Public Geriatric Care in India

Syllabus: Inclusive growth and issues arising from it

Demographic Shifts Across States

  • RBI projects Kerala and Tamil Nadu as ageing States by 2036. Elderly population will exceed 22% in Kerala and 20% in Tamil Nadu.
  • Bihar, Uttar Pradesh, and Jharkhand will experience rising working-age populations beyond 2031.
  • Karnataka and Maharashtra occupy a middle position between growth and ageing pressures.

RBI’s Fiscal Recommendations

  • RBI advises ageing States to rationalise subsidies to manage rising pension expenditures.
  • Youthful States are urged to invest heavily in human capital development.
  • Southern States face reduced Central tax devolution due to population-based Finance Commission weightage.
  • Upcoming delimitation exercise may further lower their parliamentary representation.

Challenges for Youthful States

  • Education spending shares have stagnated or declined in high-growth population States.
  • Questions persist regarding employability of the expanding workforce.
  • Workers will enter labour markets during manufacturing automation and AI expansion.
  • RBI’s call to boost labour-intensive sectors may risk ageing before achieving prosperity.

Gendered Impact of Ageing

  • Research shows ageing disproportionately affects women with fewer financial assets.
  • Many elderly women lack pensions due to absence from formal workforce participation.
  • RBI’s workforce-focused model assumes continued family support systems.
  • Migration and nuclear families are weakening traditional informal safety nets.

Policy Gaps and Social Security Needs

  • Fiscal measures alone cannot manage demographic transition complexities.
  • Large-scale job creation is needed in green energy and care economy sectors.
  • Youthful States must develop healthcare and pension infrastructure proactively.
  • Expansion of social pensions conflicts with RBI’s emphasis on fiscal consolidation.
  • Without public investment, geriatric care access will remain limited to the wealthy.

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