What is Elder Care?

Originally a kind of ancient etiquette, the elderly and capable people were selected to provide wine and food on time and pay respects. The second meaning is that the elderly recuperate at home, and the current pension policy mostly means this. The third meaning is to support old people who cannot support themselves.

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Pension type

Consumer pension

Consumer pension is a newly emerging pension model. At its core, after consumers purchase a company's products, the company should treat the consumer's consumption as an investment in the company, and at a certain time interval, treat the company's profit according to A certain percentage is returned to consumers, so that consumers are not only concerned about the quantity and quality of the goods they buy, but also the benefits brought by shopping.

Enterprises will have a large amount of rebates from consumers and become a strong player in the capital market, and will provide a vast source of huge funds for endowment insurance, which can gradually accumulate a considerable amount of money for consumers without increasing the burden on consumers. Pension funding, thereby solving many of the problems related to pensions.

Housing Endowment

On September 13, 2013, the State Council issued Several Opinions on Accelerating the Development of the Pension Service Industry, which mentioned the need to carry out the pilot work of reverse mortgage of housing pension insurance (that is, retirement by housing). ^[3]

In March 2014, Li Guoli, Minister of Civil Affairs, stated that the relevant financial supervision institutions will formulate pilot policies as soon as possible. The housing reverse mortgage pilot work is not the government's basic pension policy. This policy is a market-oriented selection mechanism and a financial tool for the elderly to choose whether to choose it. ^[4]

Institutional Pension

Elderly care institutions are the proper term for social elderly care, which refers to institutions that provide comprehensive services such as diet and living, sanitation, life care, health management, and recreational activities for the elderly. It can be an independent legal entity, or a department or branch affiliated with a medical institution, an enterprise, a social group or organization, or a comprehensive social welfare institution.

Retirement abroad

International Online Special: In the corridor, there is a fragrant leek box made by Mother Wang; Uncle Li's Yan Duxian; and the spicy hot pot of the Wu family ... you must not think of it, this is not the Beijing Courtyard or the old lane in Shanghai It's the United States across the ocean. ^[5]

They live in the same place: senior apartments in the United States. They all have the same name: Chinese seniors who are retired in the United States. ^[5]

In recent years, there has been a sudden influx of Chinese elderly into the United States, almost occupying elderly apartments in Southern California. They come from all corners of the world and come together for a common goal-to enjoy American welfare.

The apartment for the elderly is built near the hospital and the supermarket. In order to ensure the elderly's illness and convenience, the decoration of the apartment for the elderly is strictly inspected, and the interior and exterior are like new houses.

Each floor of the elderly apartment has a large shared living room with a large sofa, TV, bookshelf and piano. Anyone can come together in the living room. There is a lift in the building and laundry is available on each floor. The laundry room is spacious and bright, and the gym is open 24 hours.

Treadmills, table tennis tables, whenever you want to play, you can go at any time. Free internet access in the computer room and printer inks. Stay here without worrying about your bills and worrying about your children. All the time is spent looking for happiness.

There are 100 households here, and 80 of them are Chinese. Those entertainment equipments are left unattended, the most popular is the reserved area in the yard downstairs. The Chinese like a good harvest, so those flower beds have been divided up. Two of them, some of which are on the 38th line of territorial division, are insurmountable. The flowerbed is planted with tomatoes, cucumbers, leeks, green onions, and everything, but each onion has its owner. California sunshine is the best nutrient for all things. As long as it is sown, it will be harvested. ^[5]

Multiple Models for the Elderly

Family pension This is a "feedback" pension model that is based on blood relationship and is carried out within the family. However, family care for the elderly lacks institutional guarantees, and family conflicts and intergenerational conflicts are likely to occur due to the family structure of the same generation.

Housekeeping for the elderly refers to the contribution of family members or the elderly themselves, allowing professional housekeeping service companies to train domestic helpers, enter the homes of the elderly by way of dispatch, and engage in housekeeping and elderly care services.

The elderly apartment is a kind of elderly living mode with comprehensive management ability that is gradually emerging. But like the domestic helper, this model is not sound enough in terms of laws and regulations, and the quality of domestic helpers needs to be improved.

