Heebie's take: I don't understand why this is an environmental question instead of a labor question. Legislate fair wages for carers, paid by the state if the individual is taking care of a family member. Pay enough that it is a desirable job.
In the absence of approaching this as a labor rights issue, old people will live in extreme poverty that hastens their deaths, or it will fall on their daughters to take care of them, unless they are sufficiently wealthy.
Right. I'm not saying there's the political will for it, but what's the fundamental problem with a redistributive tax structure sufficient to pay decent wages for enough paid caregivers to handle the problem? The sort of care work that's nightmarish when it's an unlimited, unpaid burden on a family member is just another job when it's a reasonably paid eight hour shift.
Agreed- I can't see the environmental angle particularly. It's not like this wouldn't still be a problem if we had unrestricted use of fossil fuels. The assumption that "a carbon-neutral economy is not going to expand at the rate that our present arrangements assume" is a pretty huge one, and very far from certain; why shouldn't it? Will our software designers become less innovative because their computers are running on wind-generated electricity?
Also:
6) Improved geriatric medicine means that old people stay active and self-sufficient for much longer. I suppose this is a variant of 3). We don't worry about how we're going to care for the thousands of polio victims in iron lungs these days. The problem is not old people, the problem is old people who are either of limited mobility or mentally impaired. And forty years ahead, why shouldn't those problems have been addressed with some success? "Illnesses of old rich people" is a good area to research!
Social safety net provision certainly belongs in the list of possible outcomes. NB would certainly be acutely aware of the theoretical possibility, so I assume he just despairs of its chances.
A zero-carbon world is going to be making massive medical (and other) savings elsewhere, remember. The assumption that "zero carbon means slow growth" is a very good right-wing argument but it needs attacking. Fossil fuel burning has immense negative externalities - half a million dead a year from pollution from thermal electricity generation alone - and we won't be paying those any more.
So to put it another way: maybe those old people can be looked after by all the nurses who will be sitting around not dealing with people with chronic pulmonary and circulatory diseases any more, and by all the people who won't be slowly dying of said diseases any more.
Also, most walkers are powered by diesel.
I'm not saying there's the political will for it, but what's the fundamental problem with a redistributive tax structure sufficient to pay decent wages for enough paid caregivers to handle the problem?
As referenced in point 2), it seems politically unpalatable. The measures proposed in the Tory manifesto (for about 24 hours anyway) were surprisingly redistributive for a Tory government (especially this one). Which is precisely the reason it was dropped almost instantly - the people it hit the hardest were the Tory base. Now, maybe Labour would propose something even more ambitious and redistributive, but presumably it would get labelled as socialism or whatever.
My father always said that Social Security wouldn't be around for him in his old age. He proved himself right by dying suddenly at 65. I hope to live longer than that, obviously, but the silver lining of not burdening my kids with my elder care is a bit appealing.
What if your kids grow up to be dicks? t
The Japanese system is a compulsory Long-Term Care Insurance payment on top of regular health insurance, paid by everyone in work over 40. It works pretty well.
The premium is split 50-50 between employer and employee. The long-term care insurance premium is typically paid as a supplement of around 1% on health care insurance and is collected by the employee's chosen health care insurer. Individual premium calculations vary with different insurers but should average out the same. The insurer then makes a lump sum payment into the Social Insurance Medical Fee Payment Fund which is distributed to the municipalities who pay independent service providers for care and other services.
The long-term care itself is then financed 50% from LTCI premiums and 50% from general taxation.Thirty percent is from premiums paid by 40-64 year olds, 20% by those aged 65+, 25% from central government taxation, 12.5% from prefectures and 12.5% from municipalities. In addition service users make a 10% co-payment for the services they use, plus fees for meals and rooms (accommodation costs) for institutional care. These payments are capped at £75 per month for low earners.
LTCI, as initially set up, is a universally available needs-based service and is not means tested.A key aspect of the Japanese LTCI programme is a very formalised national system for the assessment and certification of care needs. An initial, 74-item questionnaire on activities of daily living is weighted and scored by computer into one of a number of bands which determine eligibility for services. The assessment is then reviewed by a panel of professionals before certification and is also subject to appeal.
As I understand it, the Conservatives have been working on trying to introduce something similar in the UK for at least the past couple of years, but each time a proposal is floated it gets shot down in the popular press as a "tax on getting old" or similar.
