中国人应该从日本的老龄化危机中看到什么？
What Should the Chinese Learn from Japan’s Aging Crisis?
Long-Term Care Insurance System
Chinese state media frequently reports on Japan’s pension crisis and aging population, yet it remains silent on the impending aging crisis in China.
Japan is known for its aging population, but it has also become a global leader in elderly care. It was the first country in Asia to implement a "long-term care insurance system," following Germany and the Netherlands.
To address the challenges of an aging society, Japan introduced the 10-Year Strategy for Promoting Health and Welfare for the Elderly in 1989, commonly known as the Golden Decade Plan. The goal was to establish a structured long-term care system at the municipal level (equivalent to townships in China).
As aging accelerates, Japan’s elderly care costs have risen significantly. In 2000, they accounted for just 0.7% of GDP, but by 2024, this figure had surpassed 9%—a tenfold increase in 25 years.
Another approach Japan has taken is creating and maintaining jobs suitable for elderly workers. Many elderly Japanese continue working, with some remaining employed even into their 80s.
According to Japan’s Ministry of Internal Affairs and Communications, in 2022, the number of employed individuals aged 65 and above reached 9.12 million, marking 19 consecutive years of growth. Elderly workers accounted for 13.6% of the total workforce—one in every seven employees was over 65.
The ability of some elderly individuals to work has significantly reduced Japan’s effective elderly dependency ratio, easing the financial burden on the government and younger workers.
The elderly dependency ratio refers to the proportion of elderly individuals relative to the working-age population, indicating how many elderly people each 100 working-age individuals must support.
Currently, Japan’s elderly dependency ratio is 50%, the highest in the world.
However, despite these efforts, poverty among Japanese seniors remains a serious issue. As of 2024, 18.4% of elderly men and 24.8% of elderly women lived in poverty. For those living alone, the rates soared to 38.3% for men and 52.3% for women. This data comes from the book Elderly Drifting Society, translated by Gao Huabin in 2024, based on an NHK documentary.
Gao Huabin noted that while revising the translation, both he and his wife were deeply moved by the content, even to the point of tears.
Japan is a wealthy capitalist nation that "aged after becoming rich," yet it still suffers from severe aging-related issues.
China’s Looming Aging Crisis
If the average lifespan of Chinese seniors reaches or exceeds 80 years, China’s elderly dependency ratio could surpass 90% by the mid-2040s—an unsustainable level for Chinese society. Unless society chooses to "abandon care," some elderly individuals may be left to fend for themselves.
A major challenge in China is the inability to create sufficient jobs for elderly workers, making delayed retirement ineffective. Structural labor surplus is severe, youth unemployment is high, and job opportunities for older individuals are scarce. Many workers over 45 already struggle to find jobs, making it even harder for retirees to re-enter the workforce. With insufficient pensions and rising medical expenses, many elderly individuals will be left to manage on their own.
Another significant challenge is the government’s lack of preparedness. Since 2021, the long-term care insurance system (LTCI) has been mentioned in government work reports for five consecutive years, yet implementation has been slow. Where has the funding gone? Into infrastructure projects, Made in China 2025, Chinese-style modernization, and new productive forces—all in pursuit of the Chinese Dream.
However, establishing a long-term care insurance system requires initial government investment to build and improve the elderly care system—not just collecting insurance premiums.
The Future of Elderly Care in China
The World Health Organization (WHO) estimates that by 2040, China will have 402 million elderly people. Due to high work stress, environmental pollution, food and water safety issues, and unhealthy lifestyles—including the world’s largest smoking population (300 million smokers) and widespread alcohol consumption among men—health conditions among Chinese seniors are concerning.
As of 2019, 75% of Chinese people over 60 suffered from non-communicable diseases such as cardiovascular disease, diabetes, hypertension, and Alzheimer’s. Medical care costs are expected to rise sharply.
The Blue Book of China’s Elderly Care Services (2012–2021) predicts that by 2025, the number of elderly individuals with disabilities or partial disabilities will reach 72.79 million, growing to 100 million by 2030.
During the 2025 National People’s Congress, Huaxia Times published an article titled:"In Five Years, China’s Disabled and Partially Disabled Population Will Reach 100 Million—Who Will Care for Them? The Government Work Report Mentions LTCI Again..."
Additionally, a People’s Daily article from July 2013 stated that one in 13 Chinese people suffered from mental illness. Now in 2025, has the situation improved or worsened?
By 2030, nearly 10% of China’s population could be disabled, while another 10% could suffer from mental illnesses—an alarming scenario.
The Financial and Social Crisis
With the collapse of land finance (revenue from land sales), slowing economic growth, and declining tax revenue, local governments are struggling to maintain basic operations. Expanding social care systems and improving public services are nearly impossible—fiscal constraints won’t allow it, time is running out, and aging is happening too fast.
2040: A Turning Point
I have long viewed 2040 as a crucial historical turning point for China.
By the 2040s, China’s aging crisis will shift from quantitative to qualitative change, leading to potentially catastrophic consequences. If not handled properly, it could trigger a large-scale humanitarian disaster.