Home-based care refers to a social care service model that focuses on the family, relies on the community, and relies on professional services to provide living care, medical care, spiritual consolation and daily life difficulties for the elderly living at home. The focus is to address the worries of frail, sick, elderly and empty nest families in the community.

Community retirement refers to the establishment of elderly homes, day care rooms, restaurants, nursing homes, small family nursing homes, cultural fitness activity rooms and other facilities in the community based on the number and needs of the elderly in the community. The "Living in a Home" model provides elderly care services for the elderly. Its shortcomings are that some community institutions have limited facilities, insufficient staffing, and a single content.

Institutional pension refers to the provision of funds by the state or the private sector to set up nursing homes such as nursing homes and elderly care centers. By focusing on the elderly in various nursing homes, they can solve the problem of insufficient human resources for family pension. In the process of promoting institutional pensions in our country, several investment and business models have been formed, such as state or collective development, fund raising, joint government and non-profit organizations, and private capital development, and are in the process of exploration and practice.

Home-based care is an old-age care model pioneered by Shanghai's government. It arranges the elderly in urban areas in suburbs (Shanghai Chongming, Jiading) that are qualified to provide care for the elderly through professional training in scarf service and obtaining employment service certificates. ) Families of migrant workers and politicians are fostered to ease the pressure of urban home care.

This model of pensions for clubs is a kind of pension services provided through the integration of commercial real estate resources. For example, the "Bridge Bridge Dream" set up by the housekeeper in the Thames town on the outskirts of Shanghai will integrate the advantages of home-based care and institutional care. As one.

Integrating medical care and old-age care is a new model of integrating medical resources and old-age resources. In the combined medical and nursing institutions, the elderly can meet the needs of medical care and passport materials without leaving the home. Such as Beijing Tianxi Yuhe Hospital Investment Co., Ltd.'s Yuhe Nursing Home and Yuhe Rehabilitation Home provide services for both elderly medical rehabilitation and life care.

With the continuous release of old-age care needs, some new types of old-age care have also emerged, such as the Shanghai Health-care Old-age Care Community. The project uses a member-type old-age apartment combining property-type parent-child care products and relies on full supporting facilities to realize the living concept of parents and children living for two generations. To build a community of three generations of all ages. In addition, Ping An Group deployed parent-child pension apartments, non-nursing pension apartments, and semi-nursing pension apartments in the entire community according to three different types of nursing needs. ^[6]

Old-age rural model

With the acceleration of urbanization, the hidden problems of the elderly in the rural population will become obvious. Solving the problem of supporting the rural population will be an important task facing the society. In the vast rural areas, the three modes of family pension, land pension, and social insurance pension are the basic pension security methods, while the community pension model is a new attempt. These four together constitute the rural pension system.

The current pension model in rural areas includes:

Family pension

The family support model is an emphasis on the "filial piety" of the Confucian culture. It is a fine tradition of the Chinese nation that has lasted for thousands of years. The obligation of the elderly has become the inherent responsibility and autonomy of every Chinese child and is part of his personality. This is no exception in the vast rural areas, and due to the low level of socio-economic development in the vast rural areas of our country, the conditions for implementing other modes of old-age care are not sufficient, and families are irreplaceable in providing life care and spiritual comfort. Therefore, family pension is still the main mode of rural pension in China.

Land Pension

Land is the foundation on which the majority of farmers live. For farmers, land is both a means of production and a means of life. Especially after the implementation of the household-based contract responsibility system, rural elderly can rely on land income to solve some of their sources of living. Under the current level of productivity development, using land to maintain the most basic subsistence, it can be said that land is their most stable and last safety net for the elderly.