Wealthy, healthy old people using poor, sick old people as a reason for not paying taxes is a big thing here.
each time a proposal is floated it gets shot down in the popular press as a "tax on getting old" or similar.
Well, yeah. What else would it be? No matter what we do, someone's going to get "taxed" for people getting old. The old people, their dependents, or the general public.
I don't understand why this is an environmental question instead of a labor question. Legislate fair wages for carers, paid by the state if the individual is taking care of a family member. Pay enough that it is a desirable job.
Because my assumption is that an environmentally sound economy will not be growing at the sort of rate which makes tax rises relatively painless. It will feel instead like a zero-sum game. Obviously, I may be wrong, and there may be some magic source of energy which will enable the economy to grow without consuming resources we haven't go. But that seems to me as unlikely as the sort of magical political technology which would make sensible taxation rates possible.
I'm not saying there's the political will for it, but what's the fundamental problem with a redistributive tax structure sufficient to pay decent wages for enough paid caregivers to handle the problem?
The fundamental problem is that there isn't the political will for it; nor is there any plausible route to get the necessary will. The problem is how to win elections on the necessary programme.
As long as you are imagining all possible futures it seems to me like there's an excluded reframe of "dumping it on adult daughters" -- switch to more communal, smaller-scale, intimate-with-neighbors living arrangements that allow elder care to be mostly a community responsibility. Throw in some gender parity while you're at it. Maybe climate change enforced economic contraction is what made this happen.
I don't know that you have to postulate magic energy sources -- it is possible that the sort of mobilization necessary for climate change will, in the way that wars do, stimulate economic growth.
I mean, the answer to the question "How are we going to handle elder care" is by paying for it. "How are we going to get the political will to pay for it" is a harder question, but it's not something that we're going to reason out an answer to in this thread: like any other leftist position, it'll happen if and when we get enough leftists in power.
I feel like I've been really good at sharing the burden with my sisters.
Improved geriatric medicine means that old people stay active and self-sufficient for much longer
But you can't postpone the need for care forever. The diseases may change, but barring the discovery of an elixir of youth, old people will eventually develop cancer or become demented or simply grow too frail to live independently. Or do you envisage a high proportion going straight from "healthy longevity" to dropping dead?
That's my personal preference. Let me know how to do that.
19: I have the vague impression that general 'healthy lifestyle' shows up more strongly in longer good health than in longer life; that healthy until the late eighties and then dropping dead fairly suddenly is something that you can increase your chances of by, e.g., exercising and not smoking and so on. But of course there's no way to eliminate extended poor health in old age completely, there's still going to be plenty of it.
If ajay is right and a post-fossil-fuel economy is one which continues to grow and make people richer, then the problem goes away or looks a lot more tractable.
The successful high-tax high-welfare societies of enlightened topless Europe had a couple of advantages. One was the strong states and the social solidarity left over from wartime organisation. Another was the generalised optimism about the future. Redistribution was more or less politically painless. There was an expectation that there would be enough for everyone. I think, and seem to remember, that what really put a stop to that was the first big oil price shock.
Again, Ajay may be right. The transition may turn out to be painless. But I wouldn't myself bet on it. And by the time it comes around -- we're looking at 20 years, max, if warming is to be kept under control -- the population pyramid will be even more skewed.
Something like the Japanese system seems to me the best solution but it requires the kind of grown-up thought and capacity to act on it which the British political system has not recently been displaying. Meanwhile, the US can't even get a sane health care system together.
We just need to keep the government out of Medicare.
I wouldn't set up 'painless' as the standard to be achieved. Lots of things take a certain amount of pain but work anyway -- in the US, plenty of people hated Roosevelt and the New Deal, but it still happened.
I like Tia's solution, too. I think that communalising care work in this way is necessary if only because it's so bloody awful to do it on your own.
I'm just enjoying this counterfactual where we get a handle on climate change. It feels so refreshing.
I don't mean to sound like Pollyanna -- god knows what's going to happen with climate change at all. But it seems poorly supported to look at a problem, identify that there are going to be problems with implementing the obvious, straightforward solution (redistributive taxes to pay for elder care), and give up.
I listened to the Longform podcast interview with David Wallace-Wells last night, and his best-case scenarios sounded a lot worse than anything on this thread.
I like Tia's solution, too.
