One Child (20 page)

If you look at modern China today, of these three, Fu, Lu, and Shou, probably the weakest is Shou.

Longevity, after all, is now easily achievable by all but an unlucky few. The average Chinese person can expect to live until seventy-four, a big jump from World War II, when the average life span in China was just thirty-nine.

Luck, the most ephemeral of beasts, is still hotly pursued. Prosperity is equally desirable, given there won’t be much of a social safety net for China’s huge elder cohort. Nobody wants Shou without Lu, and yet almost certainly China will have one without the other.

It’s now an old saw, the saying that China will “grow old before it grows rich.” I’ve heard this gloomy prognostication offered by economists, academics, politicians, and the average person on the street, said with an air of inevitability and submission. Nobody, it seems, is raging against the dying of this light. As the Chinese saying goes, it would be like playing a lute to a cow, an utter waste of effort. It feels irreversible, inevitable. Deng’s economic reforms may have lifted 500 million above the poverty line, but that still leaves nearly a quarter of its 185 million retirees living on less than a dollar a day.
China’s graying transition is a first-world problem, but China hasn’t achieved first-world prosperity yet. Despite becoming the world’s second-largest economy, its per-capita GDP is just a sixth of South Korea’s, and one-ninth the United States’.

Some, of course, see prosperity in China’s longevity boom. Ninie Wang was an executive at Motorola when she came up with the idea of starting a company that would be a version of AARP, the American Association of Retired Persons, and the UK’s Saga Group. It would offer a range of lifestyle services such as dancing, travel, and computer lessons to affluent middle-class retirees. She even envisioned classes
for teaching modern child-rearing methods, geared toward doting grandparents.

Wang wrote up a business plan that won her the Roland Berger prize, awarded to the INSEAD student with the best entrepreneurial concept.

She christened her brainchild “Pinetree.” “I wanted Pinetree as a name because the word for ‘pine’ in Chinese,
song
, sounds similar to the word for ‘relax.’ I didn’t want traditional, depressing names, like ‘Golden Sunset,’” said Wang.

Wang is in her mid-thirties but looks younger because of her clean-scrubbed look and honey-colored complexion. With her unflappable air and commonsense pronouncements, Wang comes across as the girl who always gets voted class president, the one who seems older than her years, who ticks all the right boxes. And so she did: raised by a loving extended family, Wang studied economics, found a suitable marriage mate, and was a rising executive at Motorola before heading to business school. Her professors at INSEAD awarded her the Berger prize not because her business plan was flawless, but because they felt confident the capable Wang would execute it.

When I first met her at a vegetarian restaurant near her office in 2013, Wang appeared to have only a couple of items left unchecked on her bucket list: having a child and growing Pinetree.

Wang built Pinetree’s original concept on what seemed like a sound premise. In China, the arc between retirement and terminal illness is probably longer than anywhere else in the world. Men retire at sixty, and women at the staggeringly early age of fifty, long before their contemporaries elsewhere.

Wang figured this herd of retirees would need something to do with all their leisure time, and she meant to fill it. In 2004, she launched Pinetree, with annual membership rates priced at about 10,000 RMB, or a little over $1,600. She forecast the company would hit $1 billion in revenue by 2008.

But Pinetree flopped. After two years, it had only two thousand members, and only after Wang slashed subscriptions several times.

“People loved it, but they didn’t want to pay for it. It came under one of those ‘nice to have’ things, but it wasn’t something they had to have,” said Wang.

Wang, like other entrepreneurs eyeing China’s vast retiree market, had come up against a dismal truth: the market was huge, but China’s retirees simply weren’t willing to spend. Unlike America’s, who’d prospered during the postwar boom years and felt entitled to enjoy their golden years, people in China, who’d lurched from crisis to crisis following the Japanese Occupation, had fewer resources and also, said Wang, an inherently different mindset. “They want to save money to pass on to their children and grandchildren.”

So she went back to the drawing board, asking herself, “What do old people in China want?”

The answer was surprisingly easy, and probably much the same as anywhere else. Old people in China want to live at home and maintain their lifestyle and independence as long as they can. More to the point: their
children
—many of whom pay the lion’s share of bills—also want this, for putting your folks in a nursing home is still stigmatized in China’s Confucian society.

