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Healthcare Service: Malhotra And Matchar

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Discuss about the Healthcare Service for Malhotra and Matchar.




Across Asia, elderly people account to 60% of entire population and this is anticipated to grow within the next 50 years. Dealing with the unprecedented pace of the population aging, the Asian government need to tackle the important policy problems (Ansah, Eberlein, Love, Bautista, Thompson, Malhotra & Matchar, 2014). This could be how best might the need of the elderly be met , additional aspect to appear might be how the current approaches to support the elderly place the undue burden to the younger generations . The means of the population aging continues to be occurring a lot more rapidly in Asia countries compared to the western countries , and it occurs in some Asia countries for example Singapore and Taiwan at a much previously phase of the economic development . According to statistics it showed that in 2000, the average age in Asia was around 29 years. Such was an estimated six percentage of the region total population were at the age of 65 and older , thirty percent were under the age of fifteen as well as sixty four were working age group of fifteen to sixty four years . The problem of the aging population in Singapore and Taiwan are renowned and it has debated much .However, the causal factors which have been associated to this phenomenon have not been understood fully, involving as they do, both:

An unprecedented and the continuing decline in all the causes all ages mortality resulting in the growing number of the elderly who are sixty five and above in the population (Tiong, Yap, Huat, Phoon & Luo, 2013). Additionally, the reduction in the number of the children being born to the families which resulted in the reduced fertility rate that are below the population replenishment level.

Consequences which is associated to the population with increase in the population has been economically inactive individual through the decrease of proportion that are economically active (Tiong, Yap, Huat Koh, Phoon & Luo, 2013). These implications have not been fully understood, while the effect of the social and the health care are well known. In this research, it will discuss the challenges which are related to the aging population especially in Singapore and Taiwan. Further, it will discuss the demographic changes, the policies and the culture in these two countries.


The demographic changes

The demographic changes which will be examined that impact on the aging population in Singapore and Taiwan are as follows; sustained baby boom, the hasty reduction in the fertility as well as steady decline in the mortality.

Sustained baby boom

In Singapore there has been decline in the birth rate and the government is spending 1.6 billion dollars in an effort to reverse the country in the declining birth rate. This money would be used for the new measures for individuals to access the public housing and help with the medical bills. In Singapore they are still at the nascent stage of development (Subramaniam, Chong, Vaingankar, Abdin, Chua, Chua & Jeyagurunathana, 2015). With the fewer children the baby boomers could have less support in their older years, and there would be greater burden to the current working generation when it comes to caring of the elderly parents, as well as their children. The graying of the boomers population, which is occurring in Singapore it will constitute to the demographic revolution as well as the most critical public policy issues currently.

In Taiwan it has a low birthrates and at the same time facing the decline in the population. According to Taiwan National Development Council they have highlighted that the population will continue to decrease. It has been estimated by the year 216 the population will decrease to seventeen million individuals and the working age group will have declined to fifty percent. The decrease in the population causes strains on the economy as well as the society (Tiong, Yap, Huat, Phoon Fong & Luo, 2013). Taiwan experienced a decline in the rate of the birth and the ageing population over the last two decades. Factors which caused this was due to the greater number of the career oriented women as well as the rise in the cost of living which contributed to the drop.


Hasty reduction in fertility

In Taiwan in regards to the fertility rate it has fallen below one baby per woman. In Taiwan the rate of fertility is at 0.9 which is a low. This is worrying the government especially to their future of supply of manpower as well as brain power. This rate of 0.9 is the world lowest rate of fertility rate (Tiong, Yap, Huat Koh, Phoon Fong & Luo, 2013). The fall in the fertility rate there is fear that the population would lead to the fall in the productivity, which make the business to be less competitive. As comparison to Singapore the rate of fertility which is 1.07 which is a significant number. The reason as to why this rate is low is that Singapore women are getting remarried, and this has taken the older couples to have the chance of getting the children.

Steady decline in mortality

In Singapore they have made a substantial progress in minimizing on the adult mortality over the last number of decades. Based on the research, it pointed out that the adult morality for the Singapore men and Women has fallen to 64% as well as 68% respectively between 1970 and 2010 (Tiong, Yap, Huat Koh, Phoon Fong & Luo, 2013). In Taiwan nation mortality rate fell in the 2013 while the life-span at the birth improved this was based on the statistics that are released in June 25 thorough the Ministry of the Health and the Welfare.