I don't know about that. I live in a very unusually community-oriented building (not formally, it's just chattier and more connected than most apartment buildings), and my next door neighbor is a old woman who really shouldn't be living alone anymore -- there have been repeated incidents when she has literally fallen and been unable to get up, which have turned into a fair amount of drama because she's uncomfortable with the building super having her keys. I have a set of her keys, and I've gotten her back on her feet a few times, but that's not nearly enough. (She has a caregiver who comes in during the day, but she's alone at night.)
I worry about her, but she doesn't seem to want me to do more than I do for her, and she wouldn't trust a broader group of people to have free access to her apartment the way they would need to to assist with care. I can't quite see how the communalized unpaid caregiving would work.
16. Here's a hopeful example: My mom lives in a middling part of Chicago. There's a pretty good density of older residents in her low-rise condo and the apartments and condos within a few miles. There's a certain amount of individuals looking out for each other, and there are some nonprofit community services (shuttles to medical appointments, a low-rent gym, maybe more) that people take advantage of. I'm not sure how well it'll work in cases of real need, but it's an improvised state that's kind of working for one pool of old people who aren't rich but aren't broke. The arrangement's for nearby religious and ethnic communities are pretty clearly more robust. Entertainingly, the street named California is an approximate border between orthodox jewish (maybe very conservative rather than orthodox, or both-- not sure. Observant enough that the big chain groceries have extensive religious accomodation, not just racks of passover Matzoh) and Pakistani/Afghan archipelagoes; one eruv goes way into the asian neighborhood.
I went up for a week to help her back into her place after rehab for an injury though. These kinds of arrangement won't help for dementia or other situations that call for high-intensity care.
Why does high economic growth make high taxes more palatable? If I earn 20k and the government takes 10k and I'm angry about that, I dont think Im going to feel better when I think that next year I'll earn 22k and the government will take 11k.
Surely, if anything, high income makes high taxes palatable. That's why we have progressive tax systems.
You're still going to feel better under that scenario than if next year you expect to earn only 19k and the government still takes 11k. Which is more or less the scenario I expect with a shrinking economy and a growing number of ill old people.
communalized unpaid
People cared for would need to cooperate, and they'd need to pay in a viable version of this I believe. In practical terms, enough density of people that a local shuttle or shared care visits to the same building keep costs low. Doesn't happen spontaneously though, there needs to be a (possibly low-budget) organizing center.
I can't quite see how the communalized unpaid caregiving would work.
As I picture it, it starts with an assisted living community, and then you add in families who enjoy the cafeteria and communal recreation spaces and college students who live for free in exchange for being an active community presence. But you don't ever pass on the actual hard work of caretaking to an unpaid person.
Which is more or less the scenario I expect with a shrinking economy
"Shrinking economy" seems to beg some necessary questions. That is, the overall size of the economy is one thing, while the median income is a very different one. The current economy could shrink a whole lot while increasing the incomes of people in the lower half of the income distribution. That's not an easy state of affairs to get to, but it's not tightly connected to the problem that climate change is going to soak up all the resources: where we are now, there are a whole lot of resources to go around, they're just badly distributed.
32: if high income makes high taxes palatable, explain the US tax code.
36: fair point. It is a loose connection.
29: Maybe dwelling structures change so that nuclear families are no longer the relevant unit. It wouldn't even be that hard to make city apartment buildings accommodate this -- you could knock down a few walls to make a super apartment. You just have to imagine a future where people's values/ideas/ideology about social organization are different than they are now. You have to have had a close relationship with that woman already, and there have to be other young families that also had that close relationship.
if high income makes high taxes palatable, explain the US tax code.
What's to explain? Rates are low by international standards, but it's still progressive overall. Most of its major pathologies are the result of outsize political power by the very wealthy and rent-seeking by accounting firms and makers of tax-prep software, but that's neither here nor there when it comes to economic growth.
Yeah, hang on, now we have a permanently shrinking economy? Like we've never had since the early Middle Ages? I'm not saying it's impossible but it's very far from inevitable. And a permanently growing dependency ratio?
I feel you're making a lot of unduly pessimistic assumptions.
Yeah, hang on, now we have a permanently shrinking economy? Like we've never had since the early Middle Ages? I'm not saying it's impossible but it's very far from inevitable. And a permanently growing dependency ratio?
I feel you're making a lot of unduly pessimistic assumptions.
Eventually, an epidemic is going to come along.
Ajay: "now we have a permanently shrinking economy?"
