admissions & 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
a. 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. Relevant 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.
b. 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 don’t avail any offset benefits. Rentals, especially in metros, are costly 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.
c. 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.Reverse Mortgage– Popularise and make changes to reverse mortgage schemes. The current reverse mortgage schemes are less popular owing to lack of lending initiatives from banks and stricter conditions. The present regulation relating to reverse mortgage to be amended to permit senior citizens to vacate the property that is under reverse mortgage to move to a senior living, care home or such other specialised facilities.Infrastructure, Community health initiative
a. 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 underprivileged. - Accessibility to public places. The government must provide for a revised guideline to make public places elder safe and also public transport accessible. State governments must be mandated to pursue these initiatives.Human Resources
a. Increase the current allocation of admissions in Medical colleges to promote MD Geriatrics course & introduce Diploma courses for MD Physicians.b. Introduce Care Giving as a specialization in Nursing colleges and promote the same extensively. Subsidize the fees for such studentsc. Evolve special labour law codes for home-based care providers
Separate Ministry
a. 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.
b. Senior Care shall be recognised as a separate industry to ensure that adequate importance is attached to the same.