Date: 07-09-2024 at 16:00
I am irrationally optimistic about humanity, of course, I would like to be biased and inclined towards India, Bihar, and us. But I love pessimists because they challenge you to push harder.
In the past 3 to 4 years, I have not come up with pessimistic thoughts. As David Dautch in his brilliant book - “The Beginning of Infinity” - said: Problems are Soluble! Therefore, every -ve thing in society is just another problem ready to be solved.
However, recently, I have experienced pessimistic thoughts - more like a sense of sadness after rereading Rohini Nilekani's article in “The New Indian Express”: Can India ensure that its elderly are taken care of?
I live in Patna, my parents are in their early fifties and live in our village - Dasaut (Bihar). The apartment that I live in Patna has 6 flats - and 3 couples in their mid-forties living alone. In the societies that I live in almost 95% of families are in their late thirties living with their kids in the age bracket 5 to 15.
The Cafe (Hideout - best Cafe Chain in Patna - you should visit, if you are coming to Patna) that I work, read, and write - 5 to 6% of staff are Elderly people (maybe in their mid-sixties but they look older).
With all the subconscious daily encounters when I read and got some sense of the grave of the problem - I was sad for a few seconds - the feeling of pessimism took over my strong sense.
The key points from Rohini’s article:
In India, 40% of older adults experience poverty, compared to less than 10% of the general population.
Only 14% can use the internet
Less than 5% report being part of a social organization
The elderly are more likely to be female, have moved less education and live more in rural areas
One in three seniors still do not have the luxury of retiring, and many continue to do unpaid work - 65% of those in agriculture and allied activities
Those who do retire can feel a sudden lack of purpose, a loneliness
In just 20 years, an estimated 80 million elderly will live alone or with just a spouse (My parents are already living alone in a village).
My pessimistic version will tell you that the problem looks bad when we look at this in a decade's time frame. Here is a table that I compiled to get a sense of the gravity of the problem.
I am not at that age and have been instructing my parents that they should not consider themselves in the Elderly age - I have increased the frequency of calls and duration.
However, I consider myself in my mid-fifties from my habits, behaviour and mind:
I wake up early
I love birds Chirping
I do Meditation
I love Mukesh Kumar, Kishore Kumar and Rafi’s Songs
I exercise and try every opportunity to walk
I read books
I pray and visit Temples
I love kids and talking with them
I love Sex [There is something magical about that sensation]
Except for the last, the rest are considered mid-sixties habits and behaviours.
We can list a few fundamentals that most older population expects or would like to have.
Access to Fundamental Needs: Food, House, Healthcare, and Money
Caretakers and people to talk: Having Known people (relatives) around
Sense of Belonging: Part of a community, Having a purpose, Contribution
The list may be longer, but the above list contains 90% of the expectations and needs of the older population.
We will come to the solutions in the last part of the essay, but let me tell you the story of 74-year-old Devcharan Yadav. By physical look - he doesn’t look like 74 at all. He is working as a gatekeeper at my favourite Patna’s Cafe - Cafe Hideout, Saguna More.
Last year, when we were thinking about building Jilo Health on the top of PMJAY (Pradhan Mantri Jan Aarogya Yojana), I created his Ayushman Card so he could avail of 5 lakhs free healthcare treatment.
I only applied for the Card and never downloaded a digital or physical copy. I forgot completely.
Fast forward a few years later, Baba has been suffering from Motiyabind for a while, however, the eye pain has grown rapidly in the past few months. And it was so high, in Aug, that Baba (everyone calls Devcharan Ji - Baba) walked to just the other side of the eye hospital - Drishtikunj Netralaya - and got diagnosed.
The hospital told him, that Motiyabind was in the final stage and he needed surgery. The total treatment expenses were above INR 25,000 - a big one-time sum for someone working as a gatekeeper.
He told this to the Cafe Manager, and he conveyed to the Cafe’s Owner - Anjesh Shandilaya. The owner was ready to pay the treatment expenses because the sun was unaffordable for Baba.
When Baba first visited the hospital, he was asked for an “Ayushman Card” to get the treatment free of cost. So, just two days before, Baba told me about this whole incident. I gave him my number and asked him to call me before finalizing the treatment expenses.
He called me around 2:30 PM from the hospital, I walked to the hospital (a 7-minute walking distance from the cafe), and talked to the staff - according to them this hospital is empanelled under the PMJAY. But to avail of the free treatment Ayusman Card was a must.
The hospital staff told me it would take a few days to get the card ready if his name would be I the beneficiaries list. In the hospital only, I installed Ayushman App to apply for Baba’s Ayushman Card - thinking it would take a few days. I asked for Baba’s Aadhar Card and when I logged in to the app, I was surprised because - the card that I applied a few years back was approved.
At this stage, I only had to do the KYC - Baba’s Aadhar Card is linked to a phone number - hence just with an OTP, I downloaded his Card. I shared his Ayushman Card in the Hospital administrative’s WA. They said, it would take one day to complete the document work and the next day was 15th Aug.
So, the final day of the surgery was scheduled for Monday (19th Aug). On Monday, the hospital performed the surgery - it was mandatory for the Baba to take the rest. So I met him after a few days with black specks on his eyes.
He was delighted that the hospital took no money for the treatment. He asked me whether I should ask for the initial 2500 of the treatment as a refund which he paid for the diagnosis. Technically, he can demand that as well - however, I told him to leave it.
The Baba in his mid-seventies is a classic example of a “Silver Economy” that is from tier-2 cities like Patna. If you look at the fundamental needs of the elderly population from the above list - Baba’s expectations are fulfilled thanks to an employment opportunity “Cafe Hideout” in his locality.
This story also reflects why the need for economic diversity is so important from the POV of making sure the next 100 million of the Elderly population have all their fundamental needs satisfied.
Our economy is concentrated in metros, we need economic diversity, and we need small and large businesses in each district, state, and even at the block level to make sure - we contain one of the biggest problems in the history of our nation.
And this would also be the solution to this problem! I am glad to see the buzz around the SME listing however, we need a lot more private investments and capital deployments in this part of the world.
Let’s say that tomorrow, Cafe Hideout goes public as an SME listing, you must invest in it considering it will not only give you a return - it will also help many like Baba!
My thoughts were clouded by pessimism, after reading Rohini’s article, but this story and everything that I see on the ground made me irrationally optimistic about India and us.