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The Aging Readiness & Competitiveness Report

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    Canada
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    United States
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    Mexico
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    Brazil
  • United Kingdom
    United Kingdom
  • Germany
    Germany
  • Turkey
    Turkey
  • Israel
    Israel
  • South Africa
    South Africa
  • China
    China
  • Korea
    Korea
  • Japan
    Japan
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Canada

Healthcare & Wellness

Canada is a global leader in longevity, although it has a larger gap between lifespan and healthspan than its peers. In light of the rising healthcare demand from an aging population and limitations on the healthcare system, both the federal and provincial governments have focused on supporting home-based care and increasing support for informal caregivers. Meanwhile, efforts are underway to improve the hospital environment so that it is friendly for older adults.

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United States

Healthcare & Wellness

While older Americans’ lifespans have improved over the past decade, they remain below the average for high-income countries. A range of factors are contributing to America’s relatively poor and deteriorating health outcomes, including education, income, job security, food insecurity, and the social safety net. Given the high cost and growing healthcare demand, there remains an acute need for improved healthcare coverage. While federal health insurance programs for older adults do exist, they only cover a portion of costs. Demand for healthcare and long-term-care services has been increasing and is expected to rise rapidly in the coming decades. Medicaid is the only program that provides financial support for long-term care, and future funding is tenuous.

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Mexico

Healthcare & Wellness

Mexico’s older population has a life expectancy and a healthspan that are above both the global and regional averages. However, unlike most OECD countries, they have actually fallen in recent years due to high levels of obesity and conditions stemming from poor diets and lack of access to quality nutrition resources. This has led to an increasing need for long -term care among the growing population of older adults, but the financial burden of care is higher than anywhere else in the OECD. The country has no formal system to provide long-term care and does not provide support for informal family caregivers.

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Brazil

Healthcare & Wellness

Although below the regional average, the longevity and healthy life expectancy of Brazilians have increased significantly over the past decade, partly thanks to the improvements in the country’s healthcare system. By introducing a dual healthcare system in 1988, Brazil guaranteed the right to free healthcare for all citizens through the Unified Health System (SUS) and allowed for the parallel existence of a private healthcare system. However, major gaps exist when it comes to older citizens in both medical and long-term care. To address this, the government is working to address the needs of older patients while also improving the broader Brazilian healthcare system.

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United Kingdom

Healthcare & Wellness

Technology also holds promise to help address one of the UK’s greatest challenges: the increase in healthcare and long-term care demand alongside declining budget allocations and increased austerity. These dynamics are putting pressure on older adults and informal caregivers. In response, the government is increasing funding transfers and allowing for local tax hikes to help fill the growing gaps in funding for local governments. Recognizing that much more will be needed, in 2016, the British government launched a major technology initiative aimed at leveraging technology to help cut costs and balance budgets in the face of an aging population. Related initiatives are just getting off the ground but hold promise for public-private collaborations between the National Health Service (NHS) and industry to develop and deploy technologies that will help reduce costs and enable older adults to age in place longer and more comfortably.

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Germany

Healthcare & Wellness

The super-aged population in Germany has a high healthy life expectancy, with three-quarters of those age 65 and older reporting that they still feel fit. However, the prevalence of chronic conditions and psychological conditions like dementia is growing and driving demand for long-term care (LTC) to increase substantially. Germany is an early mover in requiring LTC insurance and is also working to strengthen home-based care and to widen the scope of beneficiaries, with particular emphasis on the population with dementia. Policies have also endeavored to improve the quality and affordability of care. The government is also focused on ensuring that older adults in underserviced rural areas have access to the same quality of care as in urban areas, leveraging e-health technology.

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Turkey

Healthcare & Wellness

Both the lifespan and healthspan of older adults in Turkey have improved significantly over the past decade, thanks in part to the country’s impressive reforms to its healthcare system, achieving universal healthcare insurance coverage while reducing private health expenditure. The government is also paying greater attention to quality of medical care, evidenced by its recent moves to tighten regulation of prescription drugs and to curb overuse of medicines. In the face of rising care needs of the aging population, the Turkish government has prioritized family-centered care, providing support primarily through financial subsidies. However, there are significant gaps in meeting the needs of the middle-class aging population.

