No country for old people

India needs a comprehensive social security system

At first glance, the Assam government’s decision to set up a three-member commission called PRANAM (Parents Responsibility and Norms for Accountability and Monitoring) sounds absurd. The commission will adjudicate pay cuts for employees who do not take care of their dependent elderly parents and physically challenged siblings. This follows a decision in October last year to link geriatric care to state employees’ pay. If the employee is found guilty of ignoring their dependent parents or siblings, 10 to 15 per cent of their pay is liable to be deducted and deposited in the parents/siblings’ bank account. Several obvious questions arise: How can a commission determine whether someone is or isn’t neglecting her dependents? And should the state really be adjudicating on the personal lives and choices of its citizens? 

There are no easy answers to these questions. That’s the reason why a 2007 Central law — the Maintenance and Welfare of Parents and Senior Citizens Act — remains on the statute books without much enforcement. The law provides for “more effective provisions for the maintenance and welfare of parents and senior citizens guaranteed … under the Constitution”. It sets out the definition of dependent parents, stipulates the setting up of tribunals and provides for a jail sentence of three months, a fine of ~5,000 or both for anyone found guilty under the Act. 

Though the Assam government’s recent decision and the 2007 legislation are certainly open to question, the intent of these moves points to a growing social issue in India.  As we see in the West and Japan, one of the ironies of an increasingly prosperous and educated society is that birth rates fall and populations age and live longer. This tends to skew the age-dependency ratio — the proportion of older dependents (above 64 years) to the working age population — enough to create the kind of social crisis that had fed into immigration controversies in the developed world.

Indians could be facing similar issues in the not-too-distant future. The 2011 census shows that the proportion of senior citizens had jumped 35 per cent to touch 103 million, the second highest in the world (the age dependency ratio is still 14.2 against 42 in Japan). It is reasonable to assume that this trend would have accelerated since 2011. The problem is this. Post-liberalisation India has seen a significant expansion of the middle class with disposable incomes to buy an increasingly upscale array of consumer goods. But this rise up the income ladder has also wrought significant social changes: Growing urbanisation, the expansion of nuclear families, of working women and of children working overseas. This affluence has placed exponential pressure on the care of dependent parents. No longer can Indians rely on the joint family ecosystem or on housewives to look after ageing parents. 

As with all social services in India, there are solutions for the rich in luxurious retirement homes that charge astronomical fees and offer five star facilities including 24X7 medical and assisted living care. A minuscule proportion of Indians can afford these. For the vast bulk of middle and lower-middle class struggle between careers and dependent parents in ways that do not always make for healthy social outcomes. Anecdotes of abandonment and mistreatment have become depressingly frequent. Barring some states, such as Kerala and West Bengal, India is yet to develop the mobile social services for the elderly that are available in the West and would go a long way in offering a viable solution. 

The country is clearly on the cusp of a social dynamic in which the state lacks the wherewithal for a comprehensive social security system. India will soon reap the burden of neglecting its senior citizens unless the problems of poor pension coverage and inadequate health insurance issues are addressed. Doing these will surely have short-term costs, but the long-run welfare benefits to society can no longer be ignored.