Tackling the crisis of care for older people: lessons from India and Japan
nature.com
nature.com
Those old people who have lots of family that cares about them will be fine in any case. So the "problem" are those old people that are socially isolated and went all-in on the governments' promises of public retirement care. But now we're finding out that the old retirement system is too expensive for the young generation to handle, plus the young were taught not to care about anyone but themselves...
"I'll start respecting the elderly when they stop bothering me with their email problems."
That said, the horrible housing market is in my opinion mostly due to foreign mafia/dictator/oligarch investment through shell companies. The most expensive areas in London are all sold, but empty...
True, but this was allowed to happen by the current and old generation of voters.
But old people did manage to produce a first-world country as successful as any other, get their language spoken all over the globe, vastly increase college education (which they thought was doing the young a favour), build a tech sector that pays wages considered ridiculous everywhere else on the planet, create the internet and basically give it away for free, give birth to and raise us, have much less racism and sexism than there were a few generations ago (although they both remain very real problems), avoid any wars that couldn't be fought with an all-volunteer military, and avoid destroying the world with nuclear weapons - something that seemed as inevitable, in its day, as global warming is today.
Thinking the old have done _nothing_ betrays something of an ignorance of history IMHO.
West in world context is not just the USA.
It's true that (e.g.) France hasn't reaped the benefits of getting their language spoken all over the globe, but they certainly have increased college education, the internet, and no major wars. And they also managed to introduce other benefits, like quality healthcare for all.
Below them are a much much bigger block of 60+ old people. They dedicated their lives to the opposite: narrowing educational access,destroying the generous labour market they inherited, stopping people accessing housing, some are even trying to reintroduce Nazi-ism.
I suppose all those babies paid for their own housing, food, education, healthcare and vacations for up to 25 years before they were productive members of society?
Not all debt is bad but our government is using it poorly. A 30 year bond on a bridge with 60 year lifespan is good debt. A 30 year bond on 2 expensive, 20 year wars with no positive objective is bad debt.
Said argument reminds of Monty Python's "What have the Romans ever done for us".
Personally I think the correct line here is personal responsibility and fairness. OAPs have have had huge opportunitied. Until we've given the same to everyone else, they can wait.
EDIT:
BTW, if it weren't for the fact that tech pays 20x the hourly rate, I might even have stayed working in social places.
But I have also experienced the other side, like when a restaurant refused to let us in because we came with kids. They argued that their mostly elderly customers would feel disturbed by the noisyness of kids talking to each other.
The amount of money these places get per individual is fucking staggering, like $15k per month, every month. What does that get you? Like a shitty bed in a shitty room with shitty daily food and 1/10th of a nurse, who, like you said, is paid garbage.
But don't worry, some rich fucker's portfolio is doing great now that the elderly had to sell everything they've ever earned to afford end of life care, instead of letting their family, children, or even the next generation inherit it.
UK comparison: my mother spent the last few months of her life in an Alzheimer’s care home 3 miles from the family home, and that was “only” £1,000/week.
Owing to the pandemic, I wasn’t able to see the place in person, but it looked pleasant enough on video call.
as were the old.
Social Security won't have funding issues for almost a decade but there is no political will now, especially among the elderly, to find a solution to this problem
People are living longer, immigration can't solve the problem, people are relatively healthy and wealthy, etc. but there is not enough babies entering at the bottom of the pyramid to grow into tax payers to continue funding the social systems.
Dystopian me sees a world where western governments will have to institute mandatory, two child per woman births, moratoriums on birth control, huge incentives for people with children under 18, and aggressive pushes for couples to raise adopted children and/or make new ones.
Wouldn't it be a lot simpler to just allow more immigration?
I mean, there are plenty of young, able-bodied, english-speaking people who'd like to move to rich countries.
Look at Japan for example. Immigration has been touted by Western think tanks and pundits as a solution to their demographic problems, but instead they've chosen to go all in on automation and robots to attempt to solve it.
I expect Korea to follow the same path. Probably China too. A lot of East Asian countries that are at the bleeding edge of the demographic bomb place extremely high value on population and cultural homogeneity. The West would probably label that as racism.
And forcing every woman to have two children isn't?
