I have been talking about this before it was cool. One of the BIGGEST drivers of economic growth is healthy demographics. Due to China’s large population, the country has the second largest GDP, despite having 1/10 the GDP per Capita of #3, Japan. China’s one child policy is now leading to worsening demographic problems, which Japan currently faces, and Europe will be facing in the coming decades. Over the next few decades, India and America have very favorable economic trends. Search on ValueWalk for some old articles on these topics.
Wang Fuchuan lies in bed wearing a quilted black jacket, with two comforters pulled up to his chin to keep out the chilly November air. The heating at Beijing Songtang Caring Hospice is broken and the 90-year-old’s nostrils are stuffed with toilet paper to stop them dripping.
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Cockroaches scurry across the floor of his room, which has no running water or toilet. His possessions, a few articles of clothing, are in a plastic bag under his bed next to a pink wash bowl with a sliver of soap. His only entertainment is a transistor radio.
Wang counts himself lucky. While he has no family or savings, he fought against the Japanese and Kuomintang in the 1940s, so the government pays the clinic’s monthly fee of 2,000 yuan ($318). His 200-yuan pension buys food.
“A lot of people my age can’t afford to be here,” Wang says. “The food isn’t too good, but I have nothing else to complain about.”
Wang is in the vanguard of a looming demographic shift for China, Bloomberg Businessweek reports in its Jan. 9 issue. The latest government census shows 178 million Chinese were over 60 in 2009. That figure could reach 437 million — one third of the population — by 2050, the United Nations forecasts. While the elderly were looked after in the past by their children, urbanization and the nation’s one-child policy have eroded the tradition of family care.
“It’s a demographic tsunami,” says Joseph J. Christian, a fellow at the Asia Center at the Harvard Kennedy School, and former DLA Piper partner in Hong Kong, who specializes in senior housing issues in China. “The whole multigenerational housing model has disappeared.”
China’s challenge is similar to that faced by Japan in the 1990s, with one essential difference: China will grow old before it gets rich. With tens of millions of parents left to fend for themselves, the government set up a National Committee on Aging to try to devise a comprehensive strategy (CHGE7) to ensure their health and comfort.
The latest five-year plan still gives families primary responsibility for elderly care. Even so, the government is looking to the private sector, nongovernmental organizations, and local communities for a more sustainable solution. So far only a handful of companies provide service comparable to the West, and even care like the kind offered by the clinic where Wang Fuchuan lives is relatively rare.
“Elderly health care is in its infancy” in China, says Ninie Wang, founder of Beijing-based Pinetree Senior Care Services, which employs 500 nurses providing in-home support to 20,000 seniors in Beijing.
Too Few Beds
China has about 38,000 institutions serving the elderly with 2.7 million beds, enough for about 1.6 percent of the population over 60, according to the World Bank. That compares with about 8 percent in developed countries, the bank says.
Some homes are fully staffed government clinics for senior officials or private hospitals catering to the new urban elite. Most are boarding houses with few medical facilities, mainly in large cities. In towns and villages, the situation is far worse.
“If we can’t help people in Beijing, you can forget about any opportunities for helping the rural old people,” says Jing Jun, a professor of anthropology atTsinghua University.
A 2009 survey of 140 nursing homes in the eastern city of Nanjing by a group of Chinese academics found that fewer than a third employed a doctor or a nurse. Most of the staff were unskilled rural migrant workers with minimal training.
“The goal at these homes is subsistence for residents whose children can’t take care of them,” says Zhanlian Feng, a gerontologist at Brown University who wrote a paper based on the survey in the Journal of the American Geriatrics Society. Many clinics refuse people who require full-time nursing. Others may force out residents once they become too needy, he says.