On March 13 the US Census Bureau issued a press release, “Older People Projected to Outnumber Children for First Time in US History.” The year 2030, they predict, will be a major turning point for the United States – the year that the last of the Baby Boomers reaches the age of 65, and the elderly will reach 20% of the total population. According to their estimates ““By 2035, there will be 78.0 million people 65 years and older compared to 76.4 million under the age of 18.”
The US will become increasingly diverse both racially and ethnically as an increased number of immigrants are needed to maintain population growth. The non-Hispanic White-alone population is projected to shrink over the coming decades, from 199 million in 2020 to 179 million in 2060 — even as the US population continues to grow. Their decline is driven by falling birth rates and a rising number of deaths over time among non-Hispanic Whites as that population ages.
Even this growth will be slow since the older population will be dying at an increased rate. According to the National Center for Health Statistics the projected life span of an American has been in decline in recent years, “Life expectancy for the US population in 2016 was 78.6 years, a decrease of 0.1 year from 2015.”
This is particularly significant in view of a study, published in the medical journal The Lancet in February 2017. The study, which was funded in part by the US Environmental Protection Agency, concluded that by 2030, United States lifespan will fall behind other nations. The researchers wrote, “Notable among poor-performing countries is the USA whose life expectancy at birth is already lower than most other high-income countries, and is projected to fall further behind, such that its 2030 life expectancy at birth might be similar to the Czech Republic for men, and Croatia and Mexico for women.”
These reports have strong implications for national decisions. For example, the failure of the United States to keep up with the rest of the world has been associated with a poor healthcare system. The Washington Post interviewed Majid Ezzati, a professor of public health at Imperial College London, who was head of the research group. He ascribed the failure of the United States to keep up with the rest of the world to maldistribution of quality care. “If you have good insurance and you live on the East Coast and the West Coast, you probably get the best health care in the world. It’s not the technical quality of it, which is superb. It’s the spread of it.”
The United States is the only advanced nation that doesn’t offer universal healthcare, and in addition, in many parts of the country, the best quality care is simply not available. Without a universal care system and high costs for care, many people get diagnosed “too little and too late.”
It would be difficult, perhaps impossible to assure the same quality of care throughout the country, but it should be possible to assure the same availability and cost of care through a true universal healthcare plan such as Medicare for All. The Affordable Care Act was an attempt to provide near-universal care by satisfying all the stake holders – patients, providers, insurers and even politicians, but the political opposition, the Republicans, at the state level, had no qualms about leaving hundreds of thousands of people without health coverage, even when the cost of care would be covered by the Federal Government. If it’s impossible to reach a compromise then the rational step is to propose a universal system, perhaps similar to those seen in France or Japan. The HuffPost on Obamacare repeal began, “What are the political ramifications of threatening to let your constituents die needlessly?” We’ll learn, and it may be enough to take steps towards a simple, universal program that can’t be misrepresented.
As for the aging population, the Census Bureau reports, “As the population ages, the ratio of older adults to working-age adults, also known as the old-age dependency ratio, is projected to rise. By 2020, there will be about three-and-a-half working-age adults for every retirement-age person. By 2060, that ratio will fall to just two-and-a-half working-age adults for every retirement-age person.” We will have more people dependent on Social Security and other social safety net programs, and not enough people to support the program.
The rational approach would be to rescind the tax cuts that have been given to the ultra-wealthy and aim towards a more equitable distribution of wealth. At the same time, the aging population becomes progressively less capable of self-care, and needs more services provided. While thousands of jobs in manufacturing, mining, and agriculture have been, and will be lost to technology, many of the needs of the elderly will still require the capabilities of a human, whether a gerontologist, a dentist who specializes in geriatrics, physical therapist, an ambulette driver or a health care aide.
These jobs will call for far more younger people than current projections assume. The answer here is to rethink our attitudes towards immigration. The people who came here under the Deferred Action for Childhood Arrivals (DACA) Act should be treated as a national resource, welcomed and treasured, as should many of the undocumented immigrants who have made a home here. 2030 isn’t that far away.
Sam Uretsky is a writer and pharmacist living in New York. Email sdu01@outlook.com.
From The Progressive Populist, April 15, 2018
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