Taiwan steps into the new year set to become a “super-aged society,” with the population of those aged 65 or older surpassing 20 percent, or about 4.6 million.
Population aging has become a worldwide trend and a crucial challenge to the development of many nations. Taiwan only took seven years to go from “aged” in 2018 to “super-aged” this year, among the fastest jumps in the world.
The National Development Council has said that the 65-or-older age group would reach 30 percent of Taiwan’s population by 2039 and 50 percent in 2070 as a result of falling birthrates and longer life expectancies.
Adding to the concern is that Taiwan’s demographic bonus — in which the “productive” population (aged 15 to 65) is bigger than the “non-productive” population (all others) — is expected to end in 2028. The nation’s population is projected to fall below 23 million in 2030, with a median age of 48.7, meaning it is on the brink of a dire labor shortage, an issue that is already hindering its progress.
The old-age dependency ratio — ie, the number of elderly people being supported by working age adults — is expected to surge from 28 percent today to 51 percent by 2040 and 100 percent by 2070. The current ratio indicates that each elderly person is be supported by 3.6 working adults on average, but by 2070 one worker would be supporting at least one elderly person.
The Chinese Nationalist Party (KMT) and Taiwan People’s Party last month pushed through a slew of legislative amendments in favor of elderly people. The moves were seen as an effort to solidify the parties’ standing among elderly people, but they would worsen generational inequity and add to the burden of the working population, even as their earning power decreases.
An amendment to the Senior Citizen Welfare Act (老人福利法) to exempt some elderly people from having to pay National Health Insurance (NHI) premiums would cut about NT$54 billion (US$1.64 billion) from the NHI systems revenue per year, bleeding off its safety reserve and bringing forward possible bankruptcy to as early as next year. If that happens, the working age population would be required to pay more.
Medical associations called the amendment “unfair,” as the growth in medical expenditure for elderly people far exceeds that for the rest of the population, which nevertheless fund up to 70 percent of the NHI budget.
The change would wreck the NHI system, putting everyone’s healthcare at risk.
An amendment to the Employment Service Act (就業服務法) would allow people aged 80 or older to bypass Barthel Index-based health evaluations to hire caregivers. This also triggered concern that elderly people might benefit at the expense of the working age population.
The number of people aged 80 or older is 910,000, with more than 60 percent of them not in need of professional care, medical data showed. The amendment to ease requirements for hiring caregivers would prompt a significant rise in demand and deepen a shortage of migrant caregivers. That would affect elderly people with moderate to severe disabilities, who need such services the most, and would add to the financial burden on disadvantaged and young working families with disabled members who have to compete for caregiving services.
Taiwan needs to make resource-allocation and policymaking adjustments to meet the challenge of demographic aging, but it must also beware of intensifying social and generational inequity.
