亞洲部分國家人口老齡化速度驚人
世界銀行最新公佈的一份報告顯示，東亞、東南亞國家老齡化的速度快於世界其它地區。亞洲這些國家需要盡快改革現有的退休制度並且鼓勵更多女性進入就業市場。
（德國之聲中文網）世界銀行最新公佈的《富壽延年：東亞與太平洋地區的人口老齡化報告》中指出，到2040年，由於人口老齡化，韓國的勞動力人口將減少15%，中國、日本和泰國勞動力人口將減少10%以上。對於中國來說，這將意味著減少9000萬勞動力。
這份報告涵蓋了已經出現老齡化的日本、韓國等富裕發達國家，也包括了中國、泰國、越南等正在走向老齡化的中等收入國家以及柬埔寨、老撾等將在20、30年後出現老齡化的較為貧困的國家。
世界銀行東亞及太平洋地區首席經濟學家謝蒂(Sudhir Shetty)說："此前人們一直認為亞太地區擁有大量的青壯年勞動力，是一個充滿生機和活力的地區，但是正是這一地區老齡化的速度卻比世界其它地區都要快。"
謝蒂說："亞太地區多數中等收入國家將在20年至25年之內從較為年輕的社會走向逐漸變衰老的社會。而這一變化在世界其它地區則需要50至100年的時間。"
謝蒂解釋說，這一地區迅速出現老齡化現象的主要原因是最近幾十年經濟迅速發展帶來生育率降低，另外收入的增加和教育水平的提升也提高了人口的平均壽命。
報告建議亞洲國家鼓勵更多的女性參與就業，尤其是通過兒童保育改革。中國、越南、泰國等國可以取消養老金制度中存在的鼓勵部分勞動者、特別是城市婦女過早退休的鼓勵性政策。報告還警告稱，如果人口較為年輕的國家不能將退休體制落實到位，那麼未來將無法承擔龐大的社會保障費用。
December 9, 2015
World Bank Report Says Region Already Home to More than 211 Million Older People
• East Asia and Pacific is aging faster than any other region, posing risks for public finances and healthcare delivery, and increasing the challenges to sustained economic growth.
• Managing aging requires womb-to-tomb policies addressing issues such as child care, education, employment practices, health care, and pensions.
• Effective responses require strong leadership, building social consensus, and politically challenging policy choices.
• Report calls for a paradigm shift in the ways that health, pensions and long-term health care are delivered and financed across the region.
East Asia and Pacific is aging faster – and on a larger scale – than any other region in history, which could lead to a steep drop in the size of its workforce and sharp increases in public spending on pensions, health care and long-term care in the coming decades, according to a new World Bank report.
More than 211 million people aged 65 and older lived in East Asia and Pacific in 2010 – including 130 million in China alone – accounting for 36 percent of the global population in that age group. And the region is aging rapidly. Between 2015 and 2034, the older population will grow by about 22 percent every five years in East Asia. By 2060, one of five of the world’s oldest countries will be in East Asia, compared with just one in 25 in 2010, according to the report, Live Long and Prosper: Aging in East Asia and Pacific.
Much is at stake. An abundant and growing labor force was responsible for about one-third of per capita income growth in East Asia from the 1960s to the 1990s, but rapid aging has led to a dwindling labor force in an increasing number of countries. Between 2010 and 2040, the report says Korea is expected to lose more than 15 percent of its working age adults, while Thailand, Japan and China will lose more than 10 percent. That would mean around 90 million fewer workers in China alone.
The older population demands higher public spending. Without reforms, for example, pension spending is projected to increase by eight to 10 percent of gross domestic product by 2070.
“While it’s normal to spend more on public services as countries become richer and older, the rapid pace of aging in East Asia makes it especially urgent for structural reforms to make the process manageable and affordable,” says Axel van Trotsenburg, regional vice president of the World Bank’s East Asia and Pacific Region. “Policy makers should consider comprehensive, proactive policies that will increase labor force participation, encourage healthy behaviors, boost productivity, reform social security, and ensure that public services are affordable.”
