Projections that the baby boomers will tax our health system have failed to take technological advances into account.
Policy-makers who suggest big spending while holding policy more or less constant are failing to acknowledge the acceleration of health care innovation. It’s an expensive escape route and very likely false. For example, in an article published on HealthLeaders.com, the CEO of a company whose Web site proclaims it to be “the largest health care staffing company in the United States” calls for spending “billions” to train more doctors to fill a projected massive shortage in the United States.
Like many such projections, this one makes no reference to health care innovation and its accompanying surge of cures, preventive treatments, and home disease and disability management technologies. Fortunately, more rigorous projections are emerging that are at least making the attempt.
Even for health care services with the highest projected rates of growth among the baby boomers, aging is “a much less important factor than local population trends and changing practice patterns attributable to advancing medical technology,” according to a report by Bradley C. Strunk, a consulting health researcher at the Center for Studying Health System Change; Paul B. Ginsburg, president of HSC; and Michelle I. Banker, a health research assistant at HSC. Their credible study, published in Health Affairs, recognizes and tries to account for the impacts of technology on demand for hospital inpatient services. They state: “Although aging will likely have an important impact on spending, its magnitude will be dwarfed by the impact of advances in technology and other factors that affect medical practice patterns.”
Further evidence that the future painted by baby boom doomsayers is not what it used to be is available from as credible an authority on population trends as one could wish for: the U.S. Census Bureau. Reporting on the bureau’s recent report “65+ in the United States: 2005,” New York Times writer Rick Lyman commented (March 10, 2006) that “the economic and social impact of this baby boomer sunset may be gentler than had been feared.”
The report shows that today’s older Americans are more prosperous, better educated and healthier than previous generations, and that those attributes will improve further by 2011, when the first boomers reach retirement age. The director of the National Institute on Aging, on whose behalf the study was conducted, said, “Older Americans, when compared with older Americans even 20 years ago, are showing substantially less disability”--suggesting that disability will happen increasingly later in life.
Some salient statistics:
- The percentage of those over 65 who had what the report described as “a substantial limitation in a major life activity” due to disability fell from 26.2 percent in 1982 to 19.7 percent in 1999.
- In 1900, there were 120,000 Americans--about 0.1 percent of the population--over age 85. Today there are more than 4 million, or about 1 percent.
- In 2003, there were 35.9 million Americans over the age of 65, about 12 percent of the population. By 2030, there will be 72 million--about 20 percent of Americans.
- In 1959, 35 percent of people over 65 lived in poverty. By 2003, that figure had dropped to 10 percent.
- The proportion of older Americans with a high school diploma rose to 71.5 percent in 2003 from 17 percent in 1950.
Adding to the optimism is a scholar who has calculated that the age of retirement will be 85 by the year 2050, based on technology’s ability to increase the average lifespan by one year every year between 2010 and 2030. Shripad Tuljapurkar of Stanford University reported his findings at the American Association for the Advancement of Science 2006 annual meeting.
All this does not mean that some expansion of medical and nursing school enrollment will not be necessary. But we cannot know how necessary unless we factor in new variables that have arisen and will continue to arise as a result of the acceleration of health care innovation.
David Ellis is corporate director of planning and future studies at the Detroit Medical Center and publisher of Health Futures Digest, a monthly online discursive digest of news and commentary on long-range, leading-edge technological innovations and their consequences and implications for health care policy and practice. Mr. Ellis is also a regular contributor to H&HN OnLine.
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