Well, from my reading of Brad Delong, the perennially growing economy is a modern phenomenon, and relies on burning buried sunshine, as well as dredging every last speck of ore, converting every last acre of habitat for animals, and catching every last bit of edible marine life. A sustainable economy would have to stop doing those things, and hence there would be limits on growth. I know there's a healthy debate about "growth decoupled from energy consumption" but there's a lot of (respected) economists who think it's a mirage. Maybe they're wrong, but it's not a crackpot idea to think that growth is going to stop.
It is maybe unduly pessimistic to think that an economy that isn't growing is going to be necessarily an experience of privation for most of the participants. I can believe that growth has to stop sometime without thinking that that must mean we're all going to feel poorer than we do now.
I mean, the answer to the question "How are we going to handle elder care" is by paying for it.
It is still an open question whether we will pay for it with people's money or whether old people will pay in a combination of money and misery.
Maybe there's a middle eastern county with vast deposits of elder care and an ineffective dictatorship.
I think people are underestimating the value of old people offing themselves.
According to Logan's Run, I'm already past my sell-by date.
If you've ever started to look fur an assisted living facility, you'll start to notice just how many of them there are. Once you start seeing them, it's hard to stop.
teo, you're making my point. The wealthy in the US have bent the tax code to their advantage because they dislike paying taxes at least as much as the poor schmucks or "little people" who can't help doing so. High income does not, by this measure, make high taxes more palatable.
I think that an economy that is not growing, and not expected to grow either (both parts are important) would promote a very different kind of psychology to one in which people really believe that the future ought to be better than the past.
LB, how do you know when your neighbour has fallen?
49: It's probably because the Baader-Meinhof gang is now old enough to need assisted living.
51: "Help, I've fallen and I can't get up," is a phrase every American learned from LifeAlert.
teo, you're making my point. The wealthy in the US have bent the tax code to their advantage because they dislike paying taxes at least as much as the poor schmucks or "little people" who can't help doing so. High income does not, by this measure, make high taxes more palatable.
And yet, the US tax code is in fact still progressive. Taxes are unpopular; they always have been and always will be, and raising taxes for any reason will always be a tough sell. And yet, governments still levy taxes every day. I still don't see any necessary connection to economic growth.
People only hate paying taxes themselves, though. Taxing other people is super-popular, despite the long-term efforts of libertarians to convince people to oppose it.
51: Yelling through the door the first couple of times, and then I made sure she had my cell number to call. It's surprisingly difficult to lift someone heavier than you are who's too frail to help much.
The federal tax code is progressive. The sum of all taxes, close to flat, I think.
56: Even if you gained a bunch of weight, it probably still would be difficult.
An account of one of the first times she fell, cut and pasted from when I was telling people about it three years back:
That was just before I found out Tim was moving out -- since then I got a set of Sena's keys and made sure she had my number so that wouldn't happen again. There had been a similar earlier incident, but Tim handled that one.Our paranoid elderly neighbor, Sena doesn't want the super to have her keys. But she trusts Buck, so he has her keys.
He's in Houston. I don't know where her keys are.
As I'm getting off the subway last night, I get a call from Sally. Sena has fallen, and can't get up, and is yelling through her door for help. (Coherently. Yelling, not screaming.)
Buck's not answering his phone.
I get home, and look in the plausible place that he'd be likely to put them. They're not there. The competent nurse who lives across the hall is taking point, and the hallway is filling with neighbors. Sena is still yelling.
Sally and I run downstairs and toss Buck's office, and come up with dozens of unlabeled keys, because Buck is a crazy man. None of the unlabeled keys I find in my insane husband's office work. We go down, search again, find more keys. I have been texting and calling him over and over again, figuring if his phone makes enough noise, he'll eventually answer it. No response. We try the additional keys, they don't work.
The beautiful French guy from the fourth floor asks if anyone has a radio?
Or an X-ray?
I think he thought he could break in to the apartment with an antenna.
I don't know what he meant by X-ray: that must have been a language problem.
The nurse across the hall makes an executive decision to call the fire department.
Sena is begging her not to through the door, because she's right on the brink of not being able to live alone, and if the fire department rescues her, she'll end up in assisted living.
Buck finally calls, and tells me where the key should be, which is the first place I guessed to look. But it's not there. Finally, the fire department shows up, and shoos away uninvolved neighbors, including me. So she's rescued, but not happy about it.
