Long Term Care Insurance

Most Malaysians are proud of the fact that we have a 94-year-old prime minister who travels far and wide at a punishing pace to give noteworthy speeches or media interviews, makes his views known to other leaders or just to witness something useful.

Tun Dr Mahathir Mohamad is a man in a hurry, always yearning to accomplish many things for fellow Malaysians. He’s definitely the only senior in the 90-plus bracket in our country of 32 million, still relatively healthy, mentally alert and working hard, putting many younger people to shame.

Many of his schoolmates and friends would probably have retired. But Dr Mahathir is the exception to the norm — true to the adage that age does not matter so long as the matter does not age!

The same, however, cannot be said for many other seniors in the country. Granted, Dr Mahathir may be aided by a retinue of aides looking after his needs so that he can execute things judiciously at the highest office, but not everyone who has aged would have the privilege of such assistance or the physical and mental make-up. The elderly in the country certainly need a more efficient support system.

With a fast ageing population, the question of who cares for our senior citizens is becoming increasingly crucial. Malaysia’s life expectancy has been rising. Life expectancy at birth in 2015 was projected at 72.5 years for males and 77.4 years for females.

Do we have plans in place to train more people to properly care for the elderly? Where do the elderly turn to if their offspring or relatives are unable to care for them? These are pressing issues which the government has to act on if nothing yet has been done. Gerontology has to be put into sharper focus if we’re to address the well-being of the elderly.

It’s especially compelling for those in the M40 and B40 categories while those in the T20 or with large extended families would have the luxury of caregivers, either in the form of employees or enlisted relatives.

A case in point is someone I know in the public relations industry: Ron is pushing 64 and still unmarried, although he plans to do so soon with the love of his life from Germany. He still has to work and care for his mum in her 80s. But finding the place with the right geriatric care is like looking for a needle in a haystack.

Many have lamented that most so-called geriatric care centres or nursing homes are no more than places for their operators to make big bucks. All they have to do is find a big enough accommodation with beds, television sets, toilet facilities, some able-bodied helpers and a cook or two, and they are in business! Some even equate the vastness of their premises and facilities with top-notch caring capability. But the truth is far from reality.

Fees are hefty and range around RM5,000 a month in Kuala Lumpur and Petaling Jaya. Some who can only afford to spare RM2,000 a month say they’re often in a lurch.

This brings to mind what prominent Malaysian economist Dr Jomo Kwame Sundaram opined two years ago after the Employees Provident Fund (EPF) revealed that about 70 per cent of members who withdraw their funds at age 55 use up their savings less than a decade after retiring. This meant that most EPF savings were not enough to stay out of poverty after retirement, he said.

With 69 per cent of our population of “working age” between 15 and 65, only 48 per cent of the labour force of 14.5 million have active EPF accounts. In 2017, EPF raised the minimum savings target by age 55 from RM197,000 to RM228,000.

But Jomo says that only 18 per cent of members have that much savings, far short of EPF’s target of getting at least half its members to meet the minimum level by 2021. Low investment returns and withdrawals permitted — for housing, health and education — imply even less for retirement.

More than two-thirds (68 per cent) of EPF members aged 54 had less than RM50,000 in EPF savings! Jomo says with the household poverty line income at RM930 monthly, RM50,000 in savings will last only 4½ years. The bottom fifth of EPF members have average savings of only RM6,909!

An exasperated Ron says that despite the hefty fee, the service leaves much to be desired, especially in terms of giving proper exercise to prevent the onset of dementia. He bemoans the lack of focus and enforcement on nursing homes for senior citizens.

If the government has given focus to the kind of training that kindergarten teachers must have, it’s high time that it also paid attention to the other spectrum of the population: the elderly.

Now that we’ve restarted the “Look East Policy”, perhaps it’d be pertinent to look at Japan’s widespread respect for its seniors and a powerful obligation to care for them. With changes to Japan’s demographic structure of society, caring for the elderly is increasingly seen as a social, and not exclusively family concern, according to Iza Kavedzija, an anthropology lecturer at the University of Exeter.

We ought to appraise Japan’s Long Term Care Insurance (LCTI), designed to provide cover to all those over 65.

The LCTI is one of the most comprehensive social care systems for the elderly in the world, aimed at reducing the burden of care on families.

With adequate funding, the market for providing proper geriatric care can perhaps be properly undertaken along with the creation of clear and consistent rules and roles as well as training for caregivers, operators of nursing homes and even the informal networks of volunteers.

Article by Datuk Yong Soo Heong  - former chief executive officer and editor-in-chief of Bernama