1、Challenges and Opportunities of Population Aging in the Peoples Republic of China 中國人口老齡化所帶來的機遇和挑戰NO. 2014-3觀察與建議Observations and SuggestionsDisclaimer for Translated Documents 譯文聲明This document has been translated from English in order to reach a wider audience. While the Asian Development Bank (AD

2、B) has made efforts to verify the accuracy of the translation, English is the working language of ADB and the English original of this document is the only authentic (that is, official and authoritative) text. Any citations must refer to the English original of this document.為擴大讀者范圍， 特將本報告由英文翻譯為中文。

3、亞行盡力確保翻譯的準確性。 但英語是亞行的官方語言， 因此， 本報告的英文原版為唯一具有權威性的 （即正式的和經授權的） 文本。 任何對本報告內容的引用， 必須以其英文原版內容為準。 2014 Asian Development Bank 亞洲開發銀行 2014 All rights reserved. Published in 2014.Printed in the Peoples Republic of China版權所有。2014 年出版。在中華人民共和國印刷。The views expressed in this publication are those of the authors

4、 and do not necessarily reflect the views and policies of the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. Accounts presented here are anecdotal and do not represent comprehensive impacts of projects or programs.ADB does not guarantee the accuracy of the

5、data included in this publication and accepts no responsibility for any consequence of their use.By making any designation of or reference to a particular territory or geographic area, or by using the term country in this publication, ADB does not intend to make any judgments as to the legal or othe

6、r status of any territory or area.ADB encourages printing or copying information exclusively for personal and noncommercial use with proper acknowledgment of ADB. Users are restricted from reselling, redistributing, or creating derivative works for commercial purposes without the express, written co

7、nsent of ADB.本出版物中所述為作者的觀點，不一定代表亞洲開發銀行（亞行）、亞行理事會或其代表的政府的觀點和政策。在這里所闡述的事件是實際案例，不代表項目或規劃的全面影響。亞行不擔保本出版物中所含數據的準確性，而且對使用這些數據所產生的后果不承擔責任。在此出版物中標明、參照某個版圖或地理區域，或使用術語“國家”不代表亞行對任何地域實體的合法性或其它法律地位的任何判斷。亞行鼓勵僅出于個人和非商業性目的對信息進行印刷或復制的行為，但須給予亞行適當的承認。未經申請并得到亞行書面同意，使用者嚴禁出于商業目的再出售、再發行、或創造衍生作品。Note: In this publication,

8、$ refers to US dollars.注：在本出版物中，“$”表示美元。Challenges and Opportunities of Population Aging in the Peoples Republic of China中國人口老齡化所帶來的機遇和挑戰Abstract 摘 要 The population in the Peoples Republic of China (PRC) is aging rapidly. The proportion of people aged 60 years and above is expected to increase from

9、12% in 2010 to 33% by 2050, turning the PRC into the oldest population in the world. Health care costs and dependency ratios will increase in parallel. 中華人民共和國（中國）的人口正在迅速老齡化。預計60歲及以上人口所占比例將由2010年的12%升至2050的33%，使中國成為全球老齡化程度最高的國家。衛生保健費用和撫養比率也將同時升高。 Aging results in labor force shortages, which in turn

10、 increase average salaries undermining the economys competitiveness. Rapid population aging, if unaddressed, might hamper the industrial transformation process needed to attain higher income status. The fact that the PRC is aging at a low level of income magnifies the challenge. 老齡化導致勞動力短缺，從而致使平均工資水

11、平升高，削弱了經濟競爭力。人口快速老齡化問題若得不到解決，則可能阻礙產業轉型過程，而這一過程是邁向更高收入水平所需要的。 中國在收入水平還較低時即遭遇老齡化，增加了挑戰的復雜性。 Given the limited health resources and safety nets in the PRC, aging will exert financial pressure on the provision of health care services, in particular long-term care for a growing number of elderly. This wi

12、ll aggravate fiscal constraints in local governments, who shoulder the bulk of providing these services. 鑒于中國衛生資源有限、社會安全網不夠完善，老齡化將對醫療衛生服務的提供造成資金壓力，尤其是對日益增多的老年人的長期護理。由于此類服務主要由地方政府提供，這將使地方政府的財政更為吃緊。 While aging poses great challenges, it also provides opportunities for employment generation and servic

13、es development, which are priorities in the government reform agenda. However, capturing the benefits requires policy actions to speed up the transformation of the pattern of growth, coupled with labor market reforms and improved human capital to foster labor productivity. Higher public expenditure

