Aging Chinese Face a Bleak Picture
China's elderly are poor, sick and depressed in alarming numbers, according to the first large-scale survey of those over 60, an immense challenge for Beijing and one of the greatest long-term vulnerabilities of the Chinese economy.The survey of living conditions for China's 185 million elderly paints a bleak picture that defies the efforts of the government to build what it calls a 'harmonious society,' one dedicated to human welfare rather than simply economic growth. Of the generation that built China's economic boom, 22.9%─or 42.4 million─live in poverty with consumption of less than 3,200 yuan a year ($522).
The fear of being old and poor, which prompts many Chinese to stash away their earnings, also cuts against another of Beijing's priorities: to rebalance the economy toward stronger consumption.
The survey, led by Chinese and international academics, covered 17,708 individuals across 28 of China's 31 provinces and was partly funded by the Chinese government through a science foundation. While careful to credit the government with progress on expanding pension and health-care coverage, it also showed that physical disability and mental-health problems are widespread: Of those surveyed, 38.1% reported difficulty with daily activities and 40% showed high symptoms of depression.
International comparisons are made difficult by definitional issues. But rates of poverty, disability and depression in China all appear relatively high. The poverty rate for Americans aged over 65 is 8.7% according to the Census Bureau. The U.S. Health and Retirement Study found that 26% to 27% of elderly Americans had a disability, and depression rates are also markedly lower than in China.
John Strauss, a professor at the University of Southern California and one of the leaders of the project, pointed to China's relatively low level of development as part of the explanation for higher poverty levels there. 'We need to remember that China is still a developing economy, it is not yet a high-income country,' he said.
An aging population means the problems are compounded. The number of old people for every hundred working-age members of the population─known as the dependency ratio─will rise from 11 in 2010 to 42 in 2050, according to projections from the United Nations.
Other countries will also see a rise in the dependency ratio. But the pace of aging in China is particularly marked─a consequence of the one-child policy.
The survey finds that 88.7% of the elderly who require assistance with daily activities receive it from family members. But the one-child policy and the migration of many young people to China's cities for work threaten to erode the traditional approach of children caring for elderly parents.
China is also unique in encountering a serious problem with aging while still a poor country. 'Other countries are old and rich,' said Albert Park, a professor at Hong Kong University of Science and Technology and another survey leader. 'China will be old at a relatively early stage in its development.'
Yu Baihui is one of many who have fallen through the cracks. Aged 73, Ms. Yu lives with her husband in a dilapidated house in Rensha, a town of 31,000 on the edges of Chongqing in western China. Like many of China's impoverished elderly, she is a former farmer, too old to benefit from the booming economythat has swept the younger generation into China's factories,and passed over by a benefit system that is skewed in favor of urbanites.
'My parents don't have any pension or other allowance,' said Luo Zhengfeng─Ms. Yu's son, who works selling umbrellas and tour maps in Chongqing to support his wife, child and aging parents.
China's turbulent history also appears to have had an impact on the generation that lived through it. 'China's elderly experienced famine in the 1950s, and the disturbance of the Cultural Revolution,' said Mr. Park. 'Those early experiences leave a marked impact on physical and mental health.'
In theory, respect for elders is deeply ingrained in China's culture. Confucius, China's cultural lodestone who has enjoyed a revival in popularity as leaders search for new sources of legitimacy, advocated the honoring of all old people.
On a visit to an old people's home in Tianjin in 2009, former President Hu Jintao echoed those sentiments and set the tone for government pronouncements on China's aged. 'Respecting and caring for the elderly is not only a Chinese tradition, but also a symbol of national civilization and progress,' he said.
Mr. Hu advocated a more inclusive form of development, with expansion of public pension and health-care coverage. The results of the China Health and Retirement Longitudinal Study suggest those efforts haven't so far been sufficient.
