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五、結論
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E. Conclusion
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各類數據都在表明世界正在快速變老,人類社會正在進入長壽時代,人口年齡結構將逐步形成新均衡,低死亡率、低生育率、預期壽命穩步提升、人口年齡結構趨向柱狀、平臺期老齡人口占比超越1/4構成了這一時代的五大特徵。伴隨著長壽時代的到來,帶病生存將成爲普遍現象,爲了使得漫長的長壽生涯可以更加有質量,個體投入在健康上的費用將劇增,龐大的健康需求將促進健康產業的發展和健康產業結構的變化;同時,長壽時代社會儲蓄結構及個人財富積累形式將會發生變化,個人將更加依賴投資回報和財富積累來滿足養老和健康的需求,長壽時代必將帶來健康時代和財富時代。從宏觀角度看,當前對於長壽時代對宏觀經濟的影響有不同的觀點:有的認爲老齡人口比例增加將導致經濟增速放緩,也有最新的研究表明長壽時代未必會導致經濟增速下行。長壽時代下社會經濟的發展既面臨挑戰,如社會創新效率受限以及財富不平等程度加深等,又存在機遇,尤其是適應長壽時代社會經濟結構的是更有活力的長壽經濟,老年人的價值將被重新認識、定位和發掘。日本目前是全球人口老齡化最嚴重的國家之一,長壽時代下的日本勞動力、社會經濟發生了深刻變化,對中國應對長壽時代的衝擊具有經驗啓示。從日本經驗可以推知透過提高人力資本、加快技術引導、促進社會公平、建設有效的資本市場、引入長壽經濟創造第三次人口紅利等可以有效促進經濟發展。長壽時代已經來臨,相比其他國家,中國人口基數大、老齡人口成長進程愈發加速,但人均收入及儲蓄均不及同時期發達國家,難以支撐個人退休後的健康和養老消費水準,長壽時代的到來對中國社會和經濟的影響程度更大,重新規劃長壽時代個體全生命週期的安排,是社會、政府、企業都需要考慮的問題。中國的企業已經在積極探索長壽時代的解決方案,爲中國乃至全球面對長壽時代的挑戰和機遇提供了一種以企業實踐推動社會變革的可持續穩定發展方案。
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Extensive data indicates that the world is ageing rapidly, and that human society it is now entering an age of longevity. The population age structure will gradually arrive at a new steady state with five major characteristics: low mortality, low fertility, steadily increasing life expectancy, a population age structure tending to become pillar-shaped, and an elderly proportion of the population which exceeds one quarter of the total during the plateau period. With the onset of the age of longevity, survival with illness will become a common phenomenon. In order to ensure a higher level of quality for their longer lives, the personal expenditures in healthcare will rise sharply, and massive demand for healthcare will promote the development of the health industry as well as changes in the health industry』s structure. At the same time, the social savings structure and the forms by which individual wealth is accumulated in the age of longevity will change, and individuals will rely more on investment returns and the accumulation of wealth to meet their eldercare and healthcare needs. The age of longevity will inevitably also bring an era of health and an era of wealth. From a macro perspective, there are currently a range of views on the impact of the age of longevity on the macro-economy: some believe that the increase in the proportion of the elderly population will lead to a slowdown in economic growth, while some recent studies indicate that the age of longevity may not necessarily lead to a decline in the economic growth rate. In the age of longevity, socio-economic development will face challenges, such as the limited efficiency of social innovation and deepening wealth inequality, inter alia. Nonetheless, there are also opportunities, particularly for more vibrant longevity economies, which are better adapted to the socio-economic structure of the age of longevity. The value of the elderly will be re-recognised, positioned and discovered. Japan is currently one of the countries with the oldest population worldwide. In the age of longevity, Japan』s labour force, society and economy have undergone profound changes, a fact which has empirical implications for China as it deals with the impact of the age of longevity. It can be inferred from the Japanese experience that economic development can be effectively promoted by increasing human capital, accelerating technological guidance, promoting social equity, building effective capital markets, and ushering in a longevity economy to create a third demographic dividend, amongst others. The age of longevity has already arrived. Compared with other countries, China has a large population base, and population ageing is accelerating. However, its per capita income and savings are not as high as those of developed countries when they were at a similar stage of demographic transition, and it will face difficulties supporting the healthcare and eldercare consumption of individuals once they retire. The arrival of the age of longevity will have a greater impact on China』s society and economy, and re-planning the arrangements for the entire lifespan of an individual in the age of longevity is an issue which society, government and companies need to consider. Chinese companies are already actively exploring solutions to the age of longevity by leveraging corporate practice to drive social change in order to provide sustainable, stable development for China and the rest of the world in the face of the challenges and opportunities of the age of longevity.