14、to finance the growing needs of the elderly, including pensions, is also needed. 老齡化帶來了巨大挑戰，但同時也提供了就業機會和服務發展的機會，這也是政府改革議程的優先事項。然而，要獲取老齡化的益處，需要推出政策措施，以加快經濟增長方式的轉變。同時，還需要改革勞動力市場和改善人力資本，提升勞動生產率。此外，還應提高公共支出水平，滿足老年人日益增長的需求，包括養老金。Observations and Suggestions4觀察與建議I. INTRODUCTION1. While the best-known dim

15、ension of aging relates to fiscal sustainability due to spiraling pension and health care costs, the repercussions of aging are wider, including a shrinking working-age population. As labor absorption is a key element in the formulation of GDP growth targets, changes in the labor market will thus im

16、pact overall macroeconomic planning. Aging will also constrain economic growth as it results in labor force shortages that in the absence of productivity increases depress growth. 2. The population in the PRC is aging rapidly. The proportion of people aged 60 years and above is expected to increase

17、from 12% in 2010 to 33% by 2050, turning the population of the PRC into the oldest in the world. This trend results from the combined effect of increasing average life expectancy levels and falling fertility rates due to the impact of the one-child policy1. 3. Favorable demographics in the PRC betwe

18、en 1975 and 2005 caused the total dependency ratiodefined as the share of children and elderly to the working-age populationto fall by about 50%. This doubled the working-age population from 400 million in 1978 to 800 in 2005, generating a large demographic dividend that added about 2 percentage poi

19、nts a year to GDP growth. However, the working-age population peaked in 2011 at 940 million, and it has been declining since. Today, rapid aging has reversed a more than half-century decline in the dependency ratio, and labor market shortages are increasing average wages in labor-intensive industrie

20、s, undermining the PRCs international competitiveness. 4. Given the limited health care resources and safety nets in the PRC, aging will exert financial pressure on the provision of services, in particular long-term care, for the growing number of elderly. This will exacerbate fiscal constraints in

21、local governments, who shoulder the bulk of providing these services, demanding urgent reforms to increase fiscal revenue at the local level. The burden would be heavier in rural areas, where the old-age dependency ratio is higher, pension coverage is minimal, and elderly care facilities are rare.5.

22、 While aging poses great challenges, it also provides opportunities for employment generation and the development of services, which are priorities in the government reform agenda. Aging can unleash new drivers of growth. However, capturing the benefits requires policy actions to speed up the transf

23、ormation of the pattern of growth, coupled with labor market reforms and improved human 1. Average life expectancy in the PRC has increased from 41 years in 1950 to 74 years today. In major cities like Beijing and Shanghai it is around 80 years. In parallel, the fertility rate has declined sharply f

24、rom 6 children per woman to 1.5 in the same period.5Challenges and Opportunities of Population Aging in the Peoples Republic of China中國人口老齡化所帶來的機遇和挑戰capital to increase labor productivity. Higher public expenditure to finance the growing needs of the elderly, including pensions, is also needed. 6. B

25、ased on relevant international experiences this policy note aims to formulate policy recommendations to address the socioeconomic implications of rapid population aging in the PRC. The note will focus on reforms to increase labor productivity, health care services for an aging population, and measur

26、es to face the increasing dependency ratio. II. POPULATION AGING AND THE LABOR MARKET 7. Developed countries were the first to age. They approached the problem by shifting from input-driven growth models fueled by the accumulation of capital and labor to productivity-driven ones. However, the shift

27、requires structural reforms to boost the contribution of technology and innovation to growth, which involves investments in human capital to facilitate the adjustment of the labor force to technological change. International experience also shows that aging increases the financial responsibility of

28、governments to provide services to a growing number of elderly. This is aggravated by the impact of surging dependency ratios in aging societies, and its adverse effects on the sustainability of the pension system amidst shrinking working-age populations.8. The labor market will be particularly affe

29、cted in this process. Experiences in other countries indicate that drastic changes can be expected in the skills needed to accommodate products and services to the health, travel, care, and recreational needs of the elderly. This changes result in demand for new jobs, which require specific training

30、 or re-training efforts. For instance, in Germany, a fast aging society, it has been estimated that adjustments in the labor market triggered by the distinct consumption pattern of the elderly will force 15% of the workers to change jobs in the near future.9. Shortages in the labor market will help

31、the PRC adjust to slower growth without social instability. However, workers with limited mobility and obsolete skills might not find jobs despite the labor shortages, and thus become unemployed. Hence, efforts to increase labor mobility and upgrade skills are crucial. Mobility restrictions the hous