Home health care is still largely a private concern in China, unlike in other countries where it is funded through a mixture of government services and insurance. China’s insurers are currently rolling out some eldercare packages, but targeting people currently in their forties and fifties, so these products are still largely theoretical. China’s current crop of people in need of home health care, people mostly in their mid-sixties upward, are generally paying out of pocket.

Wang relaunched Pinetree in 2010 as a provider for home nursing services. For modest per-visit fees ranging from as little as $16 to about $120—laughably little by Western standards—Pinetree’s personnel make house calls, monitor medications, and supervise physical
rehabilitation. Unlike home health-care aides in the West, these are trained nurses, therapists—in some cases, even doctors—and they don’t cook or clean.

Business grew quickly. In 2009, Pinetree had 20,000 subscribers. Two years after its relaunch, Pinetree had more than doubled its number of subscribers to 50,000. By 2015, this had jumped to 170,000, and Pinetree had expanded to Shanghai. Pinetree broke even in 2009 and is now profitable, says Wang, who aims to expand Pinetree into a nationwide franchise.

World domination it isn’t, though. With such small costs per transaction, Wang depends on large volume. Handling a large, mobile staff requires good management skills to ensure consistent service. On the bonus side, Pinetree needs little capital infrastructure spending, so Wang is able to grow the business quickly.

“It’s not rocket science,” said Wang with a laugh. But for all her self-effacement, Wang is fiercely ambitious. She is lobbying for government funding and wants to expand Pinetree’s services to suburban areas. She would like Pinetree to eventually cover 5 million senior citizens. “The whole world is aging. I’d like to think maybe China could offer some solutions for how to handle this gracefully,” she said.

It’s unclear yet what those solutions could be, for much of Pinetree’s model—relatively cheap and abundant trained personnel, high population densities—seems unique to the Middle Kingdom. I learned a little of this through accompanying some of Pinetree’s nurses on their in-home visits.

One summer day I met Nurse Gao at Chaoyangmen’s subway station. To keep costs down, Pinetree’s nurses take public transportation or bicycle to their various appointments. It’s not easy in a place as sprawling and traffic choked as Beijing, requiring smart scheduling.

Nurse Gao, twenty-five, was a tanned native of rural Jiangxi Province. She’d been with Pinetree three years. We headed to a five-floor
walkup nearby. The patient, let’s call him Chen, was a seventy-three-year-old retired government official who suffered from early-onset Parkinson’s and Type 2 diabetes. Two years previously, he broke his hip and had since been wheelchair bound. With no elevators in the building, he had scarcely been out of the apartment.

Before entering the apartment, Nurse Gao slipped on a mint-green overall with the Pinetree logo and pinned on a nurse’s cap, also green. She put plastic covers over her shoes and handed me the same.

Chen and his wife lived in a spacious one-bedroom apartment with a sunny balcony. Their twelve-year-old grandson was playing computer games in the living room. Chen spoke slowly but was chatty. As Nurse Gao took his blood pressure, they chatted about his daughters and how city folk preferred girls to boys now. He told me about his niece, who had a good job and a flat in Singapore but was unmarried and a source of worry to her mother.

It was clear that Nurse Gao had a good bedside manner, chatting breezily as she helped Chen through a series of hand exercises. She massaged his upper torso while he remained in his wheelchair. Later, they moved to his bed, where she had him perform a series of leg and hand lifts. He was breathing heavily and sweating by the end of it. “Work harder, you can do this!” encouraged Nurse Gao.

It didn’t look like a bad way to grow old. Chen’s wife was still in good health and able to help take care of him. Their children and grandchildren lived nearby. The stairs were an inconvenience, but otherwise the apartment was handily located in central Beijing, near several hospitals, shops, and the subway. More importantly, the entire apartment block was assigned housing under Chen’s previous work unit, so they knew all their neighbors. It was a village within a city. Everybody knew each other’s business so well, when Nurse Gao entered the building, a passing neighbor hailed her. “Here for a massage again?”

We hopped on the bus to the next client. Along the way, Nurse Gao filled me in on her job. Before, she worked in a hospital, attending to hundreds of patients daily. “It was hard. I became a nurse because I wanted to help, but after a while, they just become so many bodies.” (Long lines at China’s big hospitals are so endemic, it’s common practice to hire people to stand in line for you.)