I would imagine such aggressive measures (i.e. forcing of anything) would occur first in a certain other countries before it happens in the West - if it ever does. I would also not be surprised if the West would implicitly choose to implode first before sacrificing an iota of "freedom and individuality".
Outside the West, I also would not be surprised if some countries/cultures would implicitly choose to implode before sacrificing their homogeneity.
(If more aggressive payments by other countries are any indication, this will have approximately zero effect on people's decisions.)
Both in the EU and US, various immigrants (both legal and illegal), have been coming into the continents since the 1960s.
But even with all the immigration, currently there are still near one child fertility rates.
The native inhabitants, both the native born and born from immigrant families, still need to make up the short fall of having their own children.
Is it matter while enough immigrants coming?
I would also not be surprised if the West would implicitly chooses to implode first before sacrificing an iota of "freedom and individuality". As the saying goes, "give me liberty or give me death", or that famous Benjamin Franklin quote about trading freedom for security.
Western country like USA is good for competition and individualism and you can make a lot of money because of it, and then you bring the money back to Asia, and retire in Asia, where everything is cheaper and community is stronger than in western country.
And yet, if everyone does it, then Asian countries will also end up with no community -- because all the young people will be in the West.
Already, rural parts of China and Thailand are depopulating as young people go to cities. The same in Eastern Europe. And the same, come to think of it, in the United States. What were once small towns and farming communities are now empty save for a Dollar Store and a few 50-year-olds. This would be a global-scale version of that same phenomenon.
The other issue is that this plan probably means you'll only be able to have a small family, simply because you're starting later. Over time that would also break the model. Hard for the kids to care for grandma when there are as many grandmas as kids.
But for an individual it seems like a decent plan. Except --
Well, it's a little more workable for a man, since in principle, if he's lucky, he can marry a younger woman and still have a family. But that has problems: An equal relationship is less likely, and she will be left a widow at some point. It probably just won't be as good a marriage as if you'd married your highschool sweetheart.
If you want to do geo- and cultural- arbitrage, it seems like, while harder to pull off, it might be better to do remote work and go to a traditional/low-cost country when you're younger.
Not to mention the impact on prices in those countries.
Over the long term, lots of young people starting their careers (i.e. low net worth) would leave the country to seek good jobs abroad, and only return at the end of their successful careers (i.e. high net worth). All that extra wealth would drive up prices, making it even harder on locals.
> If you want to do geo- and cultural- arbitrage, it seems like, while harder to pull off, it might be better to do remote work and go to a traditional/low-cost country when you're younger.
Wasn't this the whole idea of "digital nomadism" which seemed to be popular in the 2000s? Now that remote work is popular, we'll probably see a resurgence.
Yeah, could be. That said, the same force that allows remote work (COVID) also prevents travel, or at least makes it less attractive. We'll have to see if the remote work stays after the COVID leaves.
Also, don't they all just go to Bali anyway? ;-)
There is also a question of -- are you actually becoming part of the community you're joining? For example, I hear a lot of guys (it seems to be mostly guys) who've gone to Puerto Rico have encountered a ton of resentment. It doesn't help that many fit a "crypto bro" stereotype (or is that just the media reports?).
One of the more positive versions of this (though not without problems) has been the "back to Africa" movement. Although there's sometimes resentment, mostly I get the impression that people are received well (also, there's a choice: racism here or resentment there?). And, the thing that makes me feel a little more positively about it than "nomadism" is that this is done with an intention to stay, integrate, and invest.
(I also think some of the negative reaction comes from negative perceptions of Western culture. When the arrivals turn out to be chaste respectful people who are not on drugs, I suspect opinions change. That was certainly the case in India for a while, where it was unfairly assumed that Americans were worthless hippies who slept around too much. Well, India did get its share of hippies, so I can understand...)
I guess you also do see these things happen in an idiosyncratic way, usually as a result of marriage. For example, a European web developer who meets a Jamaican and moves there to be closer to her family, stuff like that.
> Not to mention the impact on prices in those countries.
...but yeah, it only works if it isn't popular.
Also I've witnessed first hand the Korean healthcare system at work via my wife, and it is by far not only less expensive, but also (maybe more importantly) less complicated. It's not perfect, but for the average person I'd greatly prefer it to the mess we have in the US.