32、ehold registration system (hukou) and the non-portability of benefits discourage transfers from labor-surplus provinces to labor-deficit ones. Labor market rigidities are compounded by skill shortages and mismatches that hamper productivity increases and transfers of labor across the three productiv

33、e sectors in the economy, hindering the PRCs ascent to higher income status. 10. Against this background, the PRC needs to accelerate ongoing plans to pursue innovation-driven growth to ameliorate the impact of demographic changes. The PRC is already loosing competitive advantage in labor-intensive

34、industries, but losses are not being compensated by an advantage in Observations and Suggestions6觀察與建議knowledge-intensive industries, the key to achieve higher income status. Policy actions are needed to address the aging challenge through increases of the labor supply and its productivity. The foll

35、owing policy recommendations are suggested to that effect.11. Enhance labor mobility. Reforms conducive to greater labor mobility in the PRC will foster the matching of labor demand and supply, thus curbing labor shortages stemming from rapid aging. Existing institutional barriers hukou and restrict

36、ions on the portability of benefits hinder natural migration flows and deter urbanization, resulting in an inefficient allocation of labor. Simulations suggest that reallocating labor from low-to high-productivity sectors could add several percentage points to GDP growth.2 It is thus recommended to

37、accelerate the ongoing relaxation of the hukou policy and social security reforms to foster labor mobility and sustain growth. 12. Open up to immigration. Welcoming workers from countries with younger populations is the most direct way to increase labor supply. This is best illustrated by experience

38、s in European countries, Australia, and the US, where imported labor has contributed to address labor shortages and to boost population growth. Japan, a country traditionally closed to immigration, has recently announced plans to attract 200,000 foreign workers per year. The PRC could consider openi

39、ng up specific sectors of its labor market (i.e., high-tech industries, health care) to specialized workers to rapidly address talent shortages. Similarly, incentives could be developed to facilitate the return of Chinese nationals educated aboard. 1. Upgrade the labor force. Upgrading human capital

40、 is essential to increase labor productivity in the PRC, and to support government efforts to foster innovation-driven growth. While the past decade has witnessed an expansion in tertiary education in the PRC, the country should aim to double the percentage of population with tertiary education in s

41、cientific and technical subjects. In addition, the percentage of labor force that completed high school, be it regular or vocational, should be expanded, as despite recent increases in junior secondary completion rates, high school attainment at 39% for the 25-34 year-olds in the PRC is still well b

42、elow the average in OECD countries (82%). Government efforts to strengthen technical vocation education and training are welcome steps in the right direction.14. Efforts should be complemented with incentives for firms to provide on-the-job training, and initiatives to re-train workers with obsolete

43、 skills to prolong their participation in the labor force. This would matter most in rural and less-developed areas, where improvements in human capital would be indispensable for future growth. In this regard, given the high propensity to drop out in main migrant-2.For details see K. Y. Tan and X.

44、Zhang. 2007. Incremental Reform and Distortions in Chinas Product and Factor Markets. The World Bank Economic Review. 21 (2). Washington D.C.7Challenges and Opportunities of Population Aging in the Peoples Republic of China中國人口老齡化所帶來的機遇和挑戰sending areas, subsidies could be provided for children to co

45、mplete high school, to counterbalance the trend to drop out as unskilled wages rise. III. POPULATION AGING AND LONG-TERM CARE15. Long-term care systems in developed countries differ significantly depending on the role of the state and the overall structure of the social security system. Germany, Fra

46、nce, and the Netherlands, rely on the social insurance system for long-term care because functional dependency is seen as an area where society must be able to provide a pooling mechanism. In Scandinavian countries, the state plays a key role in the financing and delivery of social services, and lon

47、g-term care is financed through taxes, and managed by public providers. Most countries have separate schemes for medical and social care. Integrating long-term care into the health care system often leads to inefficiencies if long-term care patients are treated in general hospitals at a much higher

48、cost. 16. Public safety nets for the elderly are limited in the PRC, and the development of long-term care services and institutions lags behind desirable standards. In rural areas, minimal pensions result in family members being the primary source of support for 85% of the elderly. However, the fam

49、ily-support mechanism is put at risk by the socioeconomic changes brought about by economic development and modern lifestyles. This exerts enormous pressure for the provision of sufficient beds in nursing homes and resources for long-term care expenditure. Against this background, the following poli

50、cy recommendations are suggested for the PRC to develop long-term care.17. Increase long-term care financing. Addressing the needs of a growing number of elderly requires large-scale reforms to upgrade safety nets to the challenge of aging. This implies that significantly higher public resources are