1、Challenges and Opportunities of Population Aging in the Peoples Republic of China 中国人口老龄化所带来的机遇和挑战NO. 2014-3观察与建议Observations and SuggestionsDisclaimer for Translated Documents 译文声明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.为扩大读者范围， 特将本报告由英文翻译为中文。

3、亚行尽力确保翻译的准确性。 但英语是亚行的官方语言， 因此， 本报告的英文原版为唯一具有权威性的 （即正式的和经授权的） 文本。 任何对本报告内容的引用， 必须以其英文原版内容为准。 2014 Asian Development Bank 亚洲开发银行 2014 All rights reserved. Published in 2014.Printed in the Peoples Republic of China版权所有。2014 年出版。在中华人民共和国印刷。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.本出版物中所述为作者的观点，不一定代表亚洲开发银行（亚行）、亚行理事会或其代表的政府的观点和政策。在这里所阐述的事件是实际案例，不代表项目或规划的全面影响。亚行不担保本出版物中所含数据的准确性，而且对使用这些数据所产生的后果不承担责任。在此出版物中标明、参照某个版图或地理区域，或使用术语“国家”不代表亚行对任何地域实体的合法性或其它法律地位的任何判断。亚行鼓励仅出于个人和非商业性目的对信息进行印刷或复制的行为，但须给予亚行适当的承认。未经申请并得到亚行书面同意，使用者严禁出于商业目的再出售、再发行、或创造衍生作品。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中国人口老龄化所带来的机遇和挑战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. 中华人民共和国（中国）的人口正在迅速老龄化。预计60岁及以上人口所占比例将由2010年的12%升至2050的33%，使中国成为全球老龄化程度最高的国家。卫生保健费用和抚养比率也将同时升高。 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. 老龄化导致劳动力短缺，从而致使平均工资水

11、平升高，削弱了经济竞争力。人口快速老龄化问题若得不到解决，则可能阻碍产业转型过程，而这一过程是迈向更高收入水平所需要的。 中国在收入水平还较低时即遭遇老龄化，增加了挑战的复杂性。 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. 鉴于中国卫生资源有限、社会安全网不够完善，老龄化将对医疗卫生服务的提供造成资金压力，尤其是对日益增多的老年人的长期护理。由于此类服务主要由地方政府提供，这将使地方政府的财政更为吃紧。 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. 老龄化带来了巨大挑战，但同时也提供了就业机会和服务发展的机会，这也是政府改革议程的优先事项。然而，要获取老龄化的益处，需要推出政策措施，以加快经济增长方式的转变。同时，还需要改革劳动力市场和改善人力资本，提升劳动生产率。此外，还应提高公共支出水平，满足老年人日益增长的需求，包括养老金。Observations and Suggestions4观察与建议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中国人口老龄化所带来的机遇和挑战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观察与建议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中国人口老龄化所带来的机遇和挑战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