Most Comprehensive Report on Aging in EAP
The report is a comprehensive analysis of aging in East Asia and Pacific, examining how aging affects households, economies and societies, and how they can manage the risks and realize the opportunities amid such fundamental social change.
Rapid aging is partly a result of the region’s economic development, higher life expectancy and sharp declines in fertility rates, with a growing number of countries now well below replacement levels, the report says.
Across the region, the pace of aging varies. The wealthiest countries, including Japan, South Korea, and Singapore, are “advanced agers,” with the older population making up 14 percent or more of their populations on average. Rapidly developing middle-income countries, such as China, Indonesia, Thailand, and Vietnam, are aging quickly. The third group, including Cambodia, Laos, Myanmar, the Philippines, Papua New Guinea, Pacific Island countries, and Timor-Leste, are still young, with an average of 4 percent of the population over 65, but rapid aging is in store in the coming decades.
To be sure, the report says the region is better positioned than many parts of the world to achieve healthy and productive aging. East Asians already work longer than many other societies. They have high savings rates among all ages, have seen rapidly rising education achievements, and have social security systems with fewer costly legacy entitlements.
But developing East Asia and Pacific is aging at much lower per capita income levels than did member countries of the Organization of Economic Cooperation and Development.
“It’s unavoidable that most countries in the region will grow old before getting rich,” says Philip O’Keefe, lead author of the report.
Even though older people generally have benefited from the region’s economic growth and significant poverty reduction, poverty rates tend to increase more with age in countries such as China, Indonesia and Vietnam. Poverty is also more common among the less-educated elderly, and those with fewer adult children to depend upon or with limited social security benefits.
EAP at a Crossroads
The region is at a crossroads. Managing rapid societal aging while trying to sustain economic dynamism will require strong leadership, building social consensus on how to move forward, and politically challenging policy choices.
“Changes are hard, but to stay competitive, the region must address rapid aging with sensible policy choices that promote appropriate behavioral change by households and employers,” says Sudhir Shetty, Chief Economist for the East Asia and Pacific Region of the World Bank.
To boost labor force participation, the report recommends that countries such as Japan, Korea, Malaysia and Fiji encourage more women to join the workforce, especially after child birth. They can also do away with pension policies that have led to unnecessarily early retirement of urban workers in countries such as in China and Vietnam. This can be reinforced by promoting flexible work arrangements and adapting workplaces to the needs of older workers.
To compensate for low birth rates, countries such as Korea, Japan and China can take steps to attract younger immigrants. Finally, policy makers can improve the quality of the workforce through investments in education and lifelong learning.
Fiscal and Health Challenges
To address the increasing strains an aging population places on public services, the report calls for a paradigm shift in the way that health, pensions and long-term care are provided and financed across the region. This will be necessary to strike the balance between ensuring high coverage of services and benefits, adequate financial protection for older people, and fiscal sustainability.
Without reforms, public spending on pensions is projected to rise by eight to 12 percentage points of gross domestic product by 2070, but phased increases in official retirement ages and other reforms have the potential to control costs while ensuring adequate benefits. The report recommends that countries rely more on general revenues to fund benefits for the informal sector and achieve high pension coverage rates, the same way that the poor across the region have benefited from a rapid expansion of subsidized health insurance in the last decade.
Financing alone, however, won’t address East Asia’s healthcare challenges. A hospital-centric approach, currently common in East Asian countries, pushes up the rate of inpatient care, and weak primary care systems are ill-prepared to manage chronic illnesses of the population and particularly the elderly. That not only increases out-of-pocket costs, but undermines the sustainability of public health financing.
The report suggests that governments transform healthcare systems into a model focused on primary care, with improved care management across levels of the health system, efficient care delivery, and better prevention of non-communicable diseases. Health systems will also need to address diseases of old age, such as dementia, and develop long-term care policies that combine traditional family support with strengthened community- and home-based care systems.
Shifting Aging Patterns
The tradition of relying on family support in old age is eroding in a number of countries. In Korea, fewer than 30 percent of older people live with their children. In China, 43 percent of those ages 65 to 70 live with their children, down from two-thirds in the early 1980s. Many elderly people are left in rural areas with young children to care for, as their adult children move to urban areas in search of better paid jobs.
