Aging in Singapore: Demographic transition and policy response

Transcription

1 2 nd Symposium on Aging and Old-Aging in Asia-Pacific, July 2016 Aging in Singapore: Demographic transition and policy response Leng Leng THANG National University of Singapore

2 Ref: Conference on Long term care in Asia plus three, Singapore, March 2016

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4 Population 65 years and older ( ) Singapore as one of the fastest aging country Age 65 and older 458, , 000 1,394,000 Proportion Medium age Dependency ratio (Old) Source: Singapore DOS (2010) and UN data (

5 Ethnic composition of elder population (2010) CHINESE MALAY INDIAN OTHERS Total population 100% (9%) 100% Male Female

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7 Why rapid aging: Longevity

8 Why rapid aging 2: Very low fertility countries-with-the-lowest-fertility-rates/

9 Changing Marriage trends Increase in people remaining single 2010 (2005) MALE 43.1% (34%) 23.9% (23%) 17.2% (15%) 14.3% FEMALE 30.6% (22%) 20% (15%) 15.6% (14%) 13.6% Later age of first marriage (M-30, F-27.6 in 2011) - More singles put two goals before marriage: obtain financial stability (82%/73%), establish a successful career (71%/62%) Singles attitudes towards courtship and marriage survey 2009 (/2005)

10 Fall in marriage rates (number of marriages registered among per 1,000 unmarried residents, ages years) MALE FEMALE Marriage priorities among singles decrease with age: years old: 65% years old: 53% years old: 36% years old: 17% MCYS Survey on Social Attitudes of Singaporeans, 2009

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13 Ethnic characteristics: TOTAL CHINESE MALAYS INDIANS

14 Three phases of family policy 1. Anti-natalist phase ( )

15 PHASES INCENTIVES DISINCENTIVES OTHERS Anti-natalist phase TWO IS ENOUGH -voluntary sterilization encourage: priority in pr school registration, public housing, reimbursement of delivery fees, reduced income tax -no paid maternity leave for women (3 rd birth and above) -more delivery fee FAMILY PLANNING and POPULATION BOAR (goal-zero population growth) Eugenics phase (cautiously) Pro-natalist phase Have Three or More, if You Can Afford It -For more educated mothers with more than 2 children: priority in pr school registration, enhanced tax relief. -sterlization incentive of $10K for less educated women (below 30 yr old) who sterlize after 2 children. For family with more than 2 children: tax rebates ( S$20,000 tax rebate for 4 th child born after 1/1/1988), priority in school enrollment, priority for HDB flats. General incentives: subsidies for daycare, extended sick leave for civil servants to look after sick children and up to four years' unpaid maternity leave for civil servants. Children development co-saving scheme (HOPE program for low income families to stop at 2) Social Development Unit (SDU) - graduates match making (SDS-non-g)(goal graduate women to marry n give birth) joys of marriage and parenthood campaign

16 DECLINING BIRTHS Source: Adapted from Population Trends 2011 to indicate dragon year baby boom (

17 Low fertility rapid aging Socio-Cultural : little out of wedlock childbirth less marriages, less children Effective anti-natalist policy in 1960s to 1980s Compressed modernity (Chang, 2010) condensed economic, political, social and cultural changes led to changes in values on family and child-rearing

18 Policies to address aging Policies to encourage child-birth -> increase population ->increase labor force Policies to ensure well-being of elders financial, employment, healthcare and long term care, housing, social integration

19 Characteristics of policy response to aging Anti-welfare principle not a welfare-state (workfare approach) A shift from aging as problem successful aging (aging as challenges and opportunities) (emphasis on active aging, later life employment, life long learning) Family-centric approach family as the first line of support

20 Family-centric focus in aging policy Many helping hands approach with Family as the first line of defence, Community the second line of support, State to set out the policy framework, provide infrastructure and resources for other sectors to play their part (IMC 1999)

21 Family as first line of help We believe that the family is the primary care-giving unit and the bedrock of support for seniors. The family must be supported and strengthened in its ability to care for its older members to ensure that institutionalization remains a measure of last resort. (Report on the Ageing Population, 2006:12).