Social insurance pension

Social endowment insurance The Basic Plan for Rural Social Endowment Insurance at the County Level (Trial) (hereinafter referred to as the "Plan"), which was promulgated by the Ministry of Civil Affairs in 1992, set a precedent for "rural social insurance". In the plan, a new idea is proposed in which individuals, collectives, and the state jointly pay for the society to solve the problem of rural pensions. The programme was piloted in 1994 in some developed and more developed rural areas. The main method is to set up an endowment insurance fund with the county as the unit, and in accordance with the principle of voluntariness of farmers, under the guidance of government organizations, starting from the actual situation of rural areas and farmers. The insurance fund is mainly based on individual farmers' contributions, supplemented by collective subsidies, and the state provides policy support, implements a reserve accumulation model, and receives pensions based on the total amount of funds accumulated and the expected average receiving period.

nursing home

Community (including township) old-age care refers to rural or township enterprises with relatively strong collective economic strength. Following the practice of urban enterprises and institutions, old-age pensions are issued to rural elderly. The implementation of community pensions is relatively narrow and is often subject to the level of rural economic development in the region.

Old age domestic problems

"The developing Chinese pension system is facing a severe test. There is still a long way to go to increase and maintain the value of social security funds." Xiang Huaicheng, chairman of the National Council for Social Security Fund, recently gave a keynote speech on "Several Issues for the National Social Security Fund". Xiang Huaicheng said: "Although China is still in the golden age of labor force, the population above 60 years old exceeds 14% and the population above 65 years old exceeds 10%. According to international social standards, China has clearly entered the threshold of an aging society." (Xinhuanet, October 23) A World Bank research report a few months ago pointed out that from 2001 to 2075, the gap in income and expenditure of China's basic endowment insurance will reach 9.15 trillion yuan. On the one hand, the number of elderly people is rising, and on the other hand, the pension gap is gradually widening. In the face of this suffocating reverse fracture, we have to think about it: one day, when we are dying, who will provide for us?

The representative of the Beijing People's Congress and professor of Beijing Normal University, Wang Jianmin suggested that the elderly should not only refer to the establishment of nursing homes, nursing homes and other institutions to provide specific care services, but more importantly, establish a pension mechanism and provide a set of living plans for the elderly. "Although some basic nursing positions do not necessarily have a high degree, it is sufficient to understand basic medical and nursing common sense. Many nanny schools and domestic helper service stations can take on their training tasks. But in addition to living, The basic needs of people and the spiritual needs of entertainment and travel require someone to make a professional and systematic plan. " Therefore, the representative of Wang Jianmin put forward a bold idea to set up a "master's degree specifically for the aged care industry" in colleges and universities, "to allow those students who have medical and psychological expertise in the undergraduate to further study the aged care industry." And said that the industry should be "market-oriented", and can be tried to be cultivated by enterprises and institutions in conjunction with colleges and universities, "not only can solve employment problems, but also provide talents for the market." ^[7]

Root Causes of the Elderly

Narrow coverage

Including more than 40 million retirees, the number of people insured at the end of last year in China was only over 160 million, accounting for only about 30% of the urban population, less than 15% of the labor force, and less than half the world's level of coverage.

Historical burden

Under the planned economy system, the pension and retirement of employees are contracted out by the unit and the state. In the 1990s, old retired employees and employees who participated in the work before the implementation of the new system did not have personal account accumulation. So where did their "pension money" come from? This task falls on the shoulders of the employees.

Institutional defect

Lack of the social and welfare benefits of social security. Although modern social endowment insurance emphasizes the need to enhance self-protection awareness of individual participation, it still requires the participation of the state, the collective and all sectors of society. China implements a basic old-age insurance system that combines social pooling and personal accounts. However, judging from the reform practice in recent years, the "combined accounting model" has not really been realized. According to the "Basic Plan for County-level Rural Social Endowment Insurance", rural social endowment insurance adheres to the principle of "individual payment-based, collective subsidy supplemented, and state policy support" in fund raising. However, most collectives are incapable or unwilling to subsidize rural social endowment insurance, and some places have even further changed the "individual payment mainly" to "all paid by individuals" in the implementation. This makes the current rural social endowment insurance actually a form of encouragement saving, so it is impossible to force farmers to participate. And "compulsory" has always been regarded as an inherent attribute of social insurance. Without mandatory social insurance, it is difficult to implement and lose its sociality.