Of course, South Korea also has its share of political issues both internally and externally. So it has also crossed our mind that perhaps we ought to think of obtaining citizenship or residency in a third country for when the "earning period" chapter of my life starts to close.
If you want the reverse take a look at cultures that think in the opposite fashion: SK,eastern cultures,or maybe Japan(though i'm least familiar with that, and what consists as "elderly" continues to increase);Now even there you have a lot of problems, but problems are inevitable and that is precisely the argument and reason of why we should strive to behave less "civilized" - as in staying comfortable -. The reality of life is that it is constantly degrading, generations who went through war always understand this and seem "superhuman" to later generations who grew up in peace.It's not about war and conflict between people but war against the degradation of life.
However I would argue that the vast majority of people are very selfish and do not have much more than a token amount of generosity beyond themselves or at least their immediate family.
Thus while not the ideal situation, some amount of mandatory force by society is the next best, imperfect, option I can think of.
I'm Korean, and it's been traditional in Korea for children to take care of their parents when the become old. Often times this meant multigenerational households where the elderly would live together with one of their adult children. But this too is changing, and today, quite a few of the elderly are either left alone or put into nursing homes.
Especially in countries where it has been traditionally implied that your children will take care of you when you grow old.
It seems like punishing people for not having children and not being consistently successful in their working life is going to leave a lot of old people destitute. That is not necessarily a simple cultural issue.
I had read somewhere that, long long ago people who retired at, say 60 would probably eventually die by 65.
In that case the retirement system, pensions, savings etc would work because they only need to be supported for a few years.
However, as the healthcare system across the world increased, people are now living much longer lives and hence they need to be supported longer. This stresses the existing retirement mechanisms.
It's kind of ironic if that theory is true.
The West has followed the path of freedom and free markets. The smallest unit in society is the individual, not the family (like in Asian countries). Freedom here is being celebrated, also by having the kid "finally" moving out at 18+. Those who stay are not doing it for cultural, but mostly for economical reasons.
Taking care of elderly people is not very "cool" here in Germany. My friends haven't called or visited their grandmas for many months, while my Chinese friends try to use their holidays to visit home. They are also planning longterm how to move closer together and incorporate those thoughts into the partner selection.
The Western approach is different and get often "it's me and it's my happiness".
Japan is absolutely horrible to its women. Women are expected to take care of their family, their own elderly relatives and their husband's elderly relatives. It's one of the many reasons why so many Japanese women are refusing to marry and have families.
Maybe the US doesn't have it right, but, with respect to its women, Japan has it very wrong.
The biggest problem with the US is that you need a car to do anything. This includes things from basic groceries to the doctor. That's terribly limiting to the elderly.
https://www.cnn.com/2021/01/29/china/china-millennials-marri...
This is why westerners will always be a gaijin.
The US simply doesn't have any protected leave at all, which is incredibly hostile to women trying to contribute to the labor force.
And then you meet Western people who adore, even feteshize Japan SO heavily without reflecting anything what is going on.
People have to understand that most of the things they love in Japan (cleaness, extreme degree of quality in customer service, orderliness) is due to those ultra conservative values and norms.
Hence, I am very critical towards Japan and I find people naive who one the one hand adore Japan so much (also the super conservative government) and at the same time hate the Chinese values, system and even people.
Similarly, Japanese women are usually portrayed as very submissive in Anime and Japanese movies. Probably, some people find that sexually attractive, or else they wouldn't do it.
Looking at what westerners desire of Japanese culture might be a good way to find suppressed urges in the western culture. Whether or not we as society decide to act on that knowledge is a different question.
I never met any who would approve of the sexism, xenophobia or crazy work culture. Most people love the aesthetics, literature, history, architecture, food, music...
I think you are describing a certain far-right weaboo subculture, but that's just a pocket of 4chan inanity.
Similarly, I've yet to meet someone who thought Brexit would be a good idea.
What that shows me is that the bubble is very real and that people with those views are hidden from me.
"Do you think it is, or is not, morally wrong for a couple to have a baby if they are not married?" 47% of Americans say "morally wrong". That is very conservative in my opinion.
https://news.gallup.com/poll/4315/family-values-differ-sharp...