Indeed, most older people in the region depend on their own work, instead of family and state support, as their primary source of income. A large share of people work well into their 70s, even in richer countries such as Japan and Korea, but working is especially a necessity for rural residents without pensions in developing East Asia. At the same time, some urban workers, especially women, often retire too early due to the incentives built into pension and taxation systems.
People of all ages in East Asia expect that the state will play a bigger role in supporting them in their old age by, for example, providing care for the frail and incapacitated, the report says. How the states meet that expectation will be a key social and political challenge in coming years.
東亞人口快速老齡化將導致勞動人口減少和公共支出增加
世界銀行報告稱東亞與太平洋地區老齡人口已經超過2.11億
- 東亞太平洋地區的人口老齡化速度超過世界任何其他地區，使公共財政與護理服務面臨風險，加大了對持續經濟增長的挑戰
- 管理人口老齡化，需要有“從搖籃到墳墓”的福利政策，解決好育兒、教育、就業、醫療和養老金等問題
- 有效的政策需要加強領導力、建立社會共識和作出政治上具有挑戰性的政策抉擇
- 報告呼籲在東亞地區全面轉變醫療、養老和長期護理服務和融資模式
世界銀行最新報告說，東亞的人口老齡化，在速度上和規模上均超過史上任何其他地區，這會導致未來數十年勞動人口人數銳減，公共養老金、醫療保健和長期護理開支大幅增加。
題為《福壽延年：東亞與太平洋地區的人口老齡化》的報告指出，2010年東亞與太平洋地區65歲以上老年人口超過2.11億（其中近1.3億在中國），占同一年齡組全球總人口的36%，該地區已進入快速老齡化。在2015年～2034年期間，東亞地區每五年老年人口比例將上升22%左右。到2060年，世界老齡化程度最高的五個國家將有一個在東亞，相比2010年該比例為1/25。
這一趨勢關係重大。充足且不斷增加的勞動人口貢獻了上世紀60～90年代東亞人均收入增長的1/3左右，但人口快速老齡化導致越來越多國家的勞動人口不斷減少。在2010年～2040年期間，一些國家將會出現勞動年齡成人佔比大幅下降，韓國將下降15%以上，泰國、日本、中國等國下降10%以上。這意味著中國的勞動人口減少9000萬左右。
人口老齡化增大了對公共支出的需求。如果不進行改革，預計到2070年公共養老金支出增幅將達到國內生產總值的8%～12%
“雖然隨著國家更加富裕和出現老齡化後增加公共服務支出是正常的，但東亞老齡化的速度之快，使得進行結構改革以實現老齡化過程的可控性和可負擔性成為當務之急，”世界銀行東亞與太平洋地區副行長阿克塞爾·馮·托森伯格說。“政策制定者應考慮採取綜合性的、積極主動的政策來提高勞動力參與率，鼓勵健康的行為方式，促進生產力發展，改革社會保障制度，確保公共服務的可負擔性。”
關於東亞太平洋地區人口老齡化問題最全面的報告
報告對東亞地區人口老齡化問題做了全面分析，研究了老齡化對家庭、經濟和社會帶來什麼影響，以及在這一根本性社會變化中如何能夠管理風險和抓住機遇。
