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As the global population ages, the exploration of cross-border elderly care models in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) is of increasing significance. Here, three jurisdictions collaborate to build an interconnected elderly care ecosystem.
In brief
- Overview of policymaking in elderly care in the GBA, addressing the current status, challenges and opportunities.
- Collaborative progress in areas of elderly care facilities, health care security measures, elderly care financing and innovative elderly care services.
- Strategic recommendations to seize the opportunities of cross-border elderly care.
Within the GBA’s one-hour living circle, the concept of cross-border elderly care has been steadily developing in recent years. Amidst the rise of the silver economy, how can enterprises seize the business opportunities arising from cross-border elderly care and expand into this blue ocean?
1. Overview of elderly care policies in GBA cities
The table below shows the population and dependency ratios of individuals aged 65 and above in various GBA cities from 2010 to 2020. There has been a noticeable increase in population aging over the decade, particularly in Hong Kong and Macau, indicating a growing need for local health and elderly care services.
|
Cities |
Ratio of population 65+ years |
Dependency ratio |
Ratio of population 65+ years |
Dependency ratio |
|---|---|---|---|---|
|
Hong Kong |
13% |
18% |
19% |
27% |
|
Macau |
7% |
9% |
12% |
16% |
|
Guangzhou |
7% |
8% |
8% |
10% |
|
Shenzhen |
2% |
2% |
3% |
4% |
|
Dongguan |
2% |
3% |
4% |
4% |
|
Foshan |
5% |
6% |
7% |
9% |
|
Huizhou |
6% |
8% |
7% |
9% |
|
Jiangmen |
9% |
12% |
13% |
18% |
|
Zhongshan |
4% |
5% |
6% |
8% |
|
Zhaoqing |
9% |
13% |
12% |
18% |
|
Zhuhai |
5% |
6% |
7% |
9% |
With Hong Kong’s commitment to developing the silver economy and establishment of the Working Group on Promoting Silver Economy, we anticipate that the collaborative efforts among the 11 GBA cities will lead to more opportunities.
The unique elderly care services in each city reflect their distinct economic backgrounds. Hong Kong and Macau prioritize social security measures, offering economic assistance and provident funds to ensure financial security for seniors and safeguard economic and social well-being. On the other hand, Guangdong Province’s elderly care system is centered around the principle of “rooted in home-living, with social assistance and institutions for support,” emphasizing the importance of family and community as primary care units. The focus here is on strengthening of family-based elderly care, promoting a community-centric approach to elderly well-being.
- Retirement provident fund
- Social security and subsidies
- Health care policy
- Elderly care policy
Hong Kong SAR
- Mandatory Provident Fund
The fund involves contributions from both the employer and the employee, which can be accessed upon retirement (usually at 65 years old) or under specific special circumstances.
Macao SAR
- The Non-Mandatory Central Provident Fund
This fund facilitates contributions by both the government and individuals, enabling residents to accumulate savings for their retirement.
Guangdong Province
- Basic Elderly Insurance System
This system consists of the Pension Administrator and individual pension accounts. It requires contributions from both participating units and individuals from a portion of their total salary. This system helps residents in accumulating retirement savings.
- Individual Pension System
This system operated through an individual account system where participants make all contributions for comprehensive accumulation. In the Chinese mainland, a basic three-pillar insurance infrastructure has been established, with a basis on pension insurance supplemented by enterprises making annuity (occupational) contributions, individual savings pensions and commercial pension insurances.
Hong Kong SAR
- Comprehensive Social Security Assistance
Provides economic assistance to individuals and families in need, including seniors.
- Social Security allowances
Including the Old Age Living Allowance, Normal Disability Allowance and Higher Disability Allowance.
Macao SAR
- Social Security Fund
This fund offers welfare assistance programs including old-age pension, disability pension and unemployment allowance, among others.
- Old-age Pension
This scheme provides a pension to individuals who have contributed to the social security system for a minimum of 60 months and meet the residency requirement.
Guangdong Province
- Sickness and disability subsidies system
In cases where an individual loses all work abilities due to sickness or non-work-related causes before the statutory retirement age, they can apply for Sickness and Disability Subsidies, to be paid out on a monthly basis.
- Old age subsidies system
Financial subsidies are provided to individuals aged 80 or above who are facing financial difficulties.
Hong Kong SAR
- Public health care system
The public health care system in Hong Kong SAR is heavily subsidized, ensuring that individuals will not be denied health care services due to financial constraints. These services are administered by the Department of Health and the Hospital Authority.
- The Elderly Health Care Voucher Scheme
This scheme provides health care vouchers to seniors annually, to be used for basic health care services provided by private health care providers.
Macao SAR
- Public health care system
This system is subsidized through taxation and provides free basic health care services to residents through public hospitals and health centers.
Guangdong Province
- Health care securities system
This system includes lateral coverage by the two main health care systems, Basic Healthcare Insurance for Workers in Urban Areas and Basic Healthcare for Residents of Rural Areas. It is complemented by the six health care system policies providing extensive coverage, such as medical assistance, supplementary health insurance, major illness insurance, long-term care insurance, health care insurance for the underprivileged, addressing various health care needs across society.
Hong Kong SAR
- Community and residential care services
This includes facilities such as the District Elderly Community Centres, Neighbourhood Elderly Centres, Day Care Centres/Units for the Elderly and various categories of residential care services. These services aim to provide community support to elderly individuals.
