Sustaining, Living, Caring JDC-Eshel 50th Anniversary Conference 15 - - PowerPoint PPT Presentation

Singapore’s Ageing Preparedness: Sustaining, Living, Caring

JDC-Eshel 50th Anniversary Conference 15 May 2019

Outline of Presentation

• Overview of Singapore’s Ageing story
• How Shall We Sustain Ourselves?
• How Well Can We Age-In-Place?
• How Shall We Care For Ourselves?

Demographic transitions: Rapid ageing Singapore’s Resident Population

(1980-2100)

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100 Japan South Korea Singapore Israel

Proportion of population aged 65+

Shrinking households, families

4.87 3.24

2.00 2.50 3.00 3.50 4.00 4.50 5.00 5.50 1980 1986 1990 1994 1998 2002 2006 2010 2014 2018

Resident Households By Household Size, number of persons

A society shaped by migration

3,439,177 112,132 526,619 311,264 1,646,457 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 1970 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Singapore's Population by Residency Status 1970-2017

Citizens Permanent Residents Non-PR foreigners

Singapore’s Ageing Population Preparedness

• 1980s - Report of the Committee on the Problems of the

Aged

• 1990s - Inter-Ministerial Committee on the Ageing

Population (1999)

• 2000s – Eldercare Masterplan (AY2001-2005) Report;

Committee on Ageing Issues report (2006)

• 2016 – Action Plan for Successful Ageing

Action Plan For Successful Ageing 2016

Ten Focal Areas:

Sustaining ourselves How can we Age-in- Place How will we care for each other?

Our Sustaining, Living and Caring themes

How Shall We Sustain Ourselves?

JDC-Eshel 50th Anniversary Conference

Retaining High Labour Force Participation Rates

69.5% 69.1% 62.1% 46.2% 40.8% 26.2% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% Singapore Israel OECD 55-64 years 65-69 years

Labour Force Participation Rates (55-64 and 65-69 year olds)

But older workers tend to be in lower skilled

• ccupations

0% 5% 10% 15% 20% 25% 30% 35% 40%

Composition of Singapore's Workforce by Age Range and Occupation

25-54 55-64 65 & Over

Flexible work practices: preferences vs reality

22.3 47.4 20.8 31.3 15.7 24.2 11.7 16.6 22.2 10 20 30 40 50 Denmark Netherlands Sweden UK USA Japan S Korea Singapore Israel

Share of employed 55-64 year olds in part-time employment, %

52% 48% 61% 57% 61% 66% 60% 64% 74% 0% 10% 20% 30% 40% 50% 60% 70% 80% Denmark Netherlands New Zealand Sweden UK USA Japan Global Singapore

% employees who would prefer to work from home or other location, but in their job do not have the possibility to do so

Flexible work practices: preferences vs reality

58% 47% 55% 51% 65% 68% 81% 68% 76% 0% 20% 40% 60% 80% 100% Denmark Netherlands New Zealand Sweden UK USA Japan Global Singapore

% employees still working in a traditional manner (all ages)

Older Worker Training Participation Rates

59.7% 53.9% 50.3% 44.7% 41.9% 30.6% 31.2% 33.7% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% Denmark Sweden UK Israel USA Japan Korea Singapore

Training participation rates of 55-64 year old workers

How shall we sustain ourselves?

Promoting Employability

• Retirement and Re-

employment legislation

• Re-skilling and Re-

training

• Job Re-design and

Flexible Work Arrangements

Income Security in Old-Age

• Mandatory Savings for

Retirement Income and Medical Expenses

• Social Insurance Schemes:

Annuities, Health and Disability

• Monetisation of Housing

Equity

More flexibility for re-employment

55 62 65 67

72?

Singapore’s retirement and re-employment age thresholds since the 1950s

Employability: Skills Upgrading

• SkillsFuture Scheme

– Raising the resilience of the workforce through a general training fund

• Adapt & Grow Scheme

– Smoothening the transition of workers into new jobs and industries

• Professional Conversion Programme

– Helping professionals prepare for new jobs in new industries

Retaining and hiring older workers

• Special Employment Credit

– Employers hiring workers above the age of 55 and earning up to S$4k receive a wage-

• ffset subsidy
• WorkPro Grants

– Grants to facilitate job redesign, flexible work arrangements and adopt best age- management practices

Principles of Singapore’s social support system

Government support Community assistance Family as first line of social support Self-reliance and Individual responsibility

Self-reliance + Many Helping Hands

Pillars of Old-Age Social Security

Home Ownership Healthcare Assurance Workfare Income Supplement Income Supplement for bottom 20-30% of elderly

Singapore’s savings institution

The Central Provident Fund (CPF)

• Underpins how Singaporeans

finance:

– Home ownership – Medical bills and healthcare – Retirement expenditure

The Central Provident Fund system

Income tax- advantaged Govt pays interest on CPF balances

Savings accumulation and decumulation

CPF Account Balances (S$M) CPF Retirement Withdrawals (S$M)