人口快速老齡化部分是東亞高速經濟增長、預期壽命延長和生育率急劇下降的結果，以致越來越多的國家目前遠遠低於人口替代率的水平。
東亞各國的老齡化速度各不相同。日本、韓國、新加坡等最富裕的國家率先進入老齡化，老年人口平均佔總人口的14%以上。發展迅速的中國、印尼、泰國、越南等中等收入國家正在出現快速老齡化。第三組國家包括柬埔寨、老撾、緬甸、菲律賓、巴布亞新幾內亞、太平洋島國和東帝汶都還年輕，65歲以上老年人口平均佔總人口的4%，但在未來數十年也會出現快速老齡化。
報告指出，東亞地區比世界許多地區更有條件實現健康和有生產率的老齡化。東亞人口的工作年限已超過許多其他地區，各年齡段儲蓄率都很高，教育水平快速上升，社會保障制度較少成本昂貴的歷史遺留問題。
但是，東亞發展中國家是在人均收入水平遠低於經合組織成員國的情況下開始出現老齡化的。
報告主要作者歐凱夫說：“東亞地區大多數國家都會不可避免地出現未富先老。”
雖然總的來說老年人口得益於該地區的經濟增長和貧困顯著下降，但在中國、印尼和越南等國，貧困率隨年齡增長而上升。在教育水平較低、可依賴的成年子女較少或社保福利有限的老年人口中，貧困現像也更為普遍。
東亞太平洋地區處在十字路口
東亞地區處在一個十字路口。管理好社會的快速老齡化，同時力圖保持經濟活力，就需要加強領導力，圍繞前進方向建立社會共識，並作出在政治上具有挑戰性的政策抉擇。
“變化是困難的，但要想保持競爭力，東亞地區就必須作出理智的政策抉擇來解決快速老齡化問題，促進家庭和雇主適當改變行為方式，”世界銀行東亞與太平洋地區首席經濟學家蘇迪爾·謝蒂說。
為了提高勞動參與率，報告建議日本、韓國、馬來西亞、斐濟等國鼓勵更多的婦女參加工作，特別是在生育子女之後。中國、越南等國可以取消導致不必要的城市勞動者過早退休的養老金政策，並配合推廣靈活工作安排並使工作場所更適合年長勞動者的需要。
作為對低生育率的補償，韓國、日本、中國等國可以採取措施吸引年輕移民。最後，政策制定者可以通過教育和終身教育投資，提高勞動人口的素質。
財政和健康挑戰
為了緩解老齡化人口對公共服務帶來的不斷加大的壓力，報告呼籲東亞地區全面改變醫療、養老金和長期護理服務和融資模式。有必要在確保服務和福利的高覆蓋面、對老年人口的適當經濟保障與財政可持續性之間達成平衡。
如果不進行改革，預計到2070年公共養老金支出增幅將達到國內生產總值的8%～12%，但通過逐步延遲正式退休年齡以及其他改革，有可能在控製成本的同時確保適當的福利。報告建議各國更多地依靠一般性收入來支付非正規部門的福利和服務，實現養老金高覆蓋率，正如上個十年東亞地區快速擴大補貼醫療保險讓貧困人口受益所採取的同樣方式。
不過，僅靠融資還不能解決東亞在醫療衛生領域面臨的挑戰。目前東亞各國普遍採取以醫院為中心的醫療保健模式，提高了住院治療率，而薄弱的初級醫療保健體系準備不足，難以管理人口特別是老年人口的慢性病。這不僅增加了自付醫療費用，而且削弱了公共衛生融資的可持續性。
報告建議各國政府將醫療保健體系轉向以初級醫療保健為主的模式，改善醫療衛生體系各級的醫護管理，提高護理服務效率，更好地預防非傳染性疾病。醫療衛生體係也需要關注癡呆症等老年性疾病，制定長期護理政策，將傳統的家庭護理與加強正規的社區和居家護理制度結合起來。
養老模式改變
依靠家庭照顧的養老傳統在許多國家正在受到侵蝕。在韓國，不到30%的老年人與子女同住。在中國，43%的65～70歲老年人與子女同住，而上世紀80年代初2/3的老人與子女同住。很多老年人留在農村替進城務工的成年子女照看孩子。
確實，東亞地區大部分老年人口靠工作而不是靠家庭和國家資助作為主要收入來源。很多老年人一直工作到70多歲，日本和韓國等較富裕的國家亦如此，但對於東亞發展中國家裡沒有養老金的農村居民來說，工作尤其是必要的。與此同時，由於養老金和稅收制度裡存在的不良激勵，一些城市勞動者特別是女性卻往往過早退休。
東亞各年齡段人群都期望國家在提供養老支持方面發揮更大作用，例如為體弱和失能老人提供護理。國家如何滿足這種期望，將成為未來一項關鍵性的社會和政治挑戰。
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