Just because many many people voted for Trump or the Brexit it doesn't make this good or right.
America only ends up with a majority because the system creates and only has room for 2 political parties.
If America had a more hand wavey European like system, then America would likely have 2+ parties.
I don't understand, a large part of the last 20-30 years of American elections have been an entire outrage over how a such a small amount of people can have such outsized results in elections because of how the system is structured. Its literally the opposite of your take.
That says a lot about about US. But I never said I was talking about US.
If you just like Studio Ghibli films, or giant robots fighting each other, you might not notice that the police in Japan have a suspiciously high confession rate because it doesn't explicitly appear in the small portion of Japanese culture they're looking at.
They're entitled to live like that if they want, so long as it doesn't turn into socially and structurally coercing everyone else to live like that.
I'm sure it's very convenient for a lot of people if women were to be forced back out of the workplace and economic independence to be guilt-tripped into caring roles for the rest of their lives, but a lot of people put a lot of work into digging their way out of that and are not keen to see it undone.
Yet people routinely advocate for subsiding what we want and penalizing what we don't in damn near every other public policy context, transportation, energy, housing, etc, etc, etc.
So how do you reconcile this? Surely those people who want a conservative lifestyle have just as much right to try and get society to do what they want on the issues they care about as any (to pick an example) the people who want us to reduce outsourcing of manufacturing to countries with less environmental protections do?
Because one is about limiting women’s rights, and the other is about issues that affect all of society.
It's perfectly possible to craft policy that makes life easier for households with one working parent and one stay at home parent without doing anything to specifically restrict women. Crafting policy in such a manner would be all but necessary since we live in an age where same sex marriage is widely accepted. Heck, it could be as simple as a well crafted tax credit.
What is far harder than crafting the actual policy is having a discussion about the policy without things devolving in exactly the direction you're bringing it.
Edit: Now that I think about it policy that promotes married couples with a single stay at home parent would likely go a long way toward un-screwing the people who've been screwed out of stable households for several generations due to welfare and state assistance rules that highly dis-incentivize marriage.
Nothing about healthcare reform, minimum wage laws, or parental leave policies. You have to have two working parents to afford the volatility of income, which in the US was also tied to healthcare, and still is in some sense (until Democrats helped changed that with ACA, not the people that call themselves conservatives).
Reducing this volatility for families is not the “conservative” position in the US.
As someone raised by non westerners, every single woman cousin of mine chose to become financially independent. And why would they not? Who wants to live under the thumb of someone else?
Ignore my anecdote. The proof is the simple fact that wherever women are allowed to financial independence, they choose to take if.
I have had this conversation come up many times before and the people always say that their daughter in law is their daughter and everything that is theirs is hers. So then I tell them, well, they should have no problem signing over their assets to her, and they clam up pretty quickly.
Ask this question in the West and you may be surprised too.
You are generalizing aspects of US to the whole "west". Statistics show the opposite: in most EU countries people don't leave home at 18 by far.
Also family is important in many EU cultures and people visit close relatives often.
If you look statistics about young adults leaving home, and young adults who doesn't have a job (or don't earn enough to buy or rent a house), the correlation is pretty hard.
Maybe I am overthinking this though.
When I was a kid, it was overpopulation. Then it became overpopulation combined with the prospect of automation taking all of our jobs. Now, very suddenly as it seems to me, we’re talking about declining population and a labor shortage.
If the topic is how much of society’s resources should be allocated to maintaining quality of life for those who cannot by themselves, perhaps due to old age, then a labor “shortage” will be the problem. More accurately, it is about which proportion of society’s resources should go towards supporting those who need assistance, changes which show up as changes in prices for labor.
I am not too fond of the idea of using society’s resources to keep people of very advanced age living longer and longer with poor quality of life. This rationing of resources will exacerbate due to reduced birth rates compared to previous decades, in conjunction with increasing lifespans and medical interventions.
Completely agree with you. The "Trillion dollar question" is what to do and how to do it, once a "solution" is not enough, "democracies" have to find ways to enforce it.
Edit: Euthanasia is a solution that is starting to be sold by some politicians. I wonder if people really understand what's behind it.
He should have been given an option to go peacefully.