Apartment living. You get a real sense of community. Insane, broken community.
But community.
Tim wanted to be called Buck online. God knows why, but there's no particular reason for me to keep doing it.
I never knew any of my neighbors when I lived in an apartment. But I barely know them now either. If we had kids I would.
My building is genuinely peculiarly tightly knit. The nurse across the hall is around sixty, and was born in the building -- there's at least one other woman around the same age who's also lived there all her life. I call the super Tony the Hereditary Super because his father was the super and then his mother after his father died. I've been there nineteen years in May, and I know a lot of people who've been there longer. There's a Christmas potluck every year, and we hire an actor who used to live in the building to come back and play Santa for the kids. All the circumstances are ideal for making it unusually socially connected.
43: debatable, and anyway that's not an argument for perennial economic decline.
I don't see the environmental angle either, though that is probably because I'm very much not a Deep Green and think we can transition to a mostly-carbon neutral economy for no or minimal net cost if we were a bit less feckless.
And I think the 'walk off into the woods on a cold night' is at least as traditional as 'female offspring care for you'.
'19: I have the vague impression that general 'healthy lifestyle' shows up more strongly in longer good health than in longer life; that healthy until the late eighties and then dropping dead fairly suddenly is something that you can increase your chances of by, e.g., exercising and not smoking and so on. But of course there's no way to eliminate extended poor health in old age completely, there's still going to be plenty of it."
This is a good point, and I think the difference is that 'lifestyle' health like eating your veg and exercising disproportionately extends healthspan, whereas modern medicine extends life for people in the 'would have died in a pre-industrial society' state (though this varies and something like blood pressure meds or knee replacements don't fit this categorization).
I think you can square the circle by redirecting resources from the super expensive ICU type end-of-life care towards home/community based elder care. My wife works in an ICU and is pretty passionate about the idea that we should do less of the 'torture granny for a week so that the kids who never called can fly in and relieve their guilt'. Tens of thousands of $ spent to keep very sick, 80+ yr olds alive for a few more days, in a state of limited consciousness and significant pain beyond what strong opioids can fix. But this requires serious conversation about our excessive 'culture of life' and willingness to entertain assisted suicide and the reality of death.
I think the poor dog died and I forgot his name.
My dog? I called her DogBreath here, but she was Nafanua for real.
I really should have remembered DogBreath. Seems very obvious on retrospect.
If I have a regret about post-divorce dating, which I mostly don't, it's turned out very nicely thank you, it's that I had daydreams about dating someone with a good dog, so I could get a part share of dog time without having to do all the work or take the responsibility. That has not happened, and will not.
I know why I was confused. I'd just been texting a friend whose deceased dog was named Buck.
69: I think that's how my brother got married. Anyway, a couple of years ago when they were dating, they adopted a dog together and it mostly lived at his place.
I think you can square the circle by redirecting resources from the super expensive ICU type end-of-life care towards home/community based elder care.
This is a good thing to do regardless, but it can't be relied upon to save money. Home/community-based care might cost $10,000/person/year compared to facility-living $100,000, but you might easily have to give 10 years of the former to prevent one year of the latter.
You can get medical people to show up at your parents house and do things like PT.
Only on second reading did I realise that 73 meant physiotherapy, rather than haling the poor old folks out into the park at oh-six-hundred for press-ups and wind sprints.
Also, we don't even have press-ups or physiotherapy.
Oh, right. And here I was thinking she started avoiding men with dogs because the dogs interfered with serial killing.
A well trained dog can actually be a valuable assistant.
Mostly if you want to get children into your van. Monster.
Anyway, unfogged babysplosion was great. I can deal with unfogged mom-in-a-home-splosion. But if people's kids start writing in about troubles putting one of you in a nursing home, I'm going to feel really old.
And I have changed the nappies of both my children and my mother, and I would a million times rather deal with baby shit.
There was a period when my mother-in-law was always rushing out of town to visit Tim's brother and to help with the kids. We would ask for visits and say that we were having a hard time taking care of my parents, and she would say that her other son needed her, and we could manage. It is a source of ongoing bitterness for me that my mother-in-law often said hat she didn't want to minimize everything we were going through/had gone through with my parents but we just didn't understand how hard it was to have children.
Babies can really just poop more than you think possible. Like so much poop you expect the baby to look hollowed out.
