Japan’s ageing population problem might be the worse in the world, but it’s one that all developed economies are facing. The problem seems so intractable that Yale economist Yusuke Narita’s suggestion that the elderly commit mass suicide made international headlines. That is not a serious policy suggestion, but radical measures are needed. Charles Goodhart argues that instead of the state financing the day to day lives of retirees via a state pension, it should instead prioritise financing the increasing medical care costs of the elderly.

Japan has the highest proportion of elderly people in the world, with 29% of the population being over 65. These numbers, combined with an increasing life expectancy, bring along a host of problems. Older people tend to need more medical care, which is both expensive and requires a lot of human resources. In most developed countries, the state provides a large part of the support needed, meaning an increasingly smaller number of young people in employment foot the bill via taxes. This raises issues about economic growth, but perhaps more importantly, intergenerational justice.

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This is where the Yale economics professor named Yusuke Narita comes in. A recent New York Times profile of the 37-year-old triggered outrage at his suggestion that the solution to Japan’s ageing population problem is “mass suicide” or “mass seppuku”, essentiallyself-disembowelment, something practised by dishonoured Samurai in the late 19th century. He has since watered down his claims, saying that they were merely “abstract metaphors”. But an earlier comment by him in which he qualified his “mass suicide” suggestion, drawing a distinction between the necessity of the policy and “Whether that’s a good thing or not, that’s a more difficult question to answer” indicates that he meant what he said.

Despite Narita allegedly having quite a following amongst Japan’s disaffected youth, his proposals are clearly impractical, immoral, and almost certainly deliberatively provocative. But the problem of Japan’s ageing population remains in urgent need of a solution. What is more, this is not a problem unique to Japan, most developed countries have an increasingly older population, and are already facing versions of the same issues. The state alone cannot plausibly provide for all the needs of people who might come to live 20 or 30 years beyond their working life, and neither should it. Higher taxation is going to be inevitable, but the state should prioritise financing the “losers” of the health lottery, rather than the normal day-today living expenses of the elderly. Individuals are going to have to finance their own retirement plans, if the state is going to be able to support those who truly need care.

To be clear, the underlying problem is NOT age as such, it is medical dependency or the need for care in order to carry out the normal activities of daily living, something that rises sharply with age. If the aged remained relatively fit and healthy (and then died from some sudden organ collapse), they would not require large fiscal support from the state.  But, largely due to neurological diseases, such as dementia in its various forms, and Parkinson’s, for which medical science as yet has found no cure, but also to other factors such as arthritis, falls with brittle bones, osteoporosis, etc., the elderly do end up needing the state’s support.

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As things stand,the old (75 - 85), and old-old (85+) are now the fastest growing segments of the populations in virtually all developed economies

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