Health, Retirement and Long Term Care in China and Singapore

This seminar features two scholars discussing their research on health, retirement, and long-term care in China and Singapore. First Dr. Zhou discusses her co-authored study “Health Care Utilization at Retirement: Evidence from Urban China,” which explores the causal effect of retirement on health care utilization among urban workers using medical claims data and employing a regression discontinuity design based on mandatory retirement ages. The results show that retirement significantly increases outpatient care utilization, in part because of lower patient cost sharing and reduced opportunity cost of time after retirement.

Professor Chia will then discuss innovative policy responses in Singapore to finance the retirement and healthcare needs of its aging population. One component of her research uses actuarial modelling and simulations to explore the adequacy of the long-term care (LTC) insurance program in Singapore, also known as ElderShield, for reducing LTC cost. Dr. Chia will also discuss retirement adequacy, taking into consideration the unique housing finance mechanisms in Singapore and other social measures. Singapore also introduced healthcare policies targeted at specific cohorts and trust funds to enhance social protection.  The Pioneer Generation Fund of S$8 billion was earmarked to subsidize healthcare costs for the pioneer generation (cohorts aged 65 and above in 2014).  Simulation studies show that the adequacy of the pioneer generation fund depends on healthcare cost inflation and market performance of funds.  Most recently, a trust fund of S$6.1bn will be set up to prefund healthcare subsidies for the Merdeka Generation (those born in the 1950s).  Besides, a total of S$5.1 billion will go to a new LTC Support Fund that will help fund subsidies for long term care support measures.  This measure will improve the adequacy of the LTC Insurance.   Financing healthcare needs by setting aside funds, while innovative, is sustainable.  However, pre-funding social protection for subsequent cohorts can be challenging amidst an ageing populace and economic challenges.

Dr Ngee-Choon Chia is an Associate Professor in the Department of Economics at the National University of Singapore (NUS).  She is concurrently Director of the Singapore Centre of Applied and Policy Research (SCAPE) and Co-director of the Next Age Institute at NUS.  She is the Co-editor of the Singapore Economic Review. Her research interests include pension economics, health economics and the fiscal impacts of ageing.  She has consulted for major international agencies such ADB, ADBI, IDRC and the World Bank.  She has also conducted collaborative research on social security with government agencies in Singapore.

 

Dr. Qin Zhou is currently a visiting scholar in Stanford University. She serves as an Associate Professor in the University of International Business and Economics in Peking, China. Her research interests include Health Economics, Public Health, and Applied Econometrics. She is mainly focused on the study of Chinese health insurance and policy evaluation. She was awarded the "Australia-APEC Women in Research" fellowship and conducted a project entitled "Social Security Systems in Relation to Healthcare Utilization and Health Behaviors in Australia" in 2017. Her work at Stanford is to collaborate with Prof. Karen Eggleston to study the integration of urban-rural health insurance systems in China and other relative topics.