The New York Times: We’re Getting Old, but We’re Not Doing Anything About It


 

 

December 23, 2019

By Susan Jacoby

One of the paradoxes of this presidential campaign is that while many of the candidates are in their eighth decade of life, fundamental issues associated with the aging of American society are still receiving relatively little attention from the public, the press and politicians themselves. In 2031, the oldest baby boomers will turn 85, entering the land of the “old old” and facing exponentially higher risk for dementia, serious physical disabilities and long-term dependency.

Like climate change, the aging of America demands serious reconsideration of the way we live. Confronting the issue and its many implications, from Medicare’s failure to cover long-term care to the ethics of physician-assisted dying, requires what seems to be the most difficult task for human beings — thinking about the future.

In November, the National Center for Health Statistics reported that the birthrate among women of childbearing age had dropped to a record low, continuing a sharp decline in births that began around the financial crisis of 2008. At the same time, The Journal of the American Medical Association reported an increased death rate in the 25- to 64-year-old age group, with the main causes thought to be opioid overdoses, alcoholism and suicide.

What these statistics mean is that if these trends continue (always an important caveat in demographic studies), there will be many fewer young and middle-aged people to care for the frailest of the old, whose death rate has not increased in recent years. The population of the prime caregiving age group, from 45 to 64, is expected to increase by only 1 percent before 2030, while the population over 80 will increase by 79 percent.

In certain respects, the crisis is already upon us. A study published this year by Gallup and West Health, a research organization dedicated to lowering health care costs, showed that people over 65 had withdrawn an estimated $22 billion from long-term savings accounts in the previous year to pay for health expenses Medicare didn’t cover. A recently published article in The Journal of the American Geriatrics Society underscores the sobering likelihood that one out of seven 65-year-olds today can expect to be disabled for at least five years before death. The largest increase in the disabled population is projected to occur in the 2030s.

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