The Unavoidable Social Change and the Avoidable Impact on the elderly: Our aging Society and the Deficiencies of the Systems 1 Presentedby:
Our research questions Are there any changes in the elderly society in Hong Kong? If so, what are they? CanHongKong’sexisting welfare policies adequate to handle the change? 2
Research Methods Literature review Focusgroupstudiesanda total of 5 one-to-one in-depth interviews and 3 NGOs group were conduct at NGO premises in October 2009. (Duetoagreement,individual and organizationshavetobe remain anonymous) 3
3 Major findings Characteristics of our Aging society Hong Kong existing elderly welfare policies The deficiencies of the existingelderlywelfare policies Summaryandrecommendation 4
Characteristics of our aging society (1)Increasing of life expectancy In 2006, the life expectancy at birth was 79.5 years for males and 85.6 years for females, and is expected to increase to 82.7 and 88.3 in 2036 The conventional retirement age is set at 65, avg. life expectancy is over 80 for both men and women. Thus, the elderly will experience a longer period of retirement life and that society will have to take care of more elderly people (Chou and Chow, 2005) 6
Characteristic of our aging society (2) Agingpopulationtrend=moreelderly Population Projection in Hong Kong from 2006 to 2036 Source: Census and Statistics Department, Hong Kong Population Projections 2007-2036
In 2006, 12.4% of the Hong Kong population was aged 65 and above, and the trends keep increasing.
By 2036, over 25% or 2 million people of our population is estimated.
Characteristic of our aging society (3)Lower fertility rate=lessyouths Fertility Rate projection in Hong Kong from 2006 to 2036 Source: Census and Statistics Department, Hong Kong Population Projections 2007-2036
The total fertility rate has a trend of decreasing for three decades.
The total fertility rate is expected to decrease from 984 in 2006 to 900 in 2036
Characteristics of our aging society (4)-Higher dependency ratio - Dependency ratio is an age-population ratio of those typically not in the labor force(the dependent part and those typically in the labor force(the productive part).
As the ratio increases, there means an increased burden on the productive part of the society to maintain the social securities
Median Age and Dependency ratio projection in Hong Kong from 2006 to 2036 Source: Census and Statistics Department, Hong Kong Population Projections 2007-2036 As projected, the median age and overall dependency ratio will increase from 39.6 years old and 354 in 2006 to 46.1 years old and 611 respectively in 2036. Conclusion: There will be an increased burden on the economically productive population to provide for the upbringing of the young and pensions for the aged. Characteristics of our aging society (5)- Higher dependency ratio 10
Characteristics of our aging society (6) Low education and skills elderly The proportion of the elderly have an education level of primary or below are 75% of the elderly in 2006 Opportunities for elderly women to receive education have been overwhelmingly lower than for older men. This explains why the present older generation finds it hard to stay in the labor force, especially elderly women. low educational attainment of the elderly, engaged in non-skilled and low-rank positions, their median income is $6,500, which is around 65% of the median income of the whole working population. (2006 Population By-Census Office). Elderly require savings as their major financial source Major source of Income is from were interest from savings/fixed deposits or dividends from stocks (89%), financial support from children (58.4%) and old age allowance (51.6%), while 12.5% received salary and 12% comprehensive social security assistance (Census and Statistics Department, 2000) Among the 900,000 old people, around 269,000 or 32.1% of them were classified as poor.(the Hong Kong Council of Social Service and the Hong Kong Social Security Society , 2009) 11
Characteristics of our aging society (7) Living alone are correlate with poverty The number of households with less than $4,000 monthly household income nearly doubled in the period between 1995 and 2005, rising from 89,100 to 192,900. . (The Commission on Poverty ,2006) Out of these 192,000 households, 66% or 126,000 were elderly households, with 78% of them being 1-person households. . (The Commission on Poverty, 2006) The correlation between 1-person households and poverty is quite significant with about 66% of 1-person households being low-income households. (The Commission on Poverty, 2006) Expecting cases of elderly living alone will increase The number of elderly living alone or with a spouse only is expected to increase because the younger generations are less inclined to live with the elder generation (Chow and Lum, 2008). 12
Summary of Aging characteristics in Hong Kong Decrease birth rate decreases and increased average life expectancy led to an increase of dependency ratio and heavier financial burden Lower educational and skill levels became low wage earners with insufficient capacity to save. Retired elderly mainly rely on their meager savings, and elderly poverty becomes a major issue. No. of elderly who live away from their families or live alone is increasing, causing an increase in the demand for welfare services. These factors show that there is a large pool of poor elderly needing care and attention. 13
