Tuesday, February 26, 2013

Busting three myths of growing old

ALMOST everyone has a point or more to make on the Population White Paper and that "6.9 million" figure.

Pessimists fret about the replacement rate and conjure up "doom and gloom" - to the extent of the country going bankrupt - as the population ages and, say, the cost of care goes up.
Meanwhile, many of my patients tell me they don't want to grow old. My reply? Growing old is not a disease.
Ageing is inevitable. The young of today will be the old of tomorrow. The only "cure" for growing older is to die young.
But what my patients are really telling me is that they don't want to grow old disabled, in pain, lonely and poor. But growing old disabled, in pain, lonely and poor is not inevitable - if steps are taken, and taken early, to tackle these urgent issues.
I can think of at least three myths that need to be vigorously addressed.
Cost of care
GRANTED, these costs - health care, long-term care, cost of living - are a real concern. Who pays? Individuals, families, insurance companies, the Government?
Let's look at health-care costs and insurance.
Much has been discussed recently about increasing premiums to match increased demand, capping payouts and excluding pre-existing diseases. However, these are not the only solutions.
Elsewhere, many governments and insurance companies - like Kaiser Permanente (USA) - actively "incentivise" policyholders to stay fit and healthy by joining healthy ageing/wellness programmes, often at affordable fees.
They invest, put aside some of the premiums into promoting health for policyholders.
This is not a common practice here and perhaps there is more we can do to bring such best practices to Singapore. Hence, rising insurance premiums can be moderated, and even if you have chronic disease, you can still be insurable. It is win-win-win for all.
Ageing = Unproductive?
AN AGEING population can be economically productive.
The myth is that an ageing workforce is not productive. But not everyone is a construction worker. Hard science has proven repeatedly that age can be a blessing for "thinking" jobs.
Experience is important. Even if one - whether young or old - has a chronic disease, technology, training and addressing the health issues that affect productivity can come into play, positively.
German carmaker BMW was facing an ageing factory workforce, many with chronic disease, at its home plant. Rather than sack the older workers, it invested in them and redesigned the workplace; everything from special aids for those with arthritis, to better health care and using technology to help them.
To its surprise, productivity was higher, errors low, and even better than at its other plants with a younger average age workforce. The additional cost of such changes was minimal.
BMW has now adopted the changes in all its plants worldwide. The issue is no longer a solution for an ageing workforce, but having a holistic plan to promote productivity for all ages.
The solution is therefore to push hard for greater productivity, encourage more value-added industries that require fewer people but generate more economic value. And train our people, young and old, for those industries. With greater productivity comes higher pay for workers.
How seniors can help boost fertility rate
YES, it is a fact that older people can't have babies. But older people are part of a family and families have babies.
Perhaps if we focus on ways to help the extended family - grandpa, grandma, the often stressed young "sandwiched" generation - the young will have more babies and there will be fewer abortions.
Grandparents, even if they are no longer working, can contribute economically by playing a crucial role in child care and teaching important family values. They will thus be contributing positively to the fertility rate.
An ageing population need not be all doom and gloom. Immigration is but one of many solutions, and partnership among the various stakeholders is key.
The Government cannot do it alone. Neither can seniors, families or doctors. The devil is also in the details of execution even if the policy is sound. It must make a difference to the person, the family, the businessman, the community.
The right win-win-win solutions will have to be found - to strengthen and build the core, our people. But let us also welcome others who share the vision of building our society, our community, our country together.
The writer is a geriatrician at Raffles Hospital and has headed geriatric medicine units in Changi and Singapore General Hospitals.