Macao SAR
- Community support and residential care facilities
These facilities provide elderly care services and support such as elderly care homes, daycare services, home care services and general elderly support. The focus is on continuously addressing the daily needs and well-being of the elderly population.
Guangdong Province
- Basic Elderly Care Services List system
This system has implemented the Elderly Ability General Assessment System, offering categorized services tailored to various elderly groups. Based on the financial capacities of different regions, a list of basic elderly care services has been rolled out, catering to health requirements, loss of abilities and financial difficulties among elderly individuals. This includes services like elderly care security, daily living assistance, rehabilitative care and social assistance.
Guangdong, Hong Kong and Macau are leveraging each other’s strengths and pushing for integration. In this respect, health care system, elderly care finance and innovative care services are key areas for this exploration.
2. Current status and synergistic development of elderly care in the GBA
Platform for resource sharing
The Hong Kong and Macao Medicine and Equipment Connect policy enables designated health care providers in the Chinese mainland to use medicine and medical equipment from Hong Kong and Macau in urgent situations. This initiative establishes a platform of cross-border resource sharing, integrating health care systems. The policy now covers all the nine Mainland cities in the GBA. Hong Kong has collaborated with Shenzhen to establish numerous cross-border elderly care communities. Through partnerships with residential care organizations under the Guangdong Residential Care Services Program, elderly individuals in Hong Kong can access high-quality and affordable services. In addition, Guangdong, Hong Kong and Macau are enhancing health care collaboration, fostering exchange and promoting mutual recognition of health care practitioners to facilitate cross-border medical services.
Development of elderly care finance
Elderly care finance is highlighted as a crucial aspect among the five key finance areas emphasized by the national authority. The GBA is actively developing the silver economy through consistent policy formation, marketization and technological innovations. By backing pertinent financial developments, the elderly care sector is strengthened, positioning the GBA closer to its goal of becoming the national financial hub for elderly care services.
Innovations in co-administration
Ensuring the security of health care data transfer and sharing across regions is vital for cross-border elderly care initiatives. Technological innovations will be instrumental in overcoming these challenges. Methods such as facilitating virtual reality (VR) and augmented reality (AR) to enable remote health care services and establishing secure digital data flow through robust big data platforms will be key in fostering trustworthy and seamless collaboration.
3. Challenges and recommendations
Policy and legal frameworks
Diverse policies and legal frameworks across the GBA cities, including variations in cross-border data flow regulations, innovations in elderly care finance and compliance issues, pose considerable challenges for the future of elderly care services.
Individual pension system in need of further improvements
The third pillar of the pension system remains underdeveloped, with a lack of comprehensive promotion of individual pension plans. Public awareness regarding the importance for elderly care planning is lacking. Existing financial products in this sector tend to be complex and offer low rates of return, which has resulted in diminished market interest.
Supply-demand gap
The demand for elderly care services has transcended the traditional service model. New expectations encompass multidimensional care services, addressing daily life needs, health care facilitation, cultural and entertainment activities and spiritual needs. Currently, the elderly care services market is encountering a significant gap between a rapidly rising demand and limited supply.
Resource allocation disparities
Each of the GBA cities has its own developmental priority and progress at varying speeds in developing foundational facilities and advancing the elderly care services industry. Consequently, this non-uniform distribution of elderly care resources has resulted in ineffective coordination and synchronization in delivering cross-border elderly care services.
4. Suggestions for future development
Multilevel safety net
Enhancing the synergy between policies and elderly care systems, as well as providing essential support for elderly care and health care, is crucial to facilitate the exchange of economic and medical resources. Offering tax relief on elderly care financial products can attract investment capital from Hong Kong and Macau, as well as funds from the insurance industry in the Chinese mainland. This strategy will incentivize financial institutions to develop innovative financial products that cater to the financing needs of cross-border elderly care services.
Resource integration
It is essential to promote the development of diverse elderly care facilities within the GBA that offer multilevel and personalized services tailored to varying elderly needs. Addressing the significant disparities in elderly care systems and demands across Guangdong, Hong Kong and Macau, regional elderly care services platforms can be established. These platforms will integrate geographical characteristics, environmental advantages and health care provisions discrepancies. By leveraging the unique strengths of Guangdong, Hong Kong and Macau, these initiatives can be aligned to generate mutual benefits for all involved parties.
Technology and legal support
New technologies enabling smart elderly care and remote health care should be widely accessible for practical implementation, incorporating intelligent features. In terms of elderly care finance, technological innovations such as blockchain and digital currency serve as drivers for the progress of elderly care finance.
Diverse service models
Creating a range of cross-border elderly care services encompassing various programs in health care, elderly care, tourism and culture is essential. Enterprises in the elder care sector should initiate thorough market research to grasp the requirements and preferences of the elderly population. By promoting practical products and services that improve the quality of life for the elderly, incorporating features that offer convenience and spiritual fulfilment, these initiatives can better meet the evolving needs of this demographic.
Synergistic development
The 11 GBA cities should draw upon their respective strengths and collaborate to foster synergistic development in the elderly care industry, working together with a comprehensive and holistic vision.
Summary
Significant prospects are present for cross-border elderly care in the GBA. The development of the silver economy will bring economic opportunities and, similarly, challenges. As Guangdong, Hong Kong and Macau harness their efforts, support will be given to policy-level coordination, facilities constructions, the raising of service quality, technological application and cultural adaptation. Cross-border elderly care in the GBA shall serve as the exemplary for the nation in the future.
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