22 Existing policies and schemes Type of Relief Staying with Parents Not Staying with Parents Parent Relief $9,000 $5,500 Handicapped Parent Relief $14,000 $10,000 Type of Relief Amount claimable Eligibility Grandparent Caregiver Relief Preventive Policy Maintenance of Parents Act (1995) -revised in 2011 to a more reconciliation first approach $3,000 Working mothers of Singapore Citizen children aged 12 years and below in the previous year How it works Any Singapore resident, 60 years old and above, who is unable to maintain himself adequately, is entitled to claim maintenance from their children, either in a lump-sum payment, or in the form of monthly allowances

23 Existing policies and schemes file:///c:/users/jpstll/downloads/press-release-mnd-c.pdf Type of Scheme Married Children Priority Scheme Multig-eneration Priority Scheme Studio apartment Priority Scheme 3 Generation flats Higer-tier CPF (Central Provident Fund) Housing Grant Minimum Sum Topping-Up Scheme How it works Give priority to applicants to encourage married children and their parents to live close by to enhance mutual care. Available to married firsttime applicants where they will be eligible for a $40,000 housing grant if they buy a resale flat from the open market near to their parents house, defined as within the same town or within 2km. Also available for singles (above 35) who list their parents as occupants for resale flat purchased Allows CPF members to voluntarily top up the CPF accounts of their aging parents or other family members (not working/unable to work). If top ups are made in case, members can receive up to $7000 or additional tax relief per year.

24 National Policies on Population Ageing: from aging as problems to opportunities 1984: Committee on Problems of Aged Population Anticipated population ageing as national challenges with major future implications and policy recommendations to alleviate problems 1988: Advisory Council on the Aged Review and strengthen politics and programs for specific issues of concern (raised retirement age to 60) : National Council on Family and the Aged (under Ministry of Community Development and Sports) 24

25 : 7-Year Eldercare Master Plan 1999: Vision of Successful Ageing for Singapore Inter-ministerial Committee (IMC) on the Ageing Population (1998) Whole-of-government approach to challenges of population ageing Vision was adopted by subsequent government committees Committee on Ageing Issues ( ) Ministerial Committee on Ageing ( ) Successful Aging Framework: 3 pillars: Security (financial security, employability) Health (affordable, holistic healthcare and eldercare) Participation (promote active aging)

26 2012: New vision of Ageing-in-Place (new) Ministerial Committee on Ageing (MCA) (Chaired by Minister of Health) Two-pronged approach to achieving vision: - Building an inclusive environment - Providing good eldercare 2015 : Action plan for successful aging (budget: $3b over 5 years)-nation for all Ages Key themes: Opportunities for All Ages Longevity is Opportunity (employment, lifelong learning, volunteering, health programs) Kampong for All Ages Cohesive Home with Intergenerational Harmony (community befriending, co-location of aged and childcare services) City for All Ages Live Well and Age Confidently in Place(aged care, active aging hubs, transport, research) S$200 million to fund research

27 -- Empowering, comprehensive, proactive, human resource approach They get it, said Paul Irving, chairman of the Center for the Future of Aging at the Milken Institute and distinguished scholar-in-residence at the University of Southern California s Davis School of Gerontology. They get that older people represent a human capital asset that can improve the country.... They re not just a burden on society, they re not just a silver tsunami, but also a wonderful opportunity to capitalize on the human resource that older adults represent and to take advantage of their wisdom and judgment. We need leaders at all levels understanding this, taking it on, and getting involved. They re really focusing on aging as a longevity issue and not just an issue of the elderly, and it s brilliant, Laura Carstensen, director of the Stanford Center on Longevity said of the Singapore plan. Too often, she said, people just focus on We ve got to build a society that supports very old, frail people. We ve got to build a society that supports people all the way through these long lives.... Any country that looks at longevity and not just old age stands to do well in the future. (Quoted from What Singapore s plan for an aging population can teach the U.S., Washington Post, Nov 2, 2015)

28 Financing and employment FAMILY RELIANCE: A norm to expect financial support from family (children) COMPULSORY SAVING FOR OWN RETIREMENT: Central Provident Fund (CPF) as social security in old age: Minimum Sum and CPF Lifelong Income for the Elderly (LIFE) annuity scheme ENCOURAGE EMPLOYMENT OF OLDER WORKERS: Workfare Income Supplement Scheme (from 2007)

29 Table: Most Important Income Sources for persons age 55 and above in 1995, 2005 and 2011 (%) Source Gender Age Group Male Female ad above Most important source (2011) Income transfers from children Personal savings Paid employment Income transfers from spouse Most important source (2005) Income transfers from children Personal savings Paid employment Income transfers from spouse Most important source (2005) Income transfers from children Personal savings Paid employment Income transfers from spouse Note: Respondent size was 4750, 4591 and 5000 for NSSC 1995, 2005 and 2011 respectively. Source: Adopted from Kang, Tan and Yap, 2013, Table 5.4, Page 40.

