Thanks in part to the medical advances in our country and indeed worldwide, our country and globe are predicting a striking increase in the number of people 65 and over. Other factors contributing to this are the increased fertility that occurred in the immediate post World War time –most often referred to as the baby boom.
The U.S. census figure below shows some very important history and trends. In terms of the history based on facts about our population through the 2010 census we see that during the 20th century this country saw about an eight-fold or 800% increase in population over 65. However, looking into the future during the first quarter of the 21stcentury, the aged population will double reaching over 70 million Americans by 2030. The remarkable, steep rise is due mainly to the baby boomers. By 2050, it is predicted that over 20 percent or 83.7 million of the U.S. total population will be over 65 years old. At present only 13% of the population is in this older category.
It is generally agreed that factors that improve human health have improved. In this country and the world there is been improved water, hygiene, and food. The vaccines that protect against a wide variety of infectious diseases have cut mortality from this cause. Knowledge concerning infections and infectious disease as well as use of antibiotics to kill known pathogens has cut mortality. The death from our still leading cause of mortality, heart disease, has seen a tremendous improvement with the new medicines and approaches to treat coronary artery disease. This has resulted in an extension of life in those who ultimately do die from heart disease. Cancer also has seen a reduction in mortality and extension of life with this set of diseases.
The U.S. population has learned to stop smoking and to exercise. These two changes in life-style have contributed enormously to longevity, but are increasingly being offset by the trends that lead to an increase in obesity. The foods we eat as much as anything are contributing to the burgeoning weight of our population, helped in large part by all the unhealthy fast food choices available to so many.
Fertility in the U.S. is fairly constant after the baby boom period and this explains the leveling off of the percentage of U.S. elderly seen after 2030. It is expected that the U.S. fertility rate will be perhaps a tad over two, meaning an even replacement for each couple and only a gentle increase in the elderly after 2030 due to increased longevity.
Public policy and medical resources will definitely be tested by the escalating older populations. Simply put, the elderly are not as well as the young. We have more disease, more medical needs like doctor visits, hospitalizations, and surgery. We have more need for medicine and we take a greater share of healthcare expenditures. These facts have at least two major implications. First, medical staffs and facilities need to be prepared for the greater number of patients who need/desire medical attention. Books can and are written about these needs. Second, among the great number of the policy questions is how to pay for all of the anticipated services, most of which are largely covered by Medicare. The added costs come at a time when the workforce supporting the costs is not rising and this creates an obvious dilemma that politicians do not often address.
In 2015 the Center for Budget and Policy Priorities reported: “The 2015 report of Medicare’s trustees finds that Medicare’s Hospital Insurance (HI) trust fund will remain solvent — that is, able to pay 100 percent of the costs of the hospital insurance coverage that Medicare provides — through 2030. Even in 2030, when the HI trust fund is projected for exhaustion, incoming payroll taxes and other revenue will still be sufficient to pay 86 percent of Medicare hospital insurance costs. This shortfall will need to be closed through raising revenues, slowing the growth in costs, or most likely both.” So there is still time to figure this policy problem out, but it can’t wait too many more election cycles.
Those of us over 65 can expect to see many more “older” folks in the coming years. Life expectancy now when one reaches 65 goes to 84 years. If we reach 85 we can expect to live 6.5 more years. If we do the things preached in this column like don’t smoke, exercise, eat well, and drink in moderation we are likely to continue to see this graying of America.