Now she saw no more than six patients a day. Many, like Chen, whom she’d been treating for eight months, were regulars. She got to know their families, their little idiosyncrasies, and took pride in being able to see some heal and progress. They invited her to their grandchildren’s weddings, gifted her with little red packets at Spring Festival. Night shifts and working during holidays were things of the past. She can’t imagine returning to hospital work, she said. “I like being able to see my clients regularly. I can tell I make a difference,” she said, beaming.

My initial forays with Nurse Gao appeared to reinforce the general feeling I had of retirement in urban China. Stroll through any park on any given weekday between the hours of 10:00 a.m. and noon, and you’ll come away feeling like life post-retirement in China’s cities is a pretty decent affair. With such early mandatory retirement comes plenty of leisure time, and so the parks are filled with pensioners engaged in picturesque activities: dancing, tai chi, sword fighting, kite flying, and, my particular favorite, a form of geriatric graffiti that involves tracing out Chinese calligraphy on pavements using brushes and water, which dries and leaves no trace.

A friend’s father once took me to see him play Rouliqiu in the park, a favorite game among retirees using principles of tai chi and lacrosse. Using a paddle with a rubber center, he flipped a weighted ball to his partner, who caught the ball, twirled like a Sufi mystic, and tossed it back. More like a dance than a ball game, the sport was invented by a university professor in the 1990s and now has hundreds of thousands of adherents, not just in China.

So many retirees are practicing public dancing that municipal governments sought to place curbs on the noise emitted by their huge boom boxes. Affected residents have hurled abuse, water balloons, and in some cases excrement at these irrepressible “dancing grannies,” as they are dubbed by local media, to little avail. “Granny square dancing” has even become a competitive sport. In Jiamusi, not far from the Korean peninsula, locals have created a style—lots of coordinated hand and hip movements, performed in white Minnie Mouse gloves—widely imitated in elderly cheerleading competitions across China.

Parks and IKEA cafeterias have also become a hot singles scene for retirees. At Beijing’s Tiantan Park, not only are parents posting singles ads seeking mates for their grown children; now the elderly are doing it for themselves. Teng De’En, one of the organizers, shows me a fat folder of ads he brings to the park every Sunday. For 5 yuan—about 80 cents—subscribers between the ages of sixty and eighty-five place lonely-hearts ads. They typically list things like age, blood type (thought to predict personality), horoscope, and whether or not they have that all-important Beijing household registration.

This emphasis on what kind of household registration you have is quite common in the young singles scene. I hadn’t thought it would be such a big deal for the elderly, who’d already raised their families. Of course, I hadn’t thought it through: health benefits are tied to your registration status, and city dwellers get better coverage than those with rural residency permits.

Matchmaker Teng, a crusty divorcé, was himself in search of a new mate. His only daughter lived in the United States, and remarriage after sixty was becoming more socially acceptable, he said. “Who wants to die alone?”

This self-sufficient, vigorous vision of China aging is its most public, most engaging face. But there’s a side to aging in China that is easily hidden. On one of my forays with Pinetree’s Nurse Gao, we
visited a woman in her eighties, living alone with severe diabetes and early-onset dementia. Almost all of Nurse Gao’s clients paid for treatment, but this woman’s once-weekly Pinetree tab was paid for by the local municipality.

We heard the TV blasting as soon as we entered the building. Nurse Gao banged on the door, yelling, “Granny, Granny, it’s me, Little Gao!”

There was no answer.

Nurse Gao then fished out her phone and called her, whispering, “She’s a little deaf.” Finally the door opened. An old lady, her bleached face emerging from the darkness, eyed me incuriously. She turned around and shuffled back to the TV set. For the rest of the time, her eyes never left the set.

It was playing a Thai soap opera, her favorite, said Nurse Gao. A miscarriage, an awakening coma patient, and a bankruptcy erupted in swift succession across the screen. Nurse Gao kneaded the old lady’s arms and legs, keeping up a patter that petered out. Questions on her diet, her daily habits, her exercise patterns, her bowel movements all died on the vine.