Institutional instability Rural social endowment insurance measures are basically modified based on the Basic Plan promulgated by the Ministry of Civil Affairs. These measures generally lack legal effect. Therefore, the collection, use and pension distribution of insurance funds are only implemented in accordance with the wishes of local government departments and even some officials. They are not a permanent contract between farmers and the government, so they are highly unstable. .

The coverage of insurance is small and the level of insurance is too low. The participation rate of the nation's age-appropriate population is quite low, and the coverage is very narrow, which makes the mutual benefit of insurance very poor. Statistics from the Ministry of Labor and Social Security show that by the end of 2005, only 55 million farmers nationwide had participated in endowment insurance, accounting for 5.8% of the country's total number of farmers. With regard to the level of protection, the "Basic Plan" stipulates that when farmers pay insurance premiums, they can pay from 2 yuan to 20 yuan in 10 grades according to their actual conditions. In most areas, farmers have chosen the lowest premium of 2 yuan / month when they apply for insurance. Without considering inflation and other factors, if farmers start to receive pension after 10 years of payment, they can receive 4.7 yuan per month, and 15 months later can receive 9.9 yuan. This amount of money is almost Does nothing. Even if farmers insured 4 yuan, 6 yuan, or even 20 yuan per month, it is still difficult to play the role of old-age security.

It is difficult to maintain and increase the value of pension insurance funds. The "Basic Plan" stipulates that "the fund shall be uniformly managed in units of counties, mainly by purchasing high-interest-rate bonds issued by the state finance and depositing in banks to maintain value and increase value." Because the management is based on counties, the related costs can only be allocated within the range of counties, and the marginal cost only moves on a smaller value, and the scale diseconomy is very obvious. In addition, in the actual operation process, due to the lack of suitable investment channels, relevant departments generally adopt the method of depositing in banks. Since the second half of 1996, bank interest rates have continued to fall, and coupled with the effects of inflation and other factors, it has been very difficult to maintain the value of rural pension insurance funds, let alone add value. On the one hand, the burden on the government is aggravated. The more people insured, the more the state has to pay. On the other hand, in order to enable the funds to operate in a balanced manner, the interest rate of the old-age insurance account originally promised by the state had to be reduced, causing the actual income of the insured to be significantly lower than the old-age pension calculated at the high interest rate in the past, making people's confidence in rural social pension insurance decline.

Aging

China's aging trend China entered an aging society in 2000. By 2010, 70 million urban retirees will reach 70 million, and by 2020, it will exceed 100 million. By 2030, it is expected that the proportion of the elderly over 60 in China will reach 24.46%, which is about 8.5 percentage points higher than the world average. The National Aging Office released the "Predictive Research Report on the Development Trend of China's Population Aging", which introduced the current development trend of China's population aging in three parts:

The first stage, from 2001 to 2020, is the stage of rapid aging. At this stage, China will add an average of 5.96 million elderly people each year, with an average annual growth rate of 3.28%. By 2020, the elderly population will reach 248 million, and the aging level will reach 17.17%, of which the elderly aged 80 and above It will reach 30.67 million, accounting for 12.37% of the elderly population.

The second stage, from 2021 to 2050, is the stage of accelerated aging. With the second peak childbearing population entering the elderly in the 1960s to the mid-1970s, the number of elderly people in China has begun to accelerate, with an average annual increase of 6.2 million people. By 2023, the number of elderly people will increase to 270 million, equal to the number of children aged 0-14. By 2050, the total elderly population will exceed 400 million, and the aging level will advance to more than 30%. Among them, the elderly population aged 80 and above will reach 94.48 million, accounting for 21.78% of the elderly population.

The third stage, from 2051 to 2100, is a stage of stable severe aging. In 2051, the size of China's elderly population will reach a peak of 437 million, about twice the number of children. At this stage, the size of the elderly population will be stable at 300-400 million, and the level of aging is basically stable at about 31%. The proportion of elderly people aged 80 and above in the total elderly population will remain at 25-30%, entering a high ageing Platform period.