Of course what the elderly can't do in volume, they can more than make up for in existential dread.
The assumption that "a carbon-neutral economy is not going to expand at the rate that our present arrangements assume" is a pretty huge one, and very far from certain; why shouldn't it?
Because all (or, okay, many or most) of our current (and, at least short-term, future) mechanisms for growth and expansion depend upon an exploitation of resources that is incompatible with a carbon-neutral economy? Or, what Chetan Murthy says in 43.
I dunno. I admittedly haven't read much on the subject (on the issue of climate change, I suffer from [am guilty of] a kind of ostrich syndrome, I suppose). But what little I've read suggests that, if we want to move to a more sustainable economy, we're going to have to adjust our assumption/expectation that perpetual growth is some kind of ahistorical norm, that it's just the natural order of things. It's not. And that, if we do have to revise or rework this assumption/expectation (which we almost surely do), the adjustment will be painful in all sorts of ways. And will affect, for example, our arrangements for retirement funding and retirement care.
As NW points out, pensions (and various other forms of retirements savings plans) are "not just the sum of our savings;" they are meant to yield (through investment) more money than we put into those plans, and are therefore based, of course, on the assumption of perpetual growth. But what if the economy must contract rather than expand in order to achieve carbon-neutrailty? What happens to pension funds if they do not grow as expected? And if people do not have enough to live on in their retirement, or not enough to pay for the care that they need when no longer young and fit and healthy, who will care for the elderly, when they don't have the money to pay?
Shorter answer: well, daughters, of course. Which is all sorts of problematic in all sorts of ways....
the Extent to which our very unequal society is also wrecking investments is underrated, Krugman used to talk about how "Yacht world" could still have robust growth, but that really isn't true.
72: I think you can square the circle by redirecting resources from the super expensive ICU type end-of-life care towards home/community based elder care.
This is a good thing to do regardless, but it can't be relied upon to save money. Home/community-based care might cost $10,000/person/year compared to facility-living $100,000, but you might easily have to give 10 years of the former to prevent one year of the latter.
I think people are seriously underestimating how much even home-based care can cost once a person becomes seriously disabled. My dad has needed 24/7 aides the last few years. In Massachusetts, that ran around $150K/year to pay for the aides (what the family was paying before he depleted his assets and was able to go on Medicaid). If you need to pay someone to manage the aides and the various agencies, that can run you another $50-100K/year (my mom basically did that as her full-time job for the first few years until she had to cut back for health reasons). (Note - these are cost figures, not what the carers are getting paid - there are agency fees and taxes on top of the wages.) The problem with getting old and sick is that you have to pay people to do a lot of stuff you would have done yourself when you were younger, and you can't go out and earn more money to pay for it. You can burn through even some pretty sizeable retirement savings pretty quickly at that rate.
It's all very well to say that you just need to pay carers a decent wage and have the state pick up the tab, but I'm pretty sure that at some point the taxpayers would revolt over paying for that level of care for everyone. For my dad, it's primarily a quality of life issue. He doesn't talk much anymore, but we can tell that he is a lot happier at home than he would be in an institution, even if that would be cheaper. He's been absolutely miserable every time he has had to go in the hospital away from my mom (not to mention, there have been some medical screwups there that made his condition worse). At home, the aides can take him to sit out on the back deck after lunch, where he can see and smell the flowers, and take him for walks in his wheelchair, where he will track the squirrels with his eyes and smile. But it's not cheap to maintain even that quality of life.
they are meant to yield (through investment) more money than we put into those plans, and are therefore based, of course, on the assumption of perpetual growth.
This isn't right, is it? That is, the concept of returns on investment isn't just a restatement of economic growth -- in a steady-state economy people would still pay interest on loans. I really don't mean to be saying everything's fine, everything is terrible and will probably turn out badly. But it's not necessarily terrible as a matter of inescapable logic.
Almost nothing is ever going to be necessarily true as a matter of inescapable logic.
E.g., people still get returns on investment when the economy is in recession. Wasn't Japan's economy steady-state or contracting on average for decades? (Not sure, but I think this is the case.) And it was still an ordinary wealthy developed country, not a collapsing hellscape where the living envied the dead.
High unemployment is societal misery. Where there's work that needs to be done and the social will to pay for it, I don't think a steady-state economy is necessarily miserable.
