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Long term care

The ageing population increases the risk of non-self-sufficiency: the role of insurance companies

Demographic growth and, in particular, the ageing population are two of the main issues being most discussed internationally, especially regarding the food needs and the resulting impoverishment of our natural resources.

Every year, the United Nations review world population growth forecasts based on a time span that identifies three different stages: 2030, 2050 and 2100, splitting available data and forecasts according to six macro geographical areas: Africa, Asia, Latin America, Europe, North America and Oceania. The same data are divided again onto four classes regarding the average age of people: from age zero to 14, from 15 to 24, from 25 to 59, and over sixty.

Taking as a reference the latest update of the study published by the UN in 2017, the world population today comes to just over 7,550,000,000 people. If we consider just Europe and North America, the total number of inhabitants in these two areas is just over one billion: 750 million in the former, 360 million in the latter.  But before looking at growth predictions for the current century, it is interesting to note that while the percentage of over-sixties worldwide reaches approximately 13% of the total, this figure rises to one quarter of the entire population of Europe and just over a fifth (22%) of that in North America. Therefore, today we can already roughly count about 275 million European and North American citizens basically no longer of working age (how the time span in which an individual is no longer able to work is elegantly defined) and, generally, exposed to self-sufficiency problems.

But even more worrying is the forecast, though it should be remembered that demographic predictions are by definition more uncertain the further such forecasts depart from the basic year of reference.

In 2030, while the world population is predicted to rise by approximately one billion people (8.550 million in total), in Europe we should expect a drop of over 20 million people and, even more worryingly, a further increase in the percentage of elderly people, a phenomenon ascribable to both dwindling birth rates as well as longer life expectancy (the latter widespread with varying intensities).

The latest study on the subject conducted by the United Nations in 2015 in fact predicted a life expectancy at birth of about 78 years in majorly developed countries, increased to almost 81 in 2030 and close to ninety in 2100.

In a recent editorial published in the World Health Organisation (WHO) monthly bulletin, the authors also highlight how age alone is not a reliable indicator of the state of health of the population.

The same organisation in fact underlines how in its own programme, with a timeline reaching 2030, what is known as “healthy aging” is not identified as the absence of illness but rather the preservation of an ability that allows for a full and dignified life to be lived. Investments into this, warns WHO, should not be to the detriment of the battle against the diseases and illnesses that normally affect the younger population, but should be focused on creating integrated person-centric services, located as near as possible to the user’s place of residence and capable of providing the assistance necessary to maintain intrinsic self-sufficiency as long as possible.

Assistance for the no longer self-sufficient elderly once “guaranteed by the family” and mainly shouldered by women, is shifting more and more, also due to the progressive increase in women’s participation in the workforce, towards specialised independent structures funded by public or private healthcare. It is nonetheless difficult to make reliable predictions since the above should be reviewed in light of the scientific progress to be made in the future in medicine, biotechnologies as well as in robotics and artificial intelligence which may prove to be exceptional allies not only in the creation of a new dimension in integrated assistance, but probably also in delaying the moment when debilitating physical and mental deficiencies arise.

It is nonetheless clear, particularly in majorly developed countries which are witnessing a progressive demographic downturn, that the cost of sustaining the ever growing “retired” population cannot be put solely on the shoulders of the working generations. So there is a needs in the years ahead for more widespread recourse to private insurance plans capable of contributing to or sustaining the costs currently borne partially or in full by public healthcare as is the case in some countries.

The falling percentage of the working population and the rise in over-sixties to peak at 36% of the total population in the median scenario show the urgency for carefully planned measures to effectively deal with this imbalance.