Summary of Key Points
With a low birth rate (only 7.92 million newborns) and an aging population (323 million people over the age of 60, accounting for 23%), cities are shifting their focus from attracting young people to attracting elderly individuals. However, not all elderly people are targeted; rather, the emphasis is on 85 million urban retirees under the age of 75 who have stable pensions and the ability to travel between provinces. These retirees carry an annual pension purchasing power of approximately 6 trillion yuan, which directly boosts local consumption, employment, and tax revenue. Cities compete through three main strategies: climate (Hainan, Yunnan), regulations (Chengde, Yangtze River Delta), and industrial chains (Panzhihua). Nevertheless, they face challenges such as zero-sum games (where one city's gain is another's loss) and mismatches between supply and demand (such as medical shortages and idle health care facilities). In the long run, the focus must shift from providing short-term subsidies to creating lasting value through services.
1. Not all elderly people are targeted; only those with money and mobility
- There are significant differences between two types of elderly populations:
- Urban retirees (142 million) receive an average monthly pension of 3,355–6,000 yuan, spending a total of 6 trillion yuan annually.
- Rural retirees (177 million) receive an average monthly pension of only 287 yuan, spending a total of 500 billion yuan annually (less than one-twelfth of the urban amount).
- Mobility is key: The 85 million urban retirees under 75 years old are in good health and willing to travel. They have the financial means to spend money across provinces, whereas rural retirees lack the ability to do so.
- Their purchasing power directly benefits local economies; for example, 1 million elderly visitors to Hainan generate nearly 10 billion yuan in spending on housing, dining, and medical services, while 980,000 elderly tourists in Yunnan contribute nearly 70 billion yuan, with both the number of visits and spending increasing.
2. How cities compete: Three different approaches
1. Climate-driven strategy: Leveraging natural advantages
- Hainan: A popular winter retreat for retirees, attracting 1 million visitors annually since it was the first to adopt this approach.
- Yunnan: With its diverse climates, it has transformed seasonal tourism into year-round travel, with average stay times increasing by 54% in 2025 (faster than the growth in visitor numbers).
- Jilin: A defensive strategy due to a high aging population (20.5% over 65) and population loss (a decrease of 4.49 million in 15 years); the government provides financial subsidies to attract visitors, aiming to add 30,000 beds and 3.8 million visits by 2027.
2. Regulation-driven strategy: Reducing barriers to intercity travel
- Chengde: Offers free access to scenic spots and public transportation for retirees from Beijing and Tianjin, and recognizes the evaluation results of health care facilities across regions.
- Yangtze River Delta: Standardizes the assessment criteria for elderly care facilities, allowing retirees from Shanghai to use services in Anji, Yixing, and Huangshan without having to comply with different regulations.
3. Industrial chain-driven strategy: Integrating health care into the economy
- Panzhihua: The health care industry accounts for 12.7% of its GDP (17.7 billion yuan in 2024). With multiple top-tier hospitals and improved transportation, it attracts 500,000 health care tourists annually.
- Guangxi: Builds a regional network with Nanning as the hub, generating 58 billion yuan in spending from 2.94 million elderly visitors in the first half of 2025.
3. Hidden concerns behind the competition
1. Zero-sum games: The total number of elderly people available for attraction remains fixed (85 million). If one province attracts more retirees, another loses them. The cost of attracting them through subsidies increases, but the overall size of the elderly economy does not grow.
2. Demand-side challenges: Medical infrastructure limitations
- Although over 90% of hospital admissions involve cross-provincial settlements, outpatient services for chronic diseases are limited to just 10 types. Since 75% of the elderly have chronic conditions, they must pay out of pocket for medication and follow-up visits, which discourages travel.
- A Boao survey found that while 15% of the elderly wish to travel, only 7.5% actually do so due to medical barriers.
3. Supply-side inefficiencies: High vacancy rates in health care facilities
- There are 7.99 million beds for the elderly nationwide, with an occupancy rate of only 45.4%. Seventy percent of health care companies have not found profitable models. On one hand, there is a shortage of services for specific needs (such as dementia care); on the other hand, the health care tourism market is highly competitive, with many facilities offering similar offerings (e.g., "hot spring + elderly care").
4. The long-term solution: Creating value rather than relying on subsidies
Short-term subsidies can attract visitors, but they do not ensure long-term retention. What truly attracts retirees are:
- A robust medical network for chronic disease services with cross-provincial settlement capabilities,
- Uniform standards for quality care,
- A sufficient supply of trained caregivers.
These improvements require time and cannot be achieved through subsidies.
The central government has begun to coordinate efforts to promote the mutual recognition of elderly care licenses and reduce barriers between regions. In the future, the success of the elderly economy will depend on cities that can address the medical and care needs of retirees. Only those cities that meet these requirements will thrive in an aging society. Subsidies provide temporary incentives, but sustainable solutions lie in providing quality services.
This competition to attract elderly residents is essentially a battle for their disposable income. In the long run, only cities that truly meet the needs of the elderly will succeed in the aging landscape.