The impacts on the healthcare services

The changes in the aging population is affecting the health care resources needed, cost of the care provided as well as the conditions which are associated with each population group. The demographic shifts changes in Singapore and Taiwan is intensifying the pressures on the health systems and demanding new directions in the delivery of the healthcare. The aging populations in both of these countries are driving up the demand for the health care. The health care systems, both in terms of the delivery of the patient care as well as the practices of the nursing.


The policies

The major population change which impact Singapore and Taiwan and their public policies in the years to come is their aging population a pattern which derive from the lower fertility rates along with the boost in the life-span (Hsu & Liao, 2015 ). There could be legislation alterations which will be executed to boost the program of versatility along with provide incentives to the aging population (Hsu & Liao, 2015). Other trends might include the financial preparedness for the retirements in addition to the cost of the federal public service pension plans. There would certainly rise in the government real cost which might be realigned for the inflation aspect. The government abilities to address on the future health care requires for the aging population may likely depend upon the aspects of the economic growth, innovations in the health care delivery which might improve the cost effectiveness, along with the health status of the seniors (Ng, Feng, Yap, Lee, Tan & Winblad, 2014). There are proposals for improving the support for the care givers through extending of the compassionate leave provisions as well as durations, making of the tax deduction refundable along with protecting of the retirement incomes to the caregivers.

Significant changes to limit impact of aging population

The increase of the share of the older people in the society has been because of the fertility declines as well as the increase in the life expectancy that has become a worldwide trends with far reaching economic as well as socio-political outcomes ( Bloom , Chatterji , Kowal , Lloyd-Sherlock , McKee , Rechel & Smith , 2015 ) . The aging population has pose a fiscal and macroeconomic stability problem to Singapore and Taiwan through increased government spending on pension, healthcare along with sociable benefit to the elderly. One of the changes would be to have a phased in retirement, fiscal sustainability along with the wellbeing. It is important for the government in these countries to encourage the older employees to remain longer in the labor force that would be solution to the fiscal pressures as well as the macroeconomic problems that are associated with the population aging (Knipscheer, 1993). The phased in the retirements entails the scheme whereby the older workers may decide to work for few hours and remain longer in the labor force that include after retire. An additional important change that can be implemented would be promoting and rewarding volunteering, and artistic function among the elderly people (Feng, Nyunt, Feng, Yap & Ng, 2014). The government through these countries could promote this element for example the unpaid actions so as to improve on the quality of the social fabric , lead to the economy and help those engaging in them , along with reduce the healthcare and the welfare costs.


Policies created by international bodies to assist countries in Asia on aging population.

One of the recommended policies is that health programmes which are designed to reduce on the morbidity and mortality needs to be integrated within the comprehensive development strategy as well as supplement a wide range of the mutually supporting social measures of policy (Chand & Tung, 2014).  There should be special attention which needs to be given towards improving the management of the existing health and the related social services towards the formulation of the policies to widen their coverage. Another policy the Asia countries could implement would be to encourage individuals to continue to work into the old age, which is mandated by the rise in the pension age or even the rise in superannuation preservation age (Chand & Tung, 2014). This option would be beneficial to these individuals in accumulation private saving and drawing down the aged pension. Moreover the countries should supplement the national pension plan with the long term care insurance (Etzioni, Liu, Maggard & Ko, 2003). This will be comprehensive and it will remove the anxiety and the unpredictable nature of the elderly care. Additional policy which has been highlighted by the international bodies it that these countries need to support the councils to provide better quality of life to the older individuals through the local services.

The cultures

The culture of Taiwan is the blend of the Confucianist Han Chinese and Taiwanese aborigines’ cultures that are more perceived in both the traditional and the modern understanding (Chand & Tung, 2014). The common socio-political experience in Taiwan had developed gradually into the sense of the cultural identification and a feeling of Taiwanese cultural awareness that has been debated domestically. In the country there is the culture of the aging population in which you will find increase in the old population that outpace the decline in fertility rate ( Etzioni, Liu, Maggard & Ko, 2003 ) . In Singapore their culture continues to be a combination of the Asian and European cultures. It is often based on the Malay, East Asian and the Eurasian cultures. Singapore has been considered a country where the East meets the West .In the country the culture of population aging has been spreading widely due to the increase longevity and declining birth rates which resulted to reduced proportion of the children and increase in older adult’s population.