The "Report" proposes that China's population aging has six major characteristics, including the large size of the elderly population, rapid development of aging, imbalanced regional development, significant urban-rural inversion, more female elderly population than male, and aging ahead of modernization. Looking at the trend of China's population aging, it can be summarized as four main conclusions: First, population aging will accompany the 21st century. Second, from 2030 to 2050 is the most severe period of China's population aging. Third, severe population aging and aging will become increasingly prominent. Fourth, China will face the dual pressures of an aging population and an overpopulated population.

Early retirement

During the past economic restructuring and the reform of state-owned enterprises, the social insurance premiums owed by the difficult enterprises were severe, especially for the placement of surplus employees, and a large number of employees retired in advance, passing on the burden to endowment insurance.

Countermeasure for old age problems

At 9 am on March 5, the first meeting of the Twelfth National People's Congress opened in the Great Hall of the People in Beijing. The Minister of Civil Affairs Li Liguo pointed out in response to a reporter's question that the Ministry of Civil Affairs and other countries will implement the 12th Five-Year Plan for the construction of China's social pension service system, increase investment, strengthen preferential policy implementation, and support and encourage social forces to participate in social pension services. , Accelerate the pace of social elderly care services.

According to Li Liguo, the construction of the social pension service system promoted by the Ministry of Civil Affairs includes the development of home pension services, community care services and institutional pension services. In terms of institutional pension services, it has reached the standard of 20 beds per 1,000 elderly people. By the end of 2015, it will reach the level of 30 beds per 1,000 people.

Li Liguo further explained that the preferential policies for the construction of the social pension service system are mainly reflected in three aspects: first, tax relief; second, the establishment of a social pension service system in places where conditions permit, and subsidies for one-time investment and operation; Social pension institutions provide preferential policies on the use of autonomous facilities and public facilities. ^[8]

National Pension Plan

Dou Yupei, Deputy Minister of the Ministry of Civil Affairs, said that during the 12th Five-Year Plan period, the Ministry of Civil Affairs decided to carry out the construction of the elderly care service system for five consecutive years to promote the annual activities and use multiple methods to solve the problem of elderly care. The project of respecting the elderly, loving the elderly, and helping the elderly was started. The project has six plans as support. ^[9]

First, in large and medium-sized cities, a large number of old-age care institutions that integrate old-age care demonstrations, training and practical training will be constructed, referred to as the "sunshine plan."

Second, at the district and county level, each district and county must build a comprehensive service facility that focuses on supporting the elderly and also serves the disabled and orphans, referred to as the "Moonlight Plan" for short. ^[9]

The third is to set up a star-studded site in the community to serve the elderly at home, referred to as the "Starlight Plan" for short. ^[9]

The fourth is to continue to build five-guarantee facilities for the elderly in rural villages and towns, referred to as the "Xiaguang Plan." ^[9]

The fifth is to start a trial and gradually roll out. The village-sponsored mutual care and happy homes built in the countryside are referred to as the "happiness plan" for short.

Sixth, at the same time, various types of rehabilitation aids are deployed in various types of elderly institutions and communities, referred to as "Fukang Plan" for short. ^[9]

Senior care system

Before reform and opening up

Prior to the reform and opening up, urban families' old-age care functions were strong, and families and units worked together to make good use of old-age care resources for the elderly. Despite their limited resources, they did their best. In rural areas, the government and the collective work together to provide endowment services for the "five guarantees" elderly people, while other rural residents rely solely on the family, and sometimes need help from relatives and neighbors to take care of them. The dual structural characteristics of Chinese society are also most vividly displayed in the field of elderly care services ^[10] .

After reform and opening up

After the reform and opening up, with the intervention of the market economy, the "unit person" has evolved into a "social person", the phenomenon of enterprises running a society has disappeared, and the unit's welfare has become less and less. Many enterprises have completely lost their opportunity to enjoy unit benefits after the transition, and they have implemented social management after retirement. So far, the age of relying on units to provide a variety of old-age services is gone, and replaced by old-age services provided by communities and enterprises and various organizations. At the same time, due to the implementation of the family planning policy, the family functions that have played a major role in providing elderly care services have gradually weakened. In China, family pensions are an institutionalized tradition with a long history and still the mainstream form of pensions. However, with the influence of many factors such as economic development, social transformation, and demographic changes, this approach is facing unprecedented challenges. Since China is in a transitional period, the government that should bear the most responsibility is not prepared for it in terms of system, policy, or finances. The contradiction between public demand and the government's ability to provide public goods and services is prominent.