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Israel

Healthcare & Wellness

Both life expectancy and healthy life expectancy in Israel are among the highest in the world and continue to extend. As in most other countries, however, the increase in “healthspan” tends to lag behind “lifespan.” In response, the government has focused on supporting home and community care services. As in many countries, Israel’s LTC system is highly fragmented in terms of care providers, regulation, and financial responsibilities, resulting in service gaps, duplication, inefficient incentives, and inadequate investment in prevention and rehabilitation. However, reform has been put on hold, partly due to budgetary concerns.

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South Africa

Healthcare & Wellness

Life expectancy and healthy life expectancy for older adults have both improved in the last decade in South Africa, although they are still lower than both the regional and global averages. The government has made reforming the healthcare system its primary focus in order to provide the entire population with better-quality healthcare, but there are still very limited resources available for long-term care (LTC). In order to make up for this, some NGOs have begun to provide health and LTC services for older people in the provinces and municipalities in which they operate, as well as transportation services so that they have easier access to medical facilities.

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China

Healthcare & Wellness

Improving healthcare and wellness of older adults is another priority on China’s aging policy agenda. Broadly, China has been undertaking a major reform of its healthcare system, including expanding the coverage of universal basic health insurance, increasing the function of primary care, and intensifying the focus on healthy lifestyle promotion across the society. Through the reform, the government is seeking to boost the health of the general population and to contribute to improved health in older adults for in the future.

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Korea

Healthcare & Wellness

Life expectancy of Korean older adults has increased significantly but has outpaced improvements in health. In an attempt to address this gap and improve the health of the older population, the government has adopted proactive, preventive approaches, including subsidizing regular checkups and promoting healthy lifestyles. More recently, the government has strived to supportlife quality and wellness of older adults by building a long-term-care benefit system, with a latest reform in 2016 aimed at improving the system’s efficiency, service coverage, and quality. To take advantage of the country’s advanced IT infrastructure, the government is seeking to harness the power of digital technology and accommodate older people’s rising demand for healthcare.

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Japan

Healthcare & Wellness

Already the global leader in longevity, the share of people age 80 and older among the senior population will increase by more than one-third to 42 percent by 2050. Japan is one of the very few countries in the world to require long-term care insurance (LTCI). To keep up with the healthcare needs of the aging population and to ensure fiscal sustainability, the Japanese government has constantly adapted its LTCI program to enable older people to lead more independent lives and to support family caregivers. In particular, the government has increasingly focused on home- and community-based care and prevention programs.

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Healthcare & Wellness

Lifespans continue to extend in most countries at a faster rate than healthspans – the years when one is generally healthy and free of disease. Extending healthy living enables older adults to engage productively in their communities and economies. There are also significant economic implications of the rising need for long-term care, which can both create a fiscal burden and draw caregivers, particularly women, out of the labor force. We looked at efforts to improve accessibility, affordability, and quality of healthcare for older adults, provide support for formal and informal caregivers, and utilize new technologies to improve the efficiency and quality of care services.

photo of a an older male patient reviewing x-rays on a digital device with a doctor and a family member

Across industrialized and developing countries, governments are increasingly adopting a proactive approach, evidenced by a sweeping focus on promoting preventive care and a healthy lifestyle. While the overall quality of care in the healthcare system varies by country, the U.S. stands out for the high cost of care and its failure to generate better health outcomes. It is the only high-income country that lacks universal coverage.

Only three of the countries included in this study require long-term care insurance. Driven by a shortage in institutional capacity, fiscal constraints, and the desire of their citizens to age in place, there is new movement to address care needs by enabling quality home- and community-based care. Leading countries are providing more support for informal caregivers, mainly in the form of financial subsidies, paid leave, and practical and emotional support. In Turkey, the government is looking to formal caregiving as a means to draw more women into the labor force, albeit at low wages, providing subsidies for low-income seniors without family support.

Robotics and eHealth have emerged as two promising areas where technology can help to address a shortage of caregiving capacity and improve the quality of healthcare, particularly for those in rural areas. Private companies also tend to see healthcare as the area of lowest risk among market opportunities related to older adults. Korea, which boasts the world’s fastest Internet speeds, plans to use its nationwide broadband network to provide more efficient and higher-quality care to its rural population, including remote checkups – 35 percent of older Koreans live in rural areas.

Percentage of Age Group 80+ of the Older Population (65+)

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