Ageing in East Asia: Challenges and Policies for the Twenty-first Century (review)

East Asia has neither distinct geographical nor cultural identity, only shared experiences in economic development with distinct social policy regimes (p. xiv). They are all rapidly ageing societies from extremes in Japan and China (versus slower-paced Europe in different economic and technological eras) to Malaysia and Thailand in-between. Except Japan, all are developing their social services in immature pension and limited public long-term care systems. The most dramatic changes occurred in South Korea and Taiwan, with China’s one-child policy as the most massive-scale transformation.

All ten chapters take a broad view to distinguish evidence, trends and issues, not yet tantamount to any ageing crisis. All country chapters start with their current systems before the changes and challenges to reform pension and social care. Pervasive emphasis on economism in the East Asian development model contrasts with more Western state welfare states. Asian family support to prevent old-age poverty is challenged by lower mortality (more elderly) and fertility rates (less young cohorts). What seems remiss or missing from the volume is the impact of migration which takes away working-age adults, but are substituted by remittances sent by migrant workers. Such globalization-induced mobility and impact on care-giving and demographic patterns as females work abroad too may be less significant on ageing in East Asia, but certainly not Southeast Asia.

Chapter 1 rationalizes omitting Indonesia as an underdeveloped country versus other two-generation-old newly-industrializing countries/economies (p. 1). Instead of Western welfare capitalism, East Asian state welfare and government expenditure as residuals are, however, converging on long-term care insurance (LTCI) as in Japan since 2000, Taiwan’s National Health Insurance, 1994 and Korea’s national pension system, 1998 and National Pension Insurance, 2008. All suffer defamilization or less family-dependent support. None escape the population and demographic trends, varying more in timing and possible solutions from technology in both technical and financial innovations to meet the greying challenge.

Ageing seems the most critical problem, more than terrorism or economic globalization, probably overstated, but not exaggerated (p. 3, Table 1.1, p. 4 for statistics covering East Asia). This is not the first volume on ageing, but is an update (p. 10). The West took seven and a half decades for those aged sixty and above to double from 7 per cent to 14 per cent in total population versus less than thirty years for Japan, China, Singapore, Taiwan and Thailand. Democratization, however defined, as more political participation, the tripartitism of state, employers and individuals (including family) or the World Bank’s three-pillar formulation remains as varied in policy-intensity and execution. All are faced with prospects of lower economic growth with the global recession.

Chapter 2 on East Asian welfarism is nothing new, except some sectoral similarities and differences given for health, education, housing and social security. It reviews three support systems: the primacy of both Confucianism and economic development and residual or reluctant state to combine the welfare market, community, family, voluntary or non-governmental organization (NGOs) with government. Added to these are the regulatory framework, roles of culture, productivistic nature, political democratization and institutional accommodation, with various maturization of actors and systems. In rethinking via the East Asian framework, there is no conclusive answer on whose responsibility it is to finesse sustainable ageing. Like the East Asian miracle, any glowing exemplary paradigm is susceptible to falter over time.

China’s one-child policy in Chapter 3 is as shaped by the above factors as it is also triggered by its defining characteristic of growing old before growing rich (p. 10). Needing an equally radical solution, China falls victim to its very success of its one-child policy just as the rest of Asia falls victim to economism, commodification and urbanization without the human face of social welfare which Asian policy-makers criticized as Western, unsustainable, and based on pay-as...