In summary, with the drastic changes in the social structure of population, economy, politics, and culture, the original social foundation on which old-age care services existed has ceased to exist. In order to meet the requirements of the times, it is urgent to restructure the old-age care system and system. .

Pension fund

A pension fund is a fund used to pay for retirement income and is part of a social security fund.

The pension fund raises social endowment insurance funds by issuing fund shares or beneficiary certificates, and entrusts professional fund management institutions to invest in industrial investment, securities investment or other projects to achieve the purpose of maintaining value and increasing value.

The full name of the pension fund is the pension insurance fund. It is a very important part of China's social security system, also known as the endowment insurance system. As far as the status quo of China's endowment insurance system is concerned, it is a social system that provides basic living security for workers when they are old and frail. If you reach the retirement age and go through the retirement approval process, you can enjoy pension benefits. The endowment insurance fund is shared by the state, enterprises and workers, and is collected and managed by the Social Insurance Center. Enterprises pay 20% of their total wages, and workers pay 8% of their total wages in the previous year. The so-called state burden does not have a specific amount, but it is reflected in taxes. The 28% that is paid is not taxed.

Old age holy place

The American International Life magazine recently evaluated the 2012 global retirement index. It looks at real estate, special benefits for retirees, cost of living,

Incorporate factors such as local difficulty, entertainment and amenities, medical care, retirement facilities, and climate to choose a destination for Americans to care for in foreign countries.

Ecuador

Prescher, the project editor of International Life magazine, lives in Ecuador. He said that his expenditure in Ecuador is only a small part of the cost of living in the United States without sacrificing any quality of life. It is said that a couple who spends their money carefully in the United States can live well in Ecuador for $ 800 a month; even if you spend generously, you can hardly exceed $ 1,500.

Don't worry about integrating into the locals. Some expatriate communities have been established locally, and retirement benefits are very good, including half of transportation, utilities, and cultural and sports fares. Medical expenses are not expensive: all foreigners can join the Ecuadorian Social Security Medical Plan and pay a monthly insurance premium of $ 57.

Panama

Panama has the best retirement benefits. This southernmost country in Central America has a discounted benefit plan that is open to foreigners and has no minimum age requirements. International Life magazine said that after participating in the plan, 20% off any professional services in Panama; 50% off for movies, theaters and sports events; 30% off for public transportation, and 30% off for restaurant meals 50% discount; 15% discount for fast food chains, 15% discount for hospitals and private clinics, 25% discount for COPA domestic flights, and many other discount benefits.

In addition, the cost of living in Panama is also very low: in a near-perfect climate, it only costs 1,500 to 2,000 dollars a month. You can buy a beachfront apartment for $ 180,000 or rent a $ 450 apartment.

Mexico

Mexico also has the highest cost-effective housing facilities as described by International Life. In Tulum, along the Caribbean coast of Mexico, and other places, you can find good homes for $ 167,000. It's also quite easy to integrate into Mexicans. For example, there are more than 80 interest groups near Lake Chapara, which has Mexico's largest expat community. The weather in Mexico is also unmatched, especially from October to April.

Malaysia

In Malaysia, you can live quite comfortably. For example, you can rent a $ 1,000-a-month seaview apartment in Penang. In addition, Malaysia has a special retirement benefit called My Second Home, which is open to all foreigners. The editors said that Malaysia is also an easy place to integrate into the local area. You can spend $ 4 to watch a movie in English.

Nicaragua

Like many Central American countries, what makes Nicaragua a top destination for retirees is the cost of living. International Life magazine says that spending about $ 1,200 a month there is pretty good. For example, the price of a "local meal" is $ 2 to $ 3. Local beers are good, prices range from $ 0.75 to $ 1.5. Nicaragua is also an easy place to integrate. There is an expat community in Granada, Nicaragua, and you will find that making new friends and building reputation in this community is much easier than you might think. In addition, the cost of seeing a doctor in Nicaragua is about $ 15.