License to Die: Life with Dignity

The death of Queen Elizabeth II brought condolences from global leaders and people from all walks of life. Her death has prompted the memories of her majestic influence that had finally come to the end after 70 years of her reign. Her legacy will remain strong. Like all others, we will miss her. What makes it sad, though, is that it is only a few months after Great Britain celebrated the Queen’s Platinum Jubilee with many spectacular events to mark 70 years of her excellent service to the nation. Life is too short. Hence, we should not brag about it. The Queen’s funeral teaches important lessons about death. Death is fair to all. Death can not be cheated. We send our best regards to those who lost their dear ones this year. 

Miu Kakiya is a prolific Japanese novelist, who wrote a book called ‘The Death of 70-Years-Old (七十歲死亡法案,可決.)’ In her own imagination, Kakiya created the context where ordinary families live under the bill that enforces mandatory death at the age of 70 as the government wants to solve many societal issues around the aging population. Kakiya talks about life and society with her ingenious imagination, sharp gaze, and pleasant sense of humor. Her work has been widely praised for broadening understanding of real-world problems. Entire plot of her book is quite crazy, though. We can’t imagine the world that the government determines the moment of our death. Fiction is fiction. However, Kakiya subtly touches on social issues that Japan is already facing at the moment. It will be burdening to take care of very aged populations. 

Chie Hayakawa, a Japanese film director, raised a similar issue in her short film, ‘Plan 75’ as part of the omnibus feature film called ‘Ten Years Japan.’ Set in the near future where increasing elderly populations have become detrimental to society, Hayakawa also imagines a nation where retired seniors or other citizens deemed unproductive are systematically eliminated. In Hayakawa’s dystopian short film, the government’s ‘Plan 75’ encourages senior citizens to be euthanized to fix the problems of an aged society. It can be interpreted as a political commentary with her own view, but that is what Japan may face in the coming decades if they don’t plan for the worst. Certainly, it shouldn’t be done that way, but what if the value of human beings is measured by the bottom line of the society when there is slow economic growth and the shortage of young workers and helpers who can take care of very aged people.

East Asia is aging faster than any other region. Japan’s super-aged society is top of the league, ranked as the oldest country in the world with 29% of its population being 65 or older. By 2035, it will grow to be one third of the population. There are now more aged adults wearing diapers than babies in Japan. China is second to none. China has one of the fastest growing aging populations in the world. By 2040, the population of people being 60 years or older would reach 28% of the population. Currently, 60 years or older accounts for more than 267 million. This phenomenon will shrink the workforce and increase public spending, posing risks for public finances and necessary healthcare delivery. As a result, it increases the challenges to sustainable economic growth.

​​Managing an aging society at a scale requires sophisticated policy design addressing issues such as child care, education, employment practices, health care, and pensions. That is why effective preparation for an aging society calls for strong leadership that can build social consensus and make challenging political decisions. Policy change for the elderly requires a paradigm shift primarily in the ways that healthcare and pensions are delivered and also financed. It should be done without burdening the next generation. For example, in the U.S. alone, the nation is spending $250 billion, taking care of Alzheimer patients. That’s going to surpass $1 trillion by 2050, which is enough to take down the entire US healthcare system. 

Life expectancy has increased significantly over the past 30 years driven by numerous technological innovations, which is a good thing. But, it has enormously pushed up healthcare costs as a by-product. I am not arguing that we need a drastic measure as we saw in aforementioned fictional scenarios. However, an aging population puts budgetary pressure on society as a whole. The number of workers declines relative to the number of consumers. The ratio of those working to those not working is set to move from 4 to 1 to 4 to 2.5 by 2050. It will create a financial burden on our next generations and put enormous pressure on society as a whole. 

The elderly contribute to the economy by putting money for consumption in a variety of ways. However, prolonged life expectancy creates huge uncertainty for the elderly. The elderly would abstain from spending if there is not enough savings or social security to support their living after retirement. They wouldn’t freely spend their life-saving. Existing pensions won’t be enough. One crucial fact is that we have to live a life of the elderly, perhaps, way too long. The elderly may earn from continuing to work after retirement, but overall productivity would not be as good as they wish. If there is no proper job or reskilling training in this technologically advanced work context, life won’t be easy for them. Therefore, policymakers should consider protecting and expanding financial security and assistance programs for the elderly, including public health insurance and also universal basic income, tailored to the standard of living for the elderly beyond this existing pensions. Financial security is vital to maintain health and quality of life. 

Nothing beats old friends. We can’t buy friendship with money. Dignity comes from respect. Dignity is a given. Dignity identifies a worthy, high, and honorable condition as part of being human. We should make the elderly feel wanted and valued like all people have the right to be recognized for their inherent humanity and treated equally. Everyone does not need to be a king or queen to be dignified. Simple paid work could strengthen and restore dignity for the elderly. What we need to give them is not money, but meaning as all want to be remembered through the work we leave behind or through our relationship in life.