HKU Bulletin November 2009 (Vol. 11 No .1)

Cover Story 8 The University of Hong Kong Bulletin 9 November 2009 “Half of Hong Kong’s hospital users today are elderly people and the daily cost of a hospital patient is $3,200. Why can’t there be a scheme worked out with the Mainland authorities, with a hospital there that’s reliable, where the Hong Kong government pays, say, $1,000 for a person’s medical coverage in China? It would be a win-win situation. I think it’s important for both governments to facilitate social integration, not only economic integration.” Retire to China? Encouraging the elderly to move to China, where the cost of living is cheaper, could help to give them a better living standard and reduce the cost of an ageing population, but this proposal has thus far fallen on deaf ears. Older Hong Kong people do not want to move over the border. According to Professor Joe Leung Cho-bun of the Department of Social Work and Social Administration, who is also Acting Director of the Sau Po Centre on Ageing and who has done a study on portable benefits for the government, only a few thousand elderly people have taken up a Hong Kong government offer to live in Guangdong and Fujian and collect their social assistance payment there. An attempt by the Jockey Club to set up homes for the elderly over the border also received scant interest. “The main reason is medical. The medical care system in Hong Kong is reliable but in China, on the one hand they don’t have medical insurance and on the other hand they may find medical care is not affordable and they may be uncertain how much they will be charged,” he says. Some 12 per cent of Hong Kong’s over-60s live alone – equivalent to nearly 100,000 people. This doesn’t chime with the traditional Chinese expectation that children will look after their parents. “There’s often this impression that elderly people are supported by their families and live with their children. That’s a myth. Of course it looks like that if you compare it to the US and Europe where only two to three per cent of elderly parents live with their children. In Hong Kong it’s about half, but co-residence is dropping off,” says Professor Nelson Chow. That leaves society picking up the slack by offering residential care and services in the community. This is by no means a perfect solution and scholars at the University are trying to help out by identifying improvements and establishing service models. One concern is the limited number of spaces in nursing homes, particularly in government-subsidized homes that provide appropriate supervision for residents with chronic health conditions such as dementia. Professor Joe Leung conducts multidisciplinary research into ageing, has helped to draw up assessment tools for the government that identify the people most in need. economic immigrants could help There are wider economic arguments in favour of encouraging people to move on. A report* by Professor Richard Wong Yue-chim and Dr Wong Ka-fu of the School of Economics and Finance shows Hong Kong is unlike other economically vibrant cities because its population distribution is becoming unstable. Elsewhere, older workers tend to leave the city when they retire (for example, moving from New York City to Florida), making room for younger, economically active people to come in and seek their fortune and keeping the numbers in balance. Not only are Hong Kong elderly not moving on, but immigration to Hong Kong has become largely driven by family reunion, rather than economic motivation, as Mainland wives and children join their Hong Kong husbands and fathers. These immigrants are less educated and not able to meet the demand for skilled workers that will help the economy to grow. Professor Wong and Dr Wong suggest changes in immigration policy could help to ease the financial burden of an ageing society and buoy up the economy. The border could be made more porous to economic migrants who could fill shortages for skilled workers, while Hong Kong’s tertiary education sector could be opened wider to attract more top students from the Mainland in the expectation that some of them will stay on. “[Fast-growing Chinese] cities are attracting educated workers not only from the rest of China, but from Hong Kong as well. If their business and working environments continue to improve with China’s liberalization, and if Hong Kong keeps to its usual course in the policies centring on immigration, education and public spending, it is not difficult to predict what lies ahead,” they say. The growing number of elderly, and the failure to attract young workers, would cause hardship not only for those trying to fend for themselves in old age, but for the economy as a whole. * ‘The Importance of Migration Flow to Hong Kong’s Future’ by Professor Richard Wong and Dr Wong Ka-fu appeared in Hong Kong Mobile: Making a Global Population, edited by Helen F. Siu and Agnes S. Ku and published by Hong Kong University Press in 2008. QUALITY OF LIFE matters Hong Kong people have the second longest life spans in the world after Japan, but those extra years may not be such a blessing if they are characterized by loneliness, a lack of support and poor preparation for the inevitable end. Older Hong Kong people do not want to move over the border... The main reason is medical.