II.Hong Kong government elderly welfare policy Positive non-intervention and a minimalist welfare regime The traditional Chinese culture of respecting the elders plays an important role. Financial crises in the past 20 years threatened the long established welfare system and also family support for the elderly. The distanced between the younger generations and the elderly has become less close. More and more elderly rely on social security payments. 90% of the elders aged 70 are receiving government welfare benefits. ( Comprehensive Social Security Assistance (CSSA); Old Age Allowance (OAA) or /and disability Allowance) 15
World Bank’s Five-pillar approach Zero Pillar: “Basic” or “social pension” First Pillar: A publicly managed mandatory to combat poverty Second Pillar: A privately managed mandatory Third Pillar: Voluntary Saving Fourth pillar: Non-financial benefits such as family support, access to healthcare and housing 16
Hong Kong government’s Four pillar approach Zero Pillar: a safety net, managed by the Government and funded by tax revenue, for the needy elders, i.e. the Comprehensive Social Security Assistance (CSSA) scheme First Pillar: Provision of Old Age Allowance Second Pillar: a mandatory retirement savings scheme managed by private institutions for the working population, i.e. MPF Third Pillar: encouraging the public to accumulate savings, including insurance policies and family support. 17
Zero pillar – ComprehensiveSocialServiceAssistant(強積金） The existing policy deter the elderly to receive CSSA: CSSA need to apply through family, thus, it is quite troublesome if the elderly are living with the family, because other family members may reluctant to apply. In some cases, elderlyrequire their son and daughtertosignthe ‘bad son’ statement(衰仔紙）to receive CSSA. In our focus group, one respondent needs to live away from her family in order to receive CSSA. There are 269,000 elders living in poverty, as defined by the Hong Kong Council of Social Service and 185,000 elders are dependent on CSSA in 2008 19
First pillar Social SecurityAllowance Frompreviousslidesweknowthat, 269,000 elders in poverty -185,000 elders on CSSA = 84,600 elders currently living in poverty but declining to apply for CSSA They willrequire Old Age Allowance as their main source of income. Around50000elderlyrelysolelyonOAA The $1000OAAcanhardlysustaintheirlivingcost. 20
Second pillar MandatoryPensionFund MPFislinkedwithfull-time employment. Self employed and part-timers are not included Itrequired30-40yearstomature, it needs long time to create a social impact. Ithasnoredistributionfunction,richbecomericherandpoorremainsthesame. Also,MPF cannot be switchedduringemployment,itentailshighadministrationcostandlowreturn. 21
Third pillar – Personal savings and family support Future elderly generation cannot depend on family Support, because: Declining family size (from 4 in 1981 to 3 in 2006) In 2009, 40% of married couples do not have children. Private Saving replace Family support in the third pillar. In the future dual society of aging, the rising middle class are concerned with investing for retirement, descending middle class and low income earners will be demanding for more welfare protection. Pension reform can hardly reach consensus if these structural issues are not tackled with great care. 22
Forth pillar – Social service (1) Housing: Is it able to live near their son and daughter? Government’s home based service team is small, 84 home-based service teams serves 26,300 elderly. With day care service include nursing care, meal service, rehabilitation training, health education, and recreational and social activities. The service volume is extremely small compared with the total aging population. Health care service 70% of the elderly in Hong Kong suffer more than 1 Chronic illness. At the moment, half of the healthcare service capacity is used by the elderly. The elderly are satisfied with the service, but the waiting time too long. Will the system overload? 23
Forth pillar – Social service (2) Dental care service Limited oral healthcare services provided by the government. In 2001, 38000 elders were toothless and 135,000 elders were with bare roots. Hong Kong standard are below the World Health Organization. Elderly home After the standard careNeed assessment in 2002 shows The average waiting time for nursing homes is 42 months and care-and-attention home is 32 month away. Over 1000 elders passed away while waiting for subsidized places during the past five years. Not only the number of bed, the quality of the services are also worrying. 24
SummaryofHKfourpillarapproach Zero Pillar – Thesystemdeter the mostneedyelderly to apply for CSSA. Second pillar MPF–takestimetomature,havenoresourcesredistributionfunction. Third Pillar –willhaveLessfamilysupport, (declining family size) Forth Pillar – Socialservicerequired long waiting times. 25
Conclusion and Recommendation In 20 years’ time, Hong Kong will have to face its peak aging problem. We suggest that the Elderly Commission should review the Five Pillar Systeminaholistway. A comprehensive policy is needed to deal with the aging population. Thegovernmentshouldnotjustfocusonthenumbers(ie,numberofbeds,theamountofsocialallowance),butalsothequalitativeoftheservice(thestandardoftheservice,doesitservethepeoplethatneeditmost?) 26