Why aged issues take increasing national priority

Kelvin Teo

A medical ethics professor who taught me before once wrote in his lecture notes: “Healthcare is an important issue in which elections can be won or lost on the basis of it”. And he is right. During the run-up to the US 2008 Presidential Elections, a website dedicated to being the central hub and repository of healthcare policy issues entitled http://www.health08.org was established. At least, it was an indication of the major role that healthcare issues play during the hustings in the run-up to the Presidential elections, that warranted a site dedicated to the consolidation of issues.

Healthcare seems a bit narrow for this intended discussion; a more apt all-encompassing term will be general care for our aged from multiple angles ranging from healthcare (of course) to senior-citizen friendly residences and transport services. And this is also inclusive of the caregiver issue….the list goes on.

Why will increasing attention be paid to senior citizen issues? In a previous piece on healthcare, I have highlighted numbers based on a presentation by Associate Professor Kalyani Mehta from NUS Department of Social Work. The gist of the statistics are as follows: 1) The baby boomer generation born after the second world war that forms the middle of the population pyramid enjoy better health, wealth and education and are likely to live beyond 65 years of age. 2) The percentage of people in Singapore above 65 years will increase from 8.4% in 2005 to 18.7% in 2030. In terms of absolute numbers, that would translate into an increase from about 296,000 in June 2005 to 873, 300 in 2030. 3) Singapore is experiencing declining birth rates, with the total fertility rate at 1.23 in 2009, which is far below the cut-off of 2.1 required for population renewal.

The statistics has one very obvious conclusion – our population is aging. And depending on whether you are politically-inclined, the numbers will translate into increased voters within the senior citizen age group, or if you are a policy wonk, that translates to the need for increased public policy discourse on aging issues.

There is no escaping the aging issue, from the political sphere to the public policy sphere. It is conceivable that the aging issue will receive attention during the run-up to Singapore’s next elections. During the unveiling of a potential PAP candidate, 27-year-old Ms Tin Pei Ling made the following statements:

“Despite being young, I am keen to learn and help the elderly because, the elderly, when I look at them, I am reminded of my parents and grandparents, so there is instant connection and affinity there already.”

“But with time, as I understand more of them, I would be better able to come up with meaningful solutions and initiatives to help them better.”

“At the end of the day, the energy and youth is on my side and I have the potential to help them more.” – Ms Tin Pei Ling, during her unveiling

One inference from the statements is that the aging agenda is on the cards, and it may be apparent that Ms Tin may potentially have taken up an interest on aging issues. Politically, it is a decent strategy to have the aging issue agenda on the cards since they will make a sizable portion of the electorate. But, enough of the political part, as the interest of this piece is slanted towards the public policy angle.

It appears at least our lawmakers have recognised the pressing nature of our aging issue. Just recently, our government launched the City For All Ages project, which would involve multiple government agencies such as Ministry of Community Development, Youth and Sports (MCYS), Ministry of National Development (MND), Housing & Development Board (HDB), Urban Redevelopment Authority (URA), Centre for Liveable Cities (CLC), Economic Development Board (EDB) and SPRING Singapore; the goal of the project is to develop urban solutions to aging in Singapore.

In a goal to develop urban solutions, for instance, the Code on Accessibility in the Built Environment (2007) and Lift Upgrading Programme are designed to make our residences more accessible and elderly-friendly. MCYS has also collaborated with HDB to introduce Senior Activity Centres and Seniors Services Centre at Studio Apartments to provide avenues for activities amongst senior citizens. The office for the City For All Ages project identified four areas of focus 1) Research collaborations with tertiary institutions to develop potential urban solutions to aging. 2) Enhance the planning and design of community care services targeted at senior citizens 3) Commercialisation and adoption of aging-related products and services 4) Establish Singapore as a Centre of Excellence for Aging.

From the public policy angle, measures to address the issue of aging like the ones mentioned before are only scraping the tip of the iceberg. Because statistics demonstrate that our population renewal rate is below the desired level, the future implication is that a smaller base of the younger population will support a larger base of senior citizens. With the increasing urgency to address healthcare, residential, community, etc, needs of our senior citizens, more resources will definitely be devoted to this area. The question is how are we going to fund the needs of our senior citizens? Through management of our budget that will see lower priority areas being slashed, and the money going to fund senior citizens-related initiatives? If we are going to manage our budget that way in future, which section of our budget should we slash? And what is the implication for our younger generation having to support a larger base of senior citizens? Will we see a greater tax burden borne by younger members of our population?

It is not difficult to envision the impact of the aging population on the younger population. If we take the fertility rate of 1.23 at face value, it can be interpreted as each parent having less kids nowadays. Unlike the baby boomer generation in which a greater number of siblings can share the workload and chip in resources in the care of their aging parents, the workload (as caregiver) and resources involved in the care of senior citizens in the not too distant future could be borne by the only child of the family. And could the latter be taking on a greater tax burden imposed by the needs of the senior citizen population?

As it is, the aging issue is only the tip of the iceberg. The rest of the iceberg concerns the government budget management especially on how much would be allocated to the needs of the aging population at the expense of other areas, the tax burden and effects on the younger population who have to support the senior citizens financially and as caregivers.

Writer’s note:
In light of the recent politically-motivated interest online in PAP candidate Ms Tin Pei Ling, and the volume of internet traffic activity devoted to personal and political issues involving her, I would like to state that this article is written mainly for public policy discourse purposes and I have no interest in the political side of things. I am satisfied in my abode here at The New Asia Republic. In fact, I consider myself among those in Ms Tin’s words interested in policy, community and national issues but NOT in politics. However, in light of recent attacks on Ms. Tin online especially with that involving her personal life, I sympathise with her situation, and at the same time, I would like to wish her all the best in her pursuits whatever it may be as a fellow human being.