本文系統性地闡述了長壽時代的特徵與形成,擴充並豐富了其內涵與外延,對相關的學術理論進行了詳實的研究,並從動態視角探討了長壽時代的挑戰和機遇,提出了對中國應對策略的建議,初步提出瞭解決方案的設想和具體商業實踐。在長壽時代的理論框架下,下一步需進一步擴充完善長壽時代相關的人口學、健康經濟學、長壽經濟等學術理論的研究,深入解析長壽經濟的需求結構和生產方式,延伸豐富長壽時代解決方案的實踐探索,重點探討在中國社會經濟發展的背景下如何前瞻性地根據長壽時代的理論推動社會產業結構的變化,引領商業企業的發展變革,解決長壽時代可能帶來的各種社會問題。
This article has provided a systematic explanation of the characteristics and causes of the age of longevity, expanding and elaborating its meaning and connotations. It also provides detailed research into the associated academic theories, and discusses the challenges and opportunities posed by the age of longevity from a dynamic view. It provides suggestions for China』s strategic response, and puts forward preliminary ideas for solutions and specific business practice. Within the theoretical framework of the age of longevity, the next step will be to further expand and enhance research into academic theories on the age of longevity, including demography, health economics and the longevity economy, inter alia, in-depth research of the demand structure and means of production of the longevity economy, as well as extend the practical exploration of solutions for the age of longevity, focusing on a discussion of ways to proactively drive change in social and industrial structures, direct the development and change of commercial enterprises, and solve the various social issues that the age of longevity may bring based on age of longevity theory within the context of China』s socio-economic development.
註釋
① 2014年International Health Economics Association(iHEA)曾以長壽時代的健康經濟(Health Economics In the Age of Longevity)爲主題舉辦世界健康經濟大會。
② 壽命損失年數(YLL)是帶病患者的死亡年齡與該年齡所對應的人口預期壽命之間的差值,殘疾生命年數(YLD)等於一種疾病/受傷的普遍性指數乘以此疾病的嚴重程度。一個單位DALY代表健康損失了1年。針對每種疾病/受傷可以計算一個人羣的DALY值,用來說明不同疾病所帶來的對於健康的損失。
③ 健康預期壽命(HALE)將傷殘權重應用於健康狀態,計算可以預期健康生存的年數,參見https://www.who.int/gho/mortality_burden_disease/life_tables/hale_text/en/
④ 數據來源UK health research analysis 2009/10報告,參見
http://www.ukcrc.org/research-coordination/health-research-analysis/uk-health-research-analysis/
⑤ 數據來源Kaiser Family Foundation analysis of Medical Expenditure Panel Survey,參見
https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#item-start
⑥ 《財經》2019年11月12日報導,格林斯潘(Alan Greenspan)表示,因爲人口老齡化,美國、英國等社會福利支出出現顯著成長,福利的支出擠佔了國內儲蓄總額的空間,進而擠出了國內投資總額,後者正是生產力成長的主要決定性因素。
⑦ 哈佛商學院案例參見Kirby, William C., Shu Lin, John P. McHugh, and Yuanzhuo Wang. "From Cradle to Heaven: Taikang Insurance Group Inc." Harvard Business School Case 320-088, February 2020. (Revised March 2020.)
Notes
⑧ In 2014, the International Health Economics Association (iHEA) held a World Health Economics Conference on the topic of Health Economics In the Age of Longevity.
⑨ Years of lost life (YLL) is the difference between the age of death of a sick patient and the population life expectancy corresponding to that age. Years lived with disability (YLD) equals the universality index of a disease/injury multiplied by the degree of severity of the disease. One DALY unit represents one year of loss of health. The DALY value for a population can be calculated for each disease/injury to illustrate the loss of health caused by different diseases.
⑩ Health life expectancy (HALE) applies a disability weighting to a healthy state, and calculates the number of years over which one can expect to remain healthy. See: https://www.who.int/gho/mortality_burden_disease/life_tables/hale_text/en/
⑪ Data source UK Health Research Analysis 2009/10, please see: http://www.ukcrc.org/research-coordination/health-research-analysis/uk-health-research-analysis/
Data source: Kaiser Family Foundation analysis of Medical Expenditure Panel Survey. See: https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#item-start
⑫ A Caijing report on 12 November 2019 quoted Alan Greenspan as saying that the significant rise in welfare expenditure driven by the ageing population in countries such as the US and UK meant that welfare expenditure was squeezing total domestic savings, and then total domestic investment, which is the decisive factor for the growth of productivity.
⑬ For the Harvard Business School School case, see: Kirby, William C., Shu Lin, John P. McHugh, and Yuanzhuo Wang. 「From Cradle to Heaven: Taikang Insurance Group Inc..」 Harvard Business School Case 320-088, February 2020. (Revised March 2020.)
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