How culture affects outcome in healthcare services.

The aspect of culture has affected on the outcome in healthcare to a great level. In Taiwan based on the culture it has enabled many individuals to take fatalistic approach when viewing the health care services (Chand & Tung, 2014). These individuals believe if they are ill, it is their fate. At the onset of their sickness they might refer to the doctor, however they lack initiative in learning on the solutions to improve their outcomes. This has been depending on the consequences of their previous life. An illustration, the parents who have children with the cerebral palsy might not be active in locating the suitable therapies to help out their children; but rather they believe the child and possibly themselves as the guardian or perhaps parents they are obtaining the just punishment they deserve. In Singapore culture has also affected on the outcome of the healthcare services in various ways. In their cultures, one aspect maintaining harmony is the most significant value as well as the conflict along with confrontation needs to be prevent (Chan, Malhotra, Malhotra, Rush & Østbye, 2013). The patient could not voice their concerns or even disagreements to their doctors. However that does not means that they would follow the recommendations.

Review of the culturally sensitive policies, solutions and recommendations.

One of the sensitive policy that need review is on the better communities in the families and the societies. There would be better changes in the better communities since it will help boost the better economy (George & Ferraro, 2015). This will be significant since it will be able to boost on the economy which will bring investment and this could be used to improve on the health services in these two countries.  Another aspect that need changes is the consumer market. The emphasis of the ageing consumers market could be a rise in the healthcare services and the support sectors in the business.


The issue of the aging population in Singapore and Taiwan are known well and it has debated much. However, the causal factors which have been associated to this phenomenon have not been understood fully. In this research it has examined on the aspect of the aging population in both of these countries.



Ansah, J. P., Eberlein, R. L., Love, S. R., Bautista, M. A., Thompson, J. P., Malhotra, R., & Matchar, D. B. (2014). Implications of long-term care capacity response policies for an aging population: a simulation analysis. Health Policy, 116(1), 105-113.

Bloom, D. E., Chatterji, S., Kowal, P., Lloyd-Sherlock, P., McKee, M., Rechel, B., ... & Smith, J. P. (2015). Macroeconomic implications of population ageing and selected policy responses. The Lancet, 385(9968), 649-657.

Chand, M., & Tung, R. L. (2014). The aging of the world's population and its effects on global business. The Academy of Management Perspectives, 28(4), 409-429. 

Chan, A., Malhotra, C., Malhotra, R., Rush, A. J., & Østbye, T. (2013). Health impacts of  caregiving for older adults with functional limitations: results from the Singapore survey on informal caregiving. Journal of Aging and Health, 25(6), 998-1012. 

Etzioni, D. A., Liu, J. H., Maggard, M. A., & Ko, C. Y. (2003). The aging population and its impact on the surgery workforce. Annals of surgery, 238(2), 170. 

Feng, L., Nyunt, M. S. Z., Feng, L., Yap, K. B., & Ng, T. P. (2014). Frailty predicts new and persistent depressive symptoms among community-dwelling older adults: findings from Singapore longitudinal aging study. Journal of the American Medical Directors  Association, 15(1), 76-e7. 

George, L., & Ferraro, K. (Eds.). (2015). Handbook of aging and the social sciences. Academic Press. 

Hsu, M., & Liao, P. J. (2015). Financing National Health Insurance: The Challenge of Fast Population Aging.  43(2), 145-182.

Knipscheer, C. P. M. (1993). Autonomy and well-being in the aging population: concepts and design of the Longitudinal Aging Study Amsterdam (Vol. 7). Netherlands Institute of Gerontology.

Ng, T. P., Feng, L., Yap, K. B., Lee, T. S., Tan, C. H., & Winblad, B. (2014). Long-term metformin usage and cognitive function among older adults with diabetes. Journal of Alzheimer's Disease, 41(1), 61-68.

Subramaniam, M., Chong, S. A., Vaingankar, J. A., Abdin, E., Chua, B. Y., Chua, H. C., ... &      Jeyagurunathana, A. (2015). Prevalence of dementia in people aged 60 years and above:        results from the WiSE study. Journal of Alzheimer's Disease, 45(4), 1127-1138. 

Tiong, W. W., Yap, P., Huat Koh, G. C., Phoon Fong, N., & Luo, N. (2013). Prevalence and risk factors of depression in the elderly nursing home residents in Singapore. Aging & mental  health, 17(6), 724-731.


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