As parents age, it gets more and more difficult for them to take care of themselves, and eventually the responsibility of tending to one’s parents both financially and psychologically falls upon other people. The manner in which parents are cared for as they age varies across cultures, and in some places aging parents can become a perpetual problem due to too large of an aging population and a lack of systematic healthcare systems. In China, this phenomenon has been especially difficult to address, as China has “the largest elderly population in the world” and is “aging at an unprecedented level” (Zhang et al., 1). In the United States, however, although aging parents is still a difficult issue to address, this situation is dealt with differently due to different cultural expectations regarding the role of family in caring for parents and because “safety net systems cover the majority of the elderly” (Zhang et al., 1). Additionally, wealth inequality and rural-urban inequality affects how individuals are able to care for their parents in both countries. In this essay, I will analyze the differences in practices and ways of thinking regarding how to care for one’s parents between the United States and China across culture, societal systems and policies, and how wealth and inequality affects these practices.
In China, there is a cultural emphasis on “filial piety”, a tradition which was emphasized during the agricultural and economic reform of the 1950’s and 60’s. This has made it so that “the family is traditionally responsible for taking care of their elders” (Zhang et al., 1), by not only physically taking care of them but also financially. This can be seen in Spring Grass both in decision how Spring Grass’s Aunt feels obliged to live in their house during her childhood, but also in how when Rivers Ho first finds out that she is covering her mothers treatment he responds with understanding, saying “if you didn’t do anything, you’d end up like me and regret it in the future” (Qiu, 23.9) Robbie’s strong regret that he did not support his parents is also representative of how traditionally, “patrilineal culture has led to parents in most parts of rural China to rely on sons rather than daughters for support” (Zhang et al., 2). Although this does not apply to Spring Grass, she does not represent a traditional Chinese woman. She actually has many qualities of traditional Chinese men, such as entrepreneurship desire, educational prowess, and freedom of love, which could be why she ends up paying for her mothers treatment.
In the United States, however, caring for one’s parents is also a filial duty, but more driven by an attitude of financial success and the American dream. A part of the American dream is to work hard through the capitalist economic structure and become successful enough so that you can then cover your parent’s expenses. Many successful athletes and celebrities greatest personal achievements is allowing their parents to retire early. In addition, there is also a traditional emphasis on patrilineal culture in the US as seen by idioms such as “like father like son” and “follow in your fathers footsteps”. However, this patrilineal attitude is more about financial success than personally caring for your parents, representative of the American dream. In addition, this financial support is not as substantial as in China, especially before the implementation of the NRPS program in 2009 which paid subsidies to elderly people, due to America’s Social Security system.
In order to better understand the differences between China‘s and the United States’ social structures that assist elderly people as they age, I will first lay out the difference between the general healthcare systems between the two. In China during the 1950’s, there was an increase in the general health of Chinese citizens due to President Mao Zedong’s policy push to “make concerted efforts to promote rural healthcare” due to the want to protect the agricultural production based economy (Shi, 724). However, when the focus of China shifted to heavy industry, several policy changes led to a disparity in healthcare between rural and urban districts. In 1978 there were several policy reforms which centralized the healthcare system around city districts, and access to city healthcare was now determined by one’s hukou status. This not only led to disparity between the quality of hospital services between rural and urban districts because of a decrease in investment into rural health services, but also greatly impacted insurance coverage and hospital fees (Shi, 729). Due to the change in funding for rural hospitals, hospitals had to shift to a fee-for-service system, and by 1986 “only 9.5% of the rural population was covered by comparative medicine, compared with 90% in 1978” (Shi, 725). This can be seen in Spring Grass in how Robbie takes his wife to the Shanghai hospital for the best treatment, and how both Robbie and Spring Grass have to pay out of pocket for these treatments. Finally, in a data analysis report in 1993, it was discovered that “The people most affected by these changes are the rural elderly” (Shi, 732), which is why it is especially important to understand the social health care system in China as it is applicable to the manner in which elders in China are cared for.
In the United States, however, there is a comprehensive Social Security system which pays out checks to senior citizens that can effectively cover most essential goods, and many jobs offer retirement benefits. In addition, insurance is emphasized in every aspect of healthcare, from complex surgeries to simple medicinal treatments. Even here at Williams, the school offers health insurance to students. Due to the naturally capitalist nature of the American economic system, it is financially beneficial for both hospitals and insurance companies to have extremely high prices as well, a phenomenon that emerged from the health sector boom of the 1970’s and 80’s. This may be economically beneficial, but these high prices and emphasis on insurance leads to an inequality of access to healthcare between wealthy and non-wealthy citizens, as if one does not have insurance in the US, it is practically impossible to afford healthcare to the astronomically high service fees.
The difference in how wealthy and non-wealthy Americans can afford to take care of their parents is also seen in China, but more based on a rural-urban disparity. As mentioned above, the healthcare policy changes in 1978 decreased the funding toward rural hospitals, and “the differences in resource allocation to rural and urban areas have increased” (Shi, 727). This also disproportionately affects elderly people, as “80% of elderly live in rural China. The greater challenge that rural elderly face due to the worse quality of care and lack of insurance can be seen in a study regarding the New Rural Pension Scheme, where not only did they find that “the NRPS only has significant effect on the poor elderly” (Zhang, 2), but they also discovered that “pension income crowds out 27.9% of the monetary support from adult sons” (Zhang, 1). The large amount of monetary support of children to parents can be seen in Spring Grass in her hesitancy to “withdraw such a large part of their savings to pay for her mothers operation” (Qiu, 23.3). In addition, the difference between wealthy versus poor families and their ability to support their parents can be seen when Rivers Ho comments on how Robbie was able to pay to treat his wife’s breast cancer and says “that’s because he has money. If it was us, wouldn’t we be as good as dead and gone.”(Qiu, 23.4). The difference in supporting aging parents between poor and wealthy families is also seen in America.
In America, there is also a gap between the rich and poor and their ability to care for aging parents, but not necessarily based on rural-urban disparity. If an American is wealthy, then usually they would put their parents into a retirement home, or even hire full time nanny care. Although these usually can be quite pricey, they are not strictly in urban locations. In fact, there is even a retirement home in Williamstown which goes to show that the inequality of access to parental care is not limited based on rural-urban locations.
In conclusion, there are both similarities and differences between the US and China in the manner in which the elderly are cared for. Both cultures see the importance of the younger generation assisting their parents, but the United States emphasizes the financial aspect. In China, there is less of a social support system than in the United States, but both societies face unequal access to affordable healthcare for parents, in the United States due to exorbitant prices while in China due to urban-rural disparity.
Word Count: 1450
Works Cited:
Qiu, Shanshan. “Spring Grass” Chapters 22-24
Shi, Leiyu. “Health care in China: a rural-urban comparison after the socioeconomic reforms” 1993, pp. 723-736
Zhaohua Zhang et. al., “Who are the Beneficiaries of China’s New Rural Pension Scheme? Sons, Daughters, or Parents?”, International Journal of Environmental Research and Public Health, 2019.