- The Washington Times - Thursday, December 29, 2005

Last of five parts

The nation’s health care system is in for a shock as the baby boomers move into their retirement years.

Geriatric care specialists agree that medical resources will be inadequate for the burgeoning senior population, expected to double from 35 million to 70 million in less than 20 years.

“The shortage will be disastrous. It’s really scary,” says Russell Bodoff, executive director of the Center for Aging Services Technology with the American Association of Homes and Services for the Aging (AAHSA).

Larry Minnix, chief executive officer of AAHSA, says an “overburdening” of health care is “coming close now.”

In this series, The Washington Times has examined how the boomers are living out their own vision of getting older, but the aging of America’s largest generation also will rock the social-service and health care systems created by their parents’ and grandparents’ generations.

The health of Americans older than 65 has been improving since the early 1980s, according to a recent Rand Corporation study. Both Rand, a California-based nonprofit research organization, and the National Institute on Aging (NIA) say some financial savings could be realized if the trend continues.

“We need to find out why and to seek ways to maintain that decrease in disability rates,” NIA spokeswoman Vicky Cahan says.

But the Rand study notes that “diseases such as obesity and diabetes are increasingly prevalent among the young,” suggesting that “future Medicare beneficiaries might be less healthy than current ones.”

According to the National Center for Health Statistics, 40 percent of Americans 45 to 64 have high blood pressure, and 36 percent are obese. Both are serious risk factors for heart disease and stroke, the number one and number three causes of death, respectively, in the United States.

The Rand study, released in late September, predicts that new medical technologies, likely to be in widespread use in the next 25 years, could greatly increase Medicare costs, posing financial risk to the government’s health insurance program for the elderly, which already faces serious problems.

Single treatments with new medical technologies, such as implantable defibrillators for heart ailments or drugs to prevent Alzheimer’s, could raise Medicare costs by as much as 70 percent, the study says.

“This technology is valuable because it will improve health and extend lives. But we need to begin thinking about how to pay for it,” says Dana Goldman, chief health economist for Rand and principal author of the report.

Growing costs

Mr. Goldman predicts that any savings realized through lower elderly disability rates will be offset by increased spending on healthy Medicare recipients who live longer.

Mr. Bodoff of AAHSA agrees.

“Everyone starts declining at some point. So if people live longer, it costs more to take care of them,” he says, adding, “The longer a person lives, the greater the financial burden they pose on the health care system.”

The outlook is particularly worrisome, Mr. Bodoff says, because of “epidemics” such as Alzheimer’s, diabetes and obesity that are plaguing the country, as well as a sharp rise in hypertension, or high blood pressure.

“Total Medicare expenditures were $309 billion in 2004 and are expected to increase in future years at a faster pace than either workers’ earnings or the economy overall,” according to the 2005 report by the Medicare Board of Trustees.

The report goes on to say that Medicare spending is expected to exceed that for Social Security in 2024 and to be almost twice as great as Social Security by 2079.

In 1966, a year after the Medicare program started, its expenses totaled $1.8 billion, while Medicaid cost $632 million, according to federal data. Total national health expenditures at that time were $45.1 billion.

National health expenditures likely will reach $3.6 trillion in 2014, more than twice the current spending, according to the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services. The agency also says Medicare costs alone are likely to reach nearly $690 billion in 2013, and Medicaid spending will top $328 billion.

Medicare trustees say the magnitude of spending growth expected for that program in the coming years, “if realized, would place a substantially greater strain on the nation’s workers, Medicare beneficiaries and the federal budget.”

Straining services

Every day, 10,000 baby boomers turn 50, and half of them will be 50 and older at the end of this year, according to the Boomer Project, a marketing consultant and research firm based in Richmond.

And those who are now 50 years old expect to live 35 more years, the Boomer Project says.

Matt Thornhill, president of the Boomer Project and a boomer himself, says he agrees that taking care of this population when they become sick will be a “huge problem,” given their numbers.

“There won’t even be close to enough” nursing homes and other medical facilities to address the need, he says.

Mr. Thornhill says he recognizes the health care industry — including acute care hospitals, long-term care facilities and assisted-living institutions that provide differing levels of service and medical care — is worried about where all these people will end up as they grow older and start facing physical and mental decline.

“There will be so many of them who are not dying,” he says, adding, “Boomers will focus on maintaining their vitality as long as they can, even though a third of them have less than $1,000 in their retirement accounts.”

Demanding patients

Indeed, the recent Rand study examining future Medicare costs showed that boomers will demand the best in medical technology to keep themselves vital and that the costs will be enormous.

For example, the study estimates that annual treatment costs for the Alzheimer’s drugs alone would be nearly $63 billion in 2030.

“You can expect Medicare costs to grow with all these emerging technologies,” Rand spokesman Warren Robak says.

The Rand study concludes that “new technologies will increase health care expenditures because the reduction in spending resulting from better health will be outweighed by the costs of the technologies themselves and by health expenditures during the additional years of life the technologies may make possible.”

Mr. Thornhill predicts that “20 years from now, health care [for seniors] will not be anything like it is today.”

According to NIA and AAHSA, there will be a shift away from nursing homes, except for those who are very sick, and a shift toward more support services that allow retirees to remain independent in their own homes longer.

Mr. Bodoff says development of technology that would allow in-home monitoring of elderly patients’ heart rates, blood pressure, cholesterol and blood sugar levels is already taking place. So, too, is work on sensory devices to dispense medications for seniors in their homes, as well as to alert health care professionals if a senior falls or is receiving inadequate nutrition, hydration or sleep, he says.

Further down the line, there could even be robots to assist seniors at home, Mr. Bodoff says.

Aging system

But Mr. Bodoff cautions that there will have to be changes in the Medicare and Medicaid reimbursement schedules to pay for such at-home support services.

“We need a policy fix to meet consumers’ preferences,” Miss Cahan of NIA says.

Problems that first need to be addressed before such a fix, Mr. Bodoff says, include “liability concerns, privacy and security issues, and current intrastate licensing restrictions on doctors.”

Says Mr. Minnix of AAHSA, “The present health care system was designed 40 years ago. There’s not enough money in America to keep doing things badly. But there is enough money to redesign the system and start doing things well.”

But Sharon Lilly, 59, a working boomer who lives in Richmond, is not optimistic.

“I would have thought something would have been done by now for the boomer population in terms of major changes in health insurance coverage,” Mrs. Lilly says. “I had expected that to happen. But at this point, I don’t expect any changes in insurance coverage.”

Another boomer, Celeste McDonald, clinical coordinator for wound care at the Carroll Hospital Center in Westminister, Md., says she feels it’s essential that aging citizens do all they can to prevent serious medical problems by keeping fit and healthy by eating properly, exercising and avoiding unhealthy habits such as smoking and overeating.

“With the increasing number of seniors, health care will become a gigantic medical issue. We’re already seeing a lot of issues with compliance, because elderly people can’t afford to follow treatment either because they can’t afford to pay for it or they have no help,” Ms. McDonald says.

Health care is “almost becoming a fast-food type of arena, and a lot more responsibility is being placed on the elderly in this area than ever before,” she says.

“As I get older, I am keeping myself as healthy as possible. I’m convinced that things I can control myself will make quite a difference.”

Part I

America’s starting to look a lot older

Part II

Boomers slow down, but won’t quit

Part III

Boomers will not retire from life

Part IV

Business targets boomers’ money

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