100,000 200,000 300,000 400,000 500,000 2006 2008 2010 2012 2014 2016 2018 Ordinary Special Account MediSave Account Retirement Account S$391 billion S$126 billion S$3.4 billion S$8.6 billion 2,000 4,000 6,000 8,000 10,000 2006 2008 2010 2012 2014 2016 2018

Social Risk Pooling: Retirement, Health and Disability

Retirement income (annuities) Universal Medical Insurance Cover Universal Severe Disability Insurance Cover (from 2020)

Social Risk Pooling: Retirement, Health and Disability

Purchased from

• wn retirement

savings (CPF) Premiums paid from

• wn MediSave account

Premiums paid from

• wn MediSave account

How Well Can We Age-in-Place?

JDC-Eshel 50th Anniversary Conference

Preferred Place of Dying

Where the would want to be cared for if they were dying Final place of death

• n Death Attitudes, 2014

70% 10% 8% 2% 1% 9%

Home Hospital Hospice Nursing Home Others No preference

77% 12% 7% 2% 2%

Actual Place of Dying

Public Sector Hospitals, 60%

Private Sector Hospitals, 3% Nursing Homes and Clinics, 2% Public and Charitable Institutions, 5% Licensed Sick Receiving Houses, 4%

At Home, 24%

Other Locations, 2%

• Less than a quarter
• f Singapore

residents die at home

• 69% pass on in

hospitals and nursing homes

Singapore Australia Japan Korea Israel Population Elderly population (aged 65+) in millions 0.5 3.6 33.1 6.6 0.9 Elderly as % of population 12% 15% 26% 13% 8% LTC Capacity Total Capacity (beds/places) per 1,000 elderly 51 76 136 72 n.a. Institutional beds per 1,000 elderly 27 55 24 24 48* Non-residential places per 1,000 elderly 24 21 112 48 n.a. LTC Workforce Total LTC Workers per 1,000 elderly 40 71 59 33 111

Comparative Long-Term Care Statistics

Ramping up Long-Term Care capacity

2,100 3,100 6,200 4,500 6,500 10,000 8,800 9,800 17,000

• 2,000

4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 2012 2017 2020 Day care places Home care places Nursing home places

From treating medical episodes to care in the community and at home

Younger population Acute, episodic healthcare needs

• Acute-centric care
• Acute care as focus of

healthcare delivery Ageing population Chronic and long-term healthcare needss

• Patient-centric care
• Primary care as focus
• f healthcare delivery
• Greater focus on

preventive and long- term care

From treating medical episodes to care in the community and at home

’

Moving from being tertiary care-centricity to care in the community and at home

Kampung Admiralty: a vision of the future?

• 100 apartments for the

elderly

• 2-storey medical centre

with specialist out-patient care

• Active Ageing Hub, co-

located with a childcare centre, dining and retail

• utlets
• 900-seat food centre

Integrated housing for the elderly with a wide range

• f social, healthcare, communal, commercial, and

retail facilities, completed in November 2017.

New living concepts: Heartland Kaki

Source: Second Beginnings: Senior Living Redefined, Chong & Kang, 2018

New living concepts: Giving Campus

Source: Second Beginnings: Senior Living Redefined, Chong & Kang, 2018

City For All Ages (CFAA) Project

• Multi-Generational Family-

Friendly Housing

• Subsidies for senior-friendly

retro-fits

• Silver Zones (senior-friendly

road areas)

• Barrier-free access (lift

upgrading, ramps)

Care infrastructure in the community

Community Network for Seniors (CNS)

How Shall We Care For Ourselves?

JDC-Eshel 50th Anniversary Conference

Life expectancy rising 3 years in every decade

61.2 80.7 65.0 85.2 50.0 55.0 60.0 65.0 70.0 75.0 80.0 85.0 90.0 1960 1970 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Life Expectancy at Birth, Singapore Residents, 1960-2017

Male Female

More healthy and unhealthy older persons in the future

2030

• Tapping on the social

capital of a larger pool of healthy older persons

• Older persons in good

health are a resource pool adding to the community’s helping hands

Longevity dividend: ageing well together

• Healthy seniors are a resource with abundant human and social

capital

• Combining data on seniors - both needs and capacity - to tap on

this valuable resource

• Senior volunteerism to boost:

– Active ageing – Befriending – Care and Support

Next steps on aged preparedness

• Upgrading the status and skills of older workers (e.g. re-skilling,

professionalisation)

• Aligning financial incentives across the care continuum
• Better monetisation options for savings (e.g. housing equity,

Medisave right-sizing)

• Strengthening community and home care
• Harnessing longevity dividends (e.g. healthy persons aged 65+

caring for each other)

END

Please contact Mr Christopher Gee at christopher.gee@nus.edu.sg or 6601- 1418 if you have any questions.