All the investment scenarios retirement companies show to convince you to save with them assume a 6% nominal return. I don't know if pensions have the same assumption, but nobody's getting an average 6% return over the next 30 years.
You need to save enough money to afford a mansion with a greenhouse and a guy to serve whisky to the private eye you've hired and enough to pay the private the to find out that your one daughter shot the other daughter's husband and enough to pay to hide the nude pictures of the first daughter while paying the gambling debts of the other.
91: yes, that's the minimum for a decent life.
No one is considering that there will probably be lots of cheap labor because of all the climate change refugees?
We're all counting on it, but didn't want to be the one to bring it up.
It's right in Werdna's original post.
94: Oh, yeah, possibility number 2. Sorry!
Wasn't Japan's economy steady-state or contracting on average for decades? (Not sure, but I think this is the case.) And it was still an ordinary wealthy developed country, not a collapsing hellscape where the living envied the dead.
I'm no economist, but as I understand it Japan has staved off economic crisis by massive stimulus spending and quantitative easing, as a result of which it's now by far the most indebted country in the world (the government debt to GDP ratio is over 250%). Just servicing that debt accounts for half of tax revenue, even at almost zero interest rates. Most of the debt is held domestically as bonds, so it's not vulnerable to international pressure, but with the population aging so fast, meaning lower tax revenues and higher spending on social security and healthcare every year, that level of debt isn't sustainable indefinitely. What I read is that if Japan can't grow itself out of debt (e.g. by accepting large numbers of immigrants), eventually the government will eventually have to implement austerity programs, and that won't be pretty.
63 I'm the "concierge". My husband used to be the "concierge", but he's dead. Now I'M the "concierge".
Awaking Godzilla is a job creation program.
96: Or, ultimately, just write off the debt, which as you say is mostly held domestically, AIUI mostly as retirement savings. By the same people who need elder-money from the state. Or are there another trillion dollars of paper riding on the bonds as collateral?
I think they'd inflate it away before writing it off.
As I vaguely understand it the entire economic history of modern Japan is a cycle of unsustainable debt accumulation followed by vast writeoffs. Some of which involved hyperinflation and major warfare, but I'm sure they can do better this time round.
Well, from my reading of Brad Delong, the perennially growing economy is a modern phenomenon, and relies on burning buried sunshine
It would surprise me if DeLong thought that economic growth is incompatible with addressing climate change. When DeLong talks about growth as a modern phenomenon, "modern" is the last three hundred years or so. So we've had a good run, and there's no necessary reason it has to stop soon.
I like the phrase "buried sunshine," but nowadays we have actual sunshine to work with in the form of sun and wind, along with tidal forces and who-knows-what.
Also, I think rich old countries learning to live with vast numbers of immigrant carers is no less plausible than any other possible solution, will anyway be part of whatever actually happens in almost all countries, and is at a global level a lot more just. Here the single largest group of immigrants (IIRC ~1/4 of total) is Indonesian women working in health and elderly care. I see them at hospitals and escorting people around parks and stuff. Mostly they just look bored, but some of them appear to be really friendly with their charges. And probably I'm being unduly optimistic, but I'd like to think a lot of those women or their relatives could move to better-paid fields, for instance teaching Indonesian, which the government now intends teaching at scale in state schools, along with other SEA languages.
They could do what my widowed uncle did and marry a much younger woman from the Philippines to care for him in his old age. She hasn't stabbed him yet.
If you do that, you do need to expect that my sisters will tend to avoid you and be very distant when they see you.
Indonesian women working in health and elderly care
Are they employed as domestic servants who are effectively tied to one employer, like in Hong Kong and Singapore, or in institutions? I remember a young Indonesian woman working in a bed and breakfast where I stayed on Roc Island who was deeply unhappy, complaining that her employer made her work from early morning to late at night for low wages with no days off or holiday. She hadn't seen her husband and child in a couple of years. That doesn't seem to be a particularly just model for other countries to follow.
To give a general sense of where I'm coming from in this thread: natural resources are a real constraint on material wealth. The labor supply is a real constraint. Productivity is a real constraint.
Economic growth, and finance generally, are artifacts of how we account for material wealth. If there's not enough food to go around, or safe places for people to live, there's a real problem. If there aren't enough workers to perform the services people need, there's a real problem. But if the resources and the labor exist, then all the problems are political problems of distribution.