Widespread poverty in old age also undermines China's attempt to put the economy on an even keel, with lower saving and investment and higher consumption. Despite rapid increases in wages─which rose 14% last year for workers in the private sector according to official data─ households remain unwilling to spend. One reason: the need to guard against poverty in old age. 'I hope the government is stung by conscience and puts more money into pensions,' said Cecilia Wang, a 30-year-old translator at a business magazine in Beijing, 'but as they don't we have to save ourselves.'
China has enjoyed some success in expanding the welfare system. Pension coverage for urban residents has expanded from 155 million in 2003, when Mr. Hu took over, to 304 million in 2012, according to data from the Ministry of Human Resources and Social Security. Pension coverage for rural residents has grown even more rapidly. But the benefits provided by the expanded schemes remain inadequate in many cases. The survey shows that on average, recipients of the government's basic rural pension receive just 720 yuan a year.
More than 90% of the elderly population is now covered by health insurance, but out-of-pocket costs remain high. 'Mom had a stroke last year, and the hospital charged 18,000 yuan, but we could claim back only 1,000 yuan from insurance,' said Mr. Luo, the Chongqing umbrella seller. The 17,000 yuan in out-of-pocket costs equaled almost half of his annual income.
'China's government is aware of the problem and addressing it aggressively,' said Mr. Park. But there are few easy answers. With a growing number of elderly relying on a shrinking workforce, the existing system of care inside the family appears untenable. But more generous pension and health-care benefits risks putting a sharply increased strain on the public finances.
Tom Orlik
2013年 05月 31日 14:41
調查：中國老齡人口境況堪憂
Reuters
中國甘肅省元古堆村的一位老人坐在自己家中。
針
對中國60歲以上人口的首次大規模調查顯示﹐中國貧窮、多病且精神抑鬱的老年人數量多得驚人﹐這既是對中國政府的巨大挑戰﹐也是中國經濟最大的長期性弱點之一。對 中國1.85億老年人生存狀況的這一調查勾勒出了一幅黯淡的畫面﹐這使中國政府構建所謂“和諧社會”的努力受到了挑戰。中國政府的這一努力致力於實現民生 幸福﹐而不僅僅是經濟增長。在創造了中國的經濟繁榮的那一代人中﹐有22.9%（4,240萬）的人生活貧困﹐年消費額不足人民幣3,200元。
