Will the “Age Wave” Make or Break America?: The Challenges that President Trump Must Face
Two-thirds of all the people who have ever lived past the age of 65 in the entire history of the world are alive today. For a more local reference, when our Constitution was crafted, the average life expectancy in the U.S. was barely 36 years and the median age was 16. During the time of our founding fathers, there was no anticipation of an “age wave.” In this regard, we are living in truly unchartered territory and longevity is humanity’s new frontier. As the Baby Boomers turn 70 at the rate of 10,000 a day, America is becoming a “gerontocracy.” Already, 42% of the entire federal budget is spent on Medicare and Social Security.
This demographic transformation will create new lifestyle, social contribution, and marketplace opportunities as well as potentially devastating medical, fiscal, and intergenerational challenges. Are we prepared? No.
Challenge # 1: What is the New Age of “Old?”
Our economy is hinged to 19th century notions of longevity and old age. When Otto Von Bismarck picked 65 to be the marker of old age in the 1880s, in preparation for Germany’s first pension plan, the average life expectancy in his country was only 45. Similarly, when Social Security began, the average American could expect to live only 62 years, and there were 42 workers paying for each “aged” recipient (“Social Security” is only the nickname for OASDI — Old Age Survivor and Disability Insurance). Today life expectancy is approaching 79 (and steadily rising) and due to decades of declining fertility, there are fewer than three workers to pay for each recipient. But, is 65 — or even 67 — the right marker of old age? This is not a Democrat or Republican issue that only impacts “seniors.” As longevity rises, continuing to use an obsolete marker of old age could have a particularly brutal impact on the Millennial generation.
1. Unhinge old age entitlements from the obsolete marker of 65, and “index” them to rising longevity.
2. Replace the linear life paradigm with a new “cyclic” one that views the longevity bonus as a time for late blooming, and/or new beginnings and re-careering.
3. Remove economic, legal and hiring/retaining disincentives for older adults who wish to — or need to — keep working. And provide more flex-work, job-sharing, phased retirement, mentoring and sabbaticals so that everyone can have more balance over this longevity-caused extended work life.
Challenge #2: The Diseases of Aging Could Become the Financial and Emotional Sinkhole of the 21st Century.
Until recently, most people died swiftly and relatively young of infectious diseases, accidents, or in childbirth. As a result of modern medical advances and public health infrastructure, we’ve managed to prolong the lifespan, but we have done far too little to extend the healthspan — as pandemics of heart disease, cancer, stroke, Alzheimer’s and diabetes are running rampant. In addition to being quite costly, our healthcare system is incompetent at preventing and treating the complex and intertwined conditions of later life. For example, Alzheimer’s (and related dementias) now afflicts one in two people over 85, and it has become the nation’s scariest disease. Unless there is a breakthrough, its sufferers are anticipated to grow from 5+ million today to 15+ million as the boomers age, with its cumulative costs soaring to $20 trillion by 2050. But our scientific priorities are out of synch: for every dollar currently spent on Alzheimer’s care, less than half a cent is being spent on innovative scientific research. Our doctors are also not aging-ready. We have more than 50,000 pediatricians, but fewer than 5,000 geriatricians. Only eight of the country’s 145 academic medical centers have full geriatrics departments, and 97% of U.S. medical students don’t take a single course in geriatrics.
1. Commit greater resources to the scientific research required to delay or, even better, eliminate the horrific diseases of aging — with particular attention to the most problematic: Alzheimer’s.
2. Establish legally binding standards of geriatric competency and provide the academic training and continuing education necessary to ensure that healthcare professionals are properly skilled to care for our aging population.
3. Establish a more humane, moral and respectful approach to late life palliative care and surround the dying process with dignity.
Challenge # 3: Averting a New Era of Mass Elder Poverty
During the 1930s, one third of America’s elders were impoverished. Since then, thanks to Social Security, Medicare, pensions and a widespread savings mentality among those who grew up in the shadow of the depression, the elder poverty rate has plummeted. However, the future is precarious. Today, according to the Government Accounting Office, 52% of all households near retirement (headed by someone age 55+) have no retirement savings and about 51% of our population have no pensions beyond Social Security. We could be heading to an era in which tens of millions of impoverished aging boomers will place crushing burdens on the U.S. economy and on the generations forced to support them. On top of this, to avert future generations of poor older adults, we are not fostering financial literacy or responsibility among the young (many of whom might live exceptionally long lives). For example, 36 states require providing sex education to high school students by law, while only five states require financial education.
1. Upgrade financial literacy and financial responsibility through a bold national “intervention” that educates people at every stage of life.
2. Help us help ourselves by encouraging increased personal savings rates, possibly through mandated, tax-advantaged savings programs.
3. Affluence-test and target entitlements, including Social Security and Medicare, to match the diverse needs and capacities of tomorrow’s elders.
Issue # 4: Establish a New Purpose for Maturity
Retirees report that they are in the best time in their lives to give back. And they do: contributing both more dollars and volunteer time than any other age group — doing everything from teaching schoolchildren to read, to helping their peers recover from loss to building homes for Habitat. Going forward, medical science can — and will — increasingly prolong life. Yet political, religious, and community leaders have yet to create a compelling vision for the purpose of those additional years. For example, our 68 million retirees currently spend an average of 49 hours (2,940 minutes) a week watching television. Ultimately, the problem may not be our growing legions of older adults, it may be our absence of imagination, creativity and leadership regarding what to do with all of this maturity, longevity and encore talent. The unprecedented historical challenge/opportunity of the age wave is how