Caring for the elderly is a human rights imperative
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As fertility rates decline and life expectancy increases, the proportion of people aged 60 and above is growing globally. Global average life expectancy has increased from 48 years in 1950 to 68 years in 2010 and is expected to become 81 years by the end of the century. Nearly 60% of the world's over 60 population resides in the Asia Pacific region and this number is expected to more than quadruple by 2050. While people living longer is a cause for celebration, this demographic transition towards an ageing society in the Asia-Pacific region brings new challenges with deep social, economic and political ramifications.
With increasing age, health and well-being take their toll. Non-communicable diseases, such as hypertension, diabetes and dementia, are becoming more widespread. Yet, health and social security systems in the region are under-prepared to meet the needs of older persons.
As countries age, they need to invest in supporting the contributions, experience and expertise of their growing number of older citizens. At the HelpAge Asia-Pacific Regional Conference 2016 on Economic Implications of Ageing, recently held in Hanoi, Viet Nam, good practice examples of how some countries were responding to their rapid population ageing were shared.
Japan: Prepared well in advance!
Japan is a hyper-ageing country, with one third of its population over 60. But it prepared well in advance to deal with it. Dr Keizo Takemi, Chairperson of Asian Forum of Parliamentarians on Population and Development (AFPPD), said that Japan began its welfare policies for the elderly way back in 1960s when the ageing rate was low at 5.7%. It adopted a comprehensive welfare policy, introduced universal healthcare, a universal social pension, and a plan for income redistribution, low unemployment rates and progressive taxation.
Healthcare was made free for the elderly Japanese in 1973. In 2000, Long Term Health Care Insurance System was enforced. Between 1990 and 2011 there was a 277% increase in the number of health facilities. All this has paid off and Japan is now not just the oldest, but also one of the healthiest and wealthiest countries, with the highest healthy life expectancy in the world. However, Takemi cautioned that as future costs of long term care benefits and premiums become high, healthcare expenditure will skyrocket. By 2025, 1 in 5 of Japan's population will become over 75 years old, and 46% of the total health budget will be spent on them. One important solution suggested by him is to increase healthy life expectancy; reduce the gap between healthy life expectancy and life expectancy (which currently stands at 9-12 years in Japan, but is much higher elsewhere); and create job opportunities for those healthy elderly people to be economically independent. Policy makers will also have to develop an integrated community care system focussed on home care services. It would make better economic sense to move elderly patients from hospital to home by strengthening the capacity to deliver medical as well as routine life support services at the home. Takemi also hinted that in future Japan is very likely to use robots to take care of the elderly persons at home.
China: Expanding basic health insurance...
Liu Zengrui, Director of Rights and Interests Protection, China National Committee on Ageing, gave an overview of how China is dealing with its ageing population. Chinese government has expanded basic health insurance to achieve complete coverage; reformed the ways for making medical insurance payouts; improved medical-care in nursing homes; introduced social insurance against chronic diseases; strengthened health education to increase fitness awareness for the aged; promoted social participation of older people by stipulating policies for gradually suspending the retirement age of employees and keeping older people in the workforce. It has launched a programme named "Yin-Ling" to encourage and support retired scientists, experts and professors to participate in volunteer activities.