這 項由中國和國際學者牽頭進行的調查訪問了中國31個省份中28個省份的17,708人﹐其部分資金由中國政府通過一個科學基金提供。調查報告雖然沒忘提及 中國政府在擴大養老和醫療保險覆蓋面方面所取得的進展﹐但它還是顯示﹐中國老年人中普遍存在身體殘疾和精神健康問題。在接受調查的人中﹐38.1%的人說 自己在日常行動方面存在困難﹐40%的人表現出高度的抑鬱症症狀。
由於定義方面的問題﹐難以將中國的上述調查結果與其他國家的情況做橫向 比較。但中國老齡人口的貧困率、殘疾率和精神抑鬱率似乎都處於相對較高的水平。美國人口普查局(Census Bureau)的數據顯示﹐美國65歲以上老年人口的貧困率為8.7%。美國健康與退休研究項目(Health and Retirement Study)發現﹐美國26%至27%的老年人存在殘疾﹐美國老年人的精神抑鬱率也明顯低於中國的水平。
美 國南加州大學(University of Southern California)教授施特勞斯(John Strauss)是中國上述調查項目的牽頭人之一﹐他認為中國相對低的發達程度是造成中國老年人貧困率較高的原因之一。他說﹐我們需要記住﹐中國依然是一 個發展中國家﹐它還不是一個高收入國家。
中國人口的老齡化程度不斷提高使中國的老年人貧困問題變得更加複雜。據聯合國預測﹐中國的贍養比率（即每100名工作年齡人口需要贍養的老人數）將從2010年的11上升至2050年的42。
雖然其他國家的贍養比率也會不斷提高﹐但中國由於獨生子女政策的影響﹐其人口老齡化的速度尤其快。
此次調查發現﹐在中國日常行動需要人幫助的老年人中﹐88.7%的人是從家人處獲得幫助的。但由於中國的獨生子女政策以及許多中國年輕人離開家鄉前往城市尋找工作﹐有可能使中國由子女照顧年邁父母的傳統養老方式受到威脅。
中國還面臨著獨特的未富先老問題。此項調查的另一位牽頭人、香港科技大學教授朴之水(Albert Park)說﹐其他國家是老而且富﹐而中國則將在尚未成為發達國家時就進入老齡化社會。
於 百惠（音）就是眾多未富先老者中的一員。她今年73歲﹐與丈夫住在重慶郊區仁沙鄉一個破破爛爛的房子裡。這個鄉有人口3.1萬。跟中國很多窮困的老年人一 樣﹐於百惠以前也是農民﹐現在因年邁體衰﹐無法受益於蓬勃的經濟發展。年輕一代紛紛被這股經濟浪潮裹挾著進入廠礦企業打工﹐而老年人則被向城鎮人群傾斜的 福利制度所忽略。
於百惠的兒子羅正峰（音）說﹐我父母沒有養老金﹐也沒有別的津貼。他在重慶賣雨傘和旅遊地圖﹐以此來養活妻兒和年邁的父母。
中國動盪的歷史也好像對經歷了這段時期的人們產生了影響。朴之水說﹐中國老一代人經歷過上世紀50年代的飢荒和後來文化大革命的騷亂﹐那些早年的經歷給他們身心都留下了印記。
按理說﹐“尊老”是中國文化中根深蒂固的東西。中國文化先師孔子就主張要“上敬老”。在中國領導人尋求新的合法性之際﹐孔子再度受到追捧。
2009年﹐時任中國國家主席的胡錦濤到天津某敬老院看望老人時﹐也對這一傳統表示肯定﹐並且為中國政府在這方面的表態定了基調。他說﹐尊敬和愛護老人是中華民族的優良傳統﹐也是一個國家文明進步的標志。
胡錦濤主張的是一種更加廣泛的發展形式﹐擴大公共養老金和醫療保險的覆蓋面。中國健康與養老追蹤調查(China Health and Retirement Longitudinal Study)結果顯示﹐這些努力到目前為止都還不夠。
中 國老年人到了晚年普遍貧困﹐這一現象也破壞了中國試圖以低存款、低投資和高消費來讓經濟保持平穩的努力。儘管工資收入迅速上漲（官方數據顯示民營部門員工 去年漲薪幅度達14%）﹐但中國家庭仍不願花錢﹐理由之一是要防止老來貧。北京某商業雜志30歲的翻譯Cecilia Wang說﹐我希望政府發發善心﹐給養老金多撥點款﹔但因為他們不這麼做﹐我們就得自己攢錢。
中國在擴大福利體系方面已經取得了一定的成 功。中國人力資源和社會保障部的數據顯示﹐城鎮居民的養老金覆蓋面從2003年胡錦濤上台時的1.55億增至2012年的3.04億。針對農村人口的養老 金覆蓋範圍擴展速度就更為迅速。但擴大的養老計劃所提供的養老金在很多地方仍顯不足。那項調查顯示﹐農村老人平均每年只能領取到政府提供的720元基礎養 老金。
如今﹐90%以上的中國老年人都有醫療保險﹐但需要自己實際支付的費用仍很高。在重慶靠賣傘為生的羅正峰說﹐我母親去年中風﹐醫藥費花了1.8萬元﹐但保險只能報1,000元。這自掏腰包的1.7萬元幾乎相當於他半年的收入。
朴之水說﹐中國政府意識到了這個問題﹐正在積極應對。但這個問題幾乎沒有輕鬆的解決之道。中國現在有越來越多的老年人依靠不斷萎縮的勞動力來贍養﹐這種靠家人養老的模式似乎看上去已經為繼。然而﹐擴大養老和醫療支出又會讓政府面臨公共財政壓力劇增的風險。
Tom Orlik
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