That doesn't mean they aren't hard problems, but they aren't insoluble in the sense of 2+2 is never going to equal 5, and I think it's incredibly muddling to clear thought about this sort of issue to confuse material constraints on available resources with distributional problems.
108: Both, though I think mostly institutional. I know little. Low-skill migrants are indeed often, maybe mostly, mistreated; like I said, I'm probably too optimistic. (Though AIUI it the woman you met wasn't working in health/care.) And again, I think ensuring decent labor conditions for migrant carers is no less plausible than other alternatives. In a loose sense of "justice" one could also plausibly say (though I don't) that employing people in richer countries than their own can increase net justice, even with shitty working conditions (I think rich countries are obliged to ensure decent conditions regardless).
Most of the staff that takes care of my stepdaughter are immigrants. It's unfortunate, because she doesn't like people with accents.
Also, my mentally handicapped cousin in Israel is cared for by a Nepalese woman. My mother always describes her as a saint.
I mean, honestly, we're all fucked. I'm just thinking, try to take the good with the bad.
I think a steady state economy needs to have a lot less social mobility though. Falling down the ranks doesn't hurt so much if you are still better off than your parents. I think a lot of the hypercompetitive preschool though college stuff if from parents realizing their kids might end up objectively worse off. Also, all the growing fascism in small town rust-belt areas. Obviously financial redistribution helps with this, but that seems a lot less likely to me. Steady state = feudal style strong class distinctions, hopefully with less famine and plague, and the brutishness only in the movies.
The current economy could shrink a whole lot while increasing the incomes of people in the lower half of the income distribution.
If we did get to a cap, auction, rebate treatment of fossil fuel -- cap to control atmospheric CO2, auction the sellable fuel after extraction, rebate the auction income per capita -- could most old people live on that? Does in-home, not-medically-intensive care use less carbon than surgical interventions do, or more? (Exasperating that medical prices are so wonky I can't guess.)
I have zip-doodle faith in the `involved community' approach based on, e.g., Akenfield, in which the first visiting nurse remembers finding aged person stuck in cupboards as a form of in-home care. Possibly better than Eppie in the coal-hole, which was also a reasonable approach given real constraints.
Did they clean out the coal hole first?
Looking at it through the savings/investment/expected return/economic growth lens is probably misleading. Savings are just a way for people now to get a claim on the labour of other people in the future. But they could get that claim in other ways, for instance by increased taxation.
The situation is this: at present looking after dependent old people consumes a certain amount X of our labour as a society. In the future it will consume X'. How will the gap X'-X be filled? Forget about "paying for it via investments" - this is about how we allocate labour.
1) Same way it is today because at present we devote a fraction X/E of our economy where E is the size of the economy to looking after dependent old people, and either economic growth means that X/E = X'/E', which means it can be achieved without policy changes, or because technological advancement (robots, health care improvements) or changes in employment (more immigrants) mean that X'=X, or a bit of both.
2) More taxes in the future to pay for greater care spending - either monetary taxes, or taxes in the form of extracted unpaid labour from family members.
Those are really your only two options.
Feminist liberalism as it developed in the West over the twentieth century involved a general emancipation of women from unpaid work within the home. The work still needed doing, of course, but it was now accomplished partly by machines, and partly by other women who were paid cash or the equivalent for their services. Most of the work that had to be paid for, rather than mechanised away, was child care.
Is this actually true? Because papers like this https://www.nber.org/digest/oct08/w13985.html tell a very different story. The process happened in two stages: as you go from 1900 to 1965, US housewives did about six hours a week less housework, but mainly because they had significantly fewer children (not because of things like running water, washing machines etc).
By 2005, they did even less housework than in 1965.
The slack was not really taken up by employed servants, but by men, who increased the amount of housework they did; women did 18 hours a week less in 2005 than 1900, but men did 11 hours a week more.
Machines did not reduce the amount of hours; they increased productivity, allowing a healthier and more varied diet and cleaner and more comfortable surroundings.
42: I think we need to listen to Moby here.
That wasn't a really hard prediction.
Moby was more than five months ahead of Joe Biden on this, but was Moby's name even floated as a VP candidate? It was not! I blame the feminists.
The Star Trek asshole with the first reply hopefully feels a bit abashed but has probably moved on to worse things.
Anyway, I'm not saying my name was floated, but if it was floated, we need to burn this entire blog before the background check started.
"Mr. Hick, can you explain just what is meant by NMM?"