30 Comparison of Present and future elderly The future older persons will rely more on their own savings and CPF (Central Provident Fund savings and pension)

31 Central Provident Fund and old age security Set up in 1955 as mandatory savings scheme for both employees and employers Contribution level decline with age (ie lesser compulsory savings with age) Savings are divided into: - ordinary account (2.5% interest) - special account (4% interest) - medisave account (4% interest)

32 Retirement income from CPF ref: cpf.gov.sg Minimum Sum set aside in Retirement Account at age 55 increased from S$30,000 in 1987 to S$161,000 in 2015 for Retirement Sum scheme (first $30,000 received 6% pa, new $30,000-5%) Upon reaching age 65, monthly payout to support basic standard of living for 20 years (payout $660-$1320) Those with certain amount in Retirement Account will join the CPF LIFE Scheme (introduced in 2009) which provides lifelong income (only for those born in 1958 or after) -other conditions: $40,000 in Retirement Account at age 55; or $60,000 at age 65.

33 CPF contribution rate (1 Jan 2016) Ref: Businness Times, 6 Jan

34 Promoting employment of older workers Raising re-employment age from 65 to 67 (from July 2017) Promote age management policies, eg age-friendly human resource programs and training, campaign to enhance positive perceptions of older workers WorkPro Program (2013) three-year scheme to provide funding support and facilitate the recruitment and retention of mature workers and back-to-work locals (MOM, 2015) Special employment Credit (SEC) for employers who re-employ workers 65 years and above to off set CPF contribution by employers. Workfare Income Supplement scheme (2007, amended in 2013) - low-wage workers receive cash payouts and CPF contribution

35 Ref: /business/economy/singaporebudget-2016-more-low-wageworkers-to-qualify-for-workfareincome

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37 Issues Older workers: face ageism, lack of relevant skills, attitudes on work and retirement need for flexibility in work structure, intergenerational support and endorsement. Still the need for personal savings for old age : CPF provides basic level of financial support as CPF has other uses for paying housing loans, healthcare coverage. Options to monetize housing assets (Lease buyback, silver housing bonus) CPF contribution depends on individual earnings low income elders will not have retirement CPF support From 2016, Silver Support Scheme for elders in lowest 20-30% strata to receive quarterly payouts of S$300-S$750 (depending on housing types) Other ways: Public Assistance ($450/month), Maintenance of Parents Act file for support from children.

38 Healthcare, Integrated care and long term care 1984: National Health Plan and Medisave Scheme In anticipation of future financing for ageing population First country to introduce national compulsory savings for medical care 1990: MediShield Limited catastropic illness insurance to meet large bills which could not be sufficiently covered by Medisave 1993: MediFund An endowment fund to help needy Singaporeans who are unable to pay for their medical expenses 2016: Medishield Life Extended social health insurance to provide universal coverage for life 2015: Pioneer Generation Package (65 years and above in 2015) Subsidies in outpatient care, Medishidld life, Medisave top up, support of disability elders through Pioneer Generation Disability Assistance Scheme (

39 2002: ElderShield was introduced Affordable severe disability insurance scheme designed to meet basic expenses incurred for step-down care Means-tested for Katz Index >3 Acticities of Daily Living (ADLs) 2007-added ElderShield Supplements for higher amount/longer periods of payout. 2008: Mental Capacity Act was passed To protect persons with diminished decision-making capacity Appoint proxy decision-makers with Lasting Power of Attorney (LPA), to act in their best interests in event of being mentally incapacitated 2008: Agency for Integrated Care (AIC) From 2001 Integrated Care Services, providing integrated care to support healthcare and social care, and support of caregivers 2012: Plan to expand aged care services by 2020 Community care: 2100 to 6200 day places Home care: 4500 to 10,000 home placed Nursing homes: 8800 to 17,000 beds 39

40 Future Health Needs in Singapore

41 Issues Family still plays important role use of children s medisave to pay for elders premiums, medical costs => fear depletion of Medisave when adult children reach old age Caregiver issues - less children, more elders living alone - employment of foreign domestic workers as caregiver- training issues, elder abuse concerns etc Manpower in care sector - up to 85% foreign care staff in aged care services Eldershield eldershield life/long term care insurance?

42 Conclusion Shift from anti-welfare to welfare-orientation? -- juxtaposing the Many helping hands approach with care Diamond model (Ochiai, 2009). == role of market, family, state and community (NPO) == e.g. levy subsidy (state) to offset cost of hiring foreign domestic workers as eldercarers (family) == Family: how much can older persons still depend on their children for financing and care?

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