Wednesday, January 9, 2013

The Fiscal Nightmare of Aging

SAN DIEGO (Eileen Beal) --Keeping older people healthy so they can be independent and productive well into their 70s – and even 80s – isn’t just a medical challenge, it’s also an economic challenge, said Michael W. Hodin, executive director of the Global Coalition on Aging at a recent Gerontological Society of America workshop.

Due to the longevity revolution the world is experiencing, it’s a challenge that even developed nations aren’t addressing well.

Take age of retirement here in the United States, for example. Back in the 1930s, United States, still reeling from the Great Depression, created Social Security for older people (at the same time that other developed nations were creating their cradle-to-grave social insurance programs).

Increasing Vitality Beyond 65

Back in 1935, Social Security’s first actuaries calculated when people could begin collecting their government pensions and were surprisingly accurate in estimating the percentage of seniors in today’s American population. But they assumed that by the time people reached 65, they’d only live a few more years. In 2013, though, someone reaching age 65 in the U.S. can expect to live another 17 years on average.

The vitality of the senior population has increased in every age bracket discussed by experts in aging, the young old (those 65-74), middle-old (75-84) and old-old (85 and up).

“It’s obvious,” Hodin said, “that 20th century ‘norms’ [for retirement] aren’t conforming to 21st century realities.”

It’s not just retirement “norms” that aren’t addressing the reality that we are aging differently than Social Security’s actuaries thought we would. Health care “norms” aren’t keeping up either.

For starters, said Hodin, in this longer-lived population, the U.S. needs to increase vaccinations, not just flu and pneumonia vaccination rates. The country needs to address hearing and vision loss -- and develop cheaper drugs to manage the later. We need more dermatologists -- there’s an explosion of skin cancer looming. We need better options for treating osteoporosis.

Also, we need to cure or slow the progress of Alzheimer’s disease. Hodin said, “No one saw that coming, and it’s a game-changer in health care.”

In his data- and chart-filled presentation, Hodin zeroed in on the major factors that have come together – all around the world – to create either a health care fiscal nightmare or an engine for economic growth.

The first is the longevity bonus: Life expectancy has skyrocketed. “By mid-century, 75 percent of those over the age of 60 will be living in developed nations,” said Hodin.

He added, due to migration to cities and other nations, rural areas all over the world will be “hollowed out, populated mostly by the elderly.”

The second key development is that women – all over the world, not just in developed nations – are having fewer babies. So, while more hands-on care providers and services will be needed, fewer younger people will be available to fill those roles.

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