THE ADVENT
of baby boomers entering their sixth decade, with a population that is living longer, but not healthier, represents the potential for disaster in the healthcare industry in America.
THE BABY BOOMER BULGE, A PIG GOING THROUGH A PYTHON
It’s the “Baby Boomers!” The emergence of the baby-boomer generation has been driving many of the changes in American society and culture. Everything from hairstyles and health clubs to the Dr. Spock method of parenting is affected. Similarly, boomers are driving the healthcare needs of the future.
The Baby Boomers are the generation of Americans born between 1946 and 1964, after World War II. The leading edge of this generation turned 60 years old this year and by the year 2030, the entire baby boom generation will be 65 or over. Currently baby-boomers make up approximately 27% of the total population, or nearly 77 million people, representing a peak in the overall population of our nation.
Charting the baby-boomers on a horizontal graph would represent them as a bulge, referred to by aging expert and author Dr. Ken Dychtwald, as “a pig going through a python.” Every day, almost 11,000 boomers turn 50 – that is one every eight seconds.
Aging of the Baby Boomers
This bulge works its way through time and has had significant effects at each point in time. The baby boomers put stress on the educational system when they were coming through their K-12 years. They helped bring about a surge in the housing market when they reached middle age and, in the near future, they are going to put incredible pressure on American health care for generations to come.
While the boomers alone will create a notable rise in demand for healthcare services, the demand will continue to rise, rather than drop, as the boomer population decreases because everyone including the members of Generations X and Y are living longer.
ELDER BOOMERS ARE THE NEW AGE WAVE
• The number of Americans aged 65 or over will double by 2050
• The number of people age 85 or over will quadruple by 2050
• By 2030 over half of U.S. adults will be over age 50
• In the 21st century life expectancy may exceed 120 years
What next? Ken Dychtwald answers, “For starters, they are no longer baby boomers. They have become a continued demographic force – an “age wave”. As this generation travels along the lifeline, it will profoundly induce change in American society, now and for the future.
The boomers have broken the rules and exploded the norms at every stage of life they inhabit. Undoubtedly, they will continue to do so as they turn 60, 70, 80 or 100 years old. Imagine a nation not of baby boomers, but elder boomers. It’s coming. Our country is about to be transformed by an age wave that leaves each stage of life changed forever.”
LIFE EXPECTANCY ~ LIVING 120 TO 180 YEARS
It is not just the shear numbers of baby-boomers that will affect future health care needs and costs; it is also the overall increasing life expectancy in our society. Life expectancy in 1900 was 49 years and by the end of the 20th Century, it had increased to 77 years. The increase in life expectancy during that period was due primarily to basic improvement in living conditions as well as improved medical technology.
Futurists believe that we are again on the verge of making significant improvements in life expectancy so that in the future we may have life expectancy levels of 110 to 120. In fact, a program held at the World Future Societies annual convention in the summer of 2003 was entitled “Living 120 to 180 years.”
Life Expectancy at Birth 1900 to 2000
In one sense, increased life expectancy represents a human success story; America now has the luxury of aging. Or is it really a luxury? Most would agree that it depends on the quality of life we can maintain as our lives are extended years beyond expectations. But that isn’t always a pretty picture.
Take Gertrude from Wisconsin, for example. When she was born in 1911, her life expectancy was 53.2 years, yet she lived to almost 92. However, the difficulty was that after age 78, her health problems compounded. It began with diabetes, then a quadruple heart by-pass, followed in a couple years by a heart-valve transplant, then cancer and finally a punctured lung, which occurred while getting a pacemaker installed.
Her quality of life diminished and was dependent on thirteen different medications, family assistance, home care, then assisted living, followed by a series of hospital and recuperative nursing home stays. This all too common sequence of events and series of procedures tapped out Gertrude’s personal resources and used up many times the Medicare dollars she contributed during her working years. The point is that life expectancy often comes at a very high price financially and also in terms of human comfort.
SKYROCKETING COST OF CARE
The cost of health care has been rising at a rate much higher than inflation and family incomes. Health care expenditures in America have gone from 246 billion in 1980 to just under 1.7 trillion in 2003. The problem is compounded when employers discontinue employee insurance, contributing to the rising number of uninsured Americans.
Examples of Health Care costs in the United States
AMERICANS HAVE SUFFERED AN OVERALL DECREASED QUALITY OF LIFE
Results of a study that approximates quality of life published by the United States Department of Health and Human Services Centers for Disease Control and Prevention demonstrate that overall health-related quality of life worsened dramatically in the 12 years between 1993 and 2005. While this research does not conclude that the increase is related to extended life or to baby boomers, it does present a trend worthy of note.
BOOMERS WILL RESHAPE THE FUTURE OF HEALTHCARE
In May of this year, First Consulting Group, Long Beach, CA conducted a study that helps project the affect of the baby boomer generation on future health care in the United States. Following are some results and conclusions drawn from “When I am 64.”
“The wave of aging Baby Boomers will reshape the health care system forever. There will be more people enjoying their later years, but they’ll be managing more chronic conditions and therefore utilizing more health care services by 2030.”
- The over 65 population will nearly triple as a result of the aging Boomers.
- More than six of every 10 Boomers will be managing more than one chronic condition.
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- More than 1 out of every 3 Boomers – over 21 million – will be considered obese.
- One out of every four Boomers – 14 million – will be living with diabetes.
- Nearly one out of every two Boomers – more than 26 million – will be living with arthritis.
- Eight times more knee replacements will be performed than today.
Sixty-two percent of 50 to 64 year olds reported they had at least six chronic conditions (hypertension, high cholesterol, arthritis, diabetes, heart disease and cancer). As Boomers age, the number with multiple chronic conditions is expected to grow from almost 8.6 million today (about one out of every 10 Boomers) to almost 37 million in 2030. Since the biggest factors influencing medical spending are chronic illness and a patient’s level of disability, the growing incidence of multiple chronic conditions will put increasing demands on our health care system.
“The confluence of the large Boomer population, increase in chronic conditions and rise of available medical treatments will begin to impact health care in 2010, when the oldest Boomers turn 65 – when more health services typically begin to be used.”
- By 2030, there will be nearly twice as many adult physician visits as there were in 2004, and Boomers will account for more than four of every 10 of these visits.
- By 2030, if all Boomers with diabetes receive recommended care, they will need 55 million laboratory tests per year – 44 million more than today.
- Physician office visits will number more than one billion by 2020. Four out of 10 will be Boomers.
- The growing demand of chronic disease will increase the need for medical sub-specialists.
- The increase in longevity of Boomers – on top of advances in medications, less invasive treatments and diagnostic testing – will greatly increase the demand for cardiology.
“The severe workforce shortage will challenge the health care system’s ability to meet this Boomer demand”.
- In 2005 there was a shortage of about 220,000 registered nurses; by 2020 that gap will be over one million.
- Even if the number of geriatric specialists remains stable, there will be a shortage of almost 20,000 by 2015.
- Between 2000 and 2020 the supply of orthopedic surgeons will increase by only 2 percent while the demand will increase 23 percent.
- Between 2000 and 2020, the supply of cardiologists will increase by only 5 percent while demand will increase by 33 percent
- The projected gap for primary care physicians will increase as Boomers age.
THE DILEMMA
While the combination of the largest demographic cohort in history and the extended years provided us by new drugs and medical technology and procedures may not be a formula for disaster, it does raise a red flag and a few questions.
- How can we improve quality of life during our extended years?
- How can we pay for the health care that makes them possible?
- Where will we find the medical workforce to care for the elderly boomers?
- Will more baby boomers travel overseas to live or to receive health care?
- As more and more baby boomers get older, will Medicare allow payments to overseas providers to help reduce the cost of providing health care to baby boomers?
Bob Meister is a faculty member at CareQuest University. CQU provides education and certification for professionals in health care planning, financial planning and insurance. Most of Bob’s business experience is in designing and implementing market strategies and concepts as a consultant to manufacturers, service providers and associations. His focus the past 12 years has been aging, healthcare and retirement.
References; “The Long-Term Care Challenge”, David Wegge, CareQuest University; CareOptionsOnLine, NavGate Technologies; agewave.com, Ken Dychwald; Aetna; “When I’m 64”, FCG; “An Aging World”, US Census Bureau.
*Approximate retail costs, based on HCUP data
