五、结论
E. Conclusion
各类数据都在表明世界正在快速变老,人类社会正在进入长寿时代,人口年龄结构将逐步形成新均衡,低死亡率、低生育率、预期寿命稳步提升、人口年龄结构趋向柱状、平台期老龄人口占比超越1/4构成了这一时代的五大特征。伴随着长寿时代的到来,带病生存将成为普遍现象,为了使得漫长的长寿生涯可以更加有质量,个体投入在健康上的费用将剧增,庞大的健康需求将促进健康产业的发展和健康产业结构的变化;同时,长寿时代社会储蓄结构及个人财富积累形式将会发生变化,个人将更加依赖投资回报和财富积累来满足养老和健康的需求,长寿时代必将带来健康时代和财富时代。从宏观角度看,当前对于长寿时代对宏观经济的影响有不同的观点:有的认为老龄人口比例增加将导致经济增速放缓,也有最新的研究表明长寿时代未必会导致经济增速下行。长寿时代下社会经济的发展既面临挑战,如社会创新效率受限以及财富不平等程度加深等,又存在机遇,尤其是适应长寿时代社会经济结构的是更有活力的长寿经济,老年人的价值将被重新认识、定位和发掘。日本目前是全球人口老龄化最严重的国家之一,长寿时代下的日本劳动力、社会经济发生了深刻变化,对中国应对长寿时代的冲击具有经验启示。从日本经验可以推知通过提高人力资本、加快技术引导、促进社会公平、建设有效的资本市场、引入长寿经济创造第三次人口红利等可以有效促进经济发展。长寿时代已经来临,相比其他国家,中国人口基数大、老龄人口增长进程愈发加速,但人均收入及储蓄均不及同时期发达国家,难以支撑个人退休后的健康和养老消费水平,长寿时代的到来对中国社会和经济的影响程度更大,重新规划长寿时代个体全生命周期的安排,是社会、政府、企业都需要考虑的问题。中国的企业已经在积极探索长寿时代的解决方案,为中国乃至全球面对长寿时代的挑战和机遇提供了一种以企业实践推动社会变革的可持续稳定发展方案。
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.
本文系统性地阐述了长寿时代的特征与形成,扩充并丰富了其内涵与外延,对相关的学术理论进行了详实的研究,并从动态视角探讨了长寿时代的挑战和机遇,提出了对中国应对策略的建议,初步提出了解决方案的设想和具体商业实践。在长寿时代的理论框架下,下一步需进一步扩充完善长寿时代相关的人口学、健康经济学、长寿经济等学术理论的研究,深入解析长寿经济的需求结构和生产方式,延伸丰富长寿时代解决方案的实践探索,重点探讨在中国社会经济发展的背景下如何前瞻性地根据长寿时代的理论推动社会产业结构的变化,引领商业企业的发展变革,解决长寿时代可能带来的各种社会问题。
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.
注释
① 2014年International Health Economics Association(iHEA)曾以长寿时代的健康经济(Health Economics In the Age of Longevity)为主题举办世界健康经济大会。
② 寿命损失年数(YLL)是带病患者的死亡年龄与该年龄所对应的人口预期寿命之间的差值,残疾生命年数(YLD)等于一种疾病/受伤的普遍性指数乘以此疾病的严重程度。一个单位DALY代表健康损失了1年。针对每种疾病/受伤可以计算一个人群的DALY值,用来说明不同疾病所带来的对于健康的损失。
③ 健康预期寿命(HALE)将伤残权重应用于健康状态,计算可以预期健康生存的年数,参见https://www.who.int/gho/mortality_burden_disease/life_tables/hale_text/en/
④ 数据来源UK health research analysis 2009/10报告,参见
http://www.ukcrc.org/research-coordination/health-research-analysis/uk-health-research-analysis/
⑤ 数据来源Kaiser Family Foundation analysis of Medical Expenditure Panel Survey,参见
https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#item-start
⑥ 《财经》2019年11月12日报道,格林斯潘(Alan Greenspan)表示,因为人口老龄化,美国、英国等社会福利支出出现显著增长,福利的支出挤占了国内储蓄总额的空间,进而挤出了国内投资总额,后者正是生产力增长的主要决定性因素。
⑦ 哈佛商学院案例参见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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