Chilean President José Antonio Kast has logged nearly one hundred days in his new post. Since taking office, he has reduced the government’s spending—including its health and social budgets. In response to his critics, Kast has reasoned that while the government will spend less, it will spend each peso more efficiently.
Regardless of whether his budget cuts stick, Kast has a point: Chile should spend more efficiently, ensuring that every peso spent makes a maximum impact and, in turn, generates additional economic activity for the country. One of the ways Kast can do that is by improving Chileans’ access to the services they may need to live long and healthy lives.
Chile is aging faster than any other country in Latin America. Chileans above the age of sixty make up nearly 20 percent of the population, and that figure is expected to rise to 31.6 percent by 2050. Perhaps surprisingly to some, this group is a backbone for Chile’s economy: Beyond paid work, the unpaid work they do (including caregiving and volunteering in their communities) was estimated to have an economic value of $11.36 billion in 2021, equivalent to 4.5 percent of the country’s gross domestic product. While unpaid, this work generates tangible economic value by ensuring that others in their families and communities are able to contribute to the labor market.
Yet, the full potential of this segment of the population has not yet been realized. Roughly three out of every four older adults in Chile live with at least one chronic condition, which could impact their ability to work (whether paid or unpaid) and contribute to the economy. Additionally, dependency rates in Chile climb sharply with age, rising from 20 percent at age sixty to 62 percent by age ninety, meaning that younger family members, particularly women, could wind up reducing their contributions to the labor market to take care of aging members. And with regard to paid work, there’s a concerning gender aspect: Women in Chile live longer than men but in financially insecure conditions. Roughly 60 percent of older women work in the informal job market.
It is not enough for Chileans to live long lives—they must also be supported in living healthy and happy lives. If Kast can do that, he can help ensure that this demographic is not a fiscal burden but an economic engine.
What Kast has promised
In recognition of the United Nations Decade of Healthy Ageing, Chile has already introduced policies such as the National Policy on Positive Aging. It has also set up a network of social programs run by the National Service for Older Adults (SENAMA).
Additionally, a recently approved law on dignified aging orders the government to build a comprehensive public policy on aging within six months—one aligned with international frameworks and designed to outlast any single administration. While not a comprehensive public policy, Kast has thus far promised a couple of healthy aging initiatives.
During his campaign, Kast put forth a proposal called Plan Zero to eliminate health care waiting lists in Chile. It would work by sending unresolved public-sector cases to private providers through transparent agreements, backed by an estimated one-time investment of approximately $770 million. Over 2.5 million Chileans are currently on health care waiting lists, and the average wait for major surgery exceeds three hundred days. Plan Zero is directly related to healthy aging: Older adults disproportionately bear the cost of delayed diagnosis and untreated chronic conditions, and early, timely care is the single most effective way to reduce the number of days these adults spend affected by these conditions.
Kast, during his election, also put forward a Golden Generation Plan, which directly addresses Chile’s aging population. It seeks to improve and widen access to dignified care by professionalizing caregivers and expanding day centers and residential facilities. It would establish a senior employment statute promoting flexible work arrangements to encourage labor force participation among aging groups. Additionally, it would provide housing and financial relief by gradually eliminating property taxes for seniors on their primary residence, and it would focus on social participation and combating loneliness. The plan addresses the full spectrum of healthy aging: economic inclusion, care infrastructure, and social connection.
What Kast should do moving forward
Kast has the policy architecture. The question now is execution. Here’s what he should do next:
1. Launch Plan Zero with a focus on the aging population. The administration should prioritize clearing waiting lists for oncology, cardiovascular, and joint-replacement procedures, which skew heavily toward older patients. It should also leverage Chile’s existing—and increasingly advanced—digital infrastructure to track Plan Zero–related outcomes by age cohort in real time. Finally, it should use Chile’s Performance Management System, which incentivizes the public sector to collaborate on certain goals, to mainstream aging across all ministries rather than confining it to a single portfolio.
2. Expand employment opportunities for older adults who want to work. The recently approved law on dignified aging establishes a special employment contract for older people; but now, the administration must consider a second generation of measures (options for phased retirement, hiring incentives, and formalization pathways) that genuinely expand older adults’ participation in the labor market. Kast, who is framing his administration as an “emergency government,” should highlight the urgency of pension sustainability, since each additional year that a person works reduces fiscal pressure downstream.
3. Increase the options for daily care for the older adults who can’t work. The Kast administration should encourage the expansion of day care centers, including those offered by the private sector and by SENAMA, to defend against rising rates of dependency and loneliness. These day care centers are far more cost-effective for the government than residential care. Additionally, the administration should establish caregiver training standards and formalize caregiver roles. This is the lowest-cost, highest-impact intervention in the Golden Generation Plan. Currently, the care infrastructure gap is huge: Chile has approximately 23,000 nursing care beds, while there are nearly 500,000 adults with some degree of dependency who could need some level of care. Day care centers could help close that gap and also free up some of the currently taken beds by offering low-dependency adults an alternative option to relying on nursing homes or their families.
4. Bring aging policy to Chile’s regions. Historically, every contract the government has signed with providers of aging-related services has been at the national level through SENAMA, with nothing signed in Chile’s administrative regions. Local governments need the tools and, more importantly, the coordination capacity and budget to respond to their populations’ needs. Chile is already pushing a decentralized agenda—now, regional representatives (CORES) are elected to their posts and manage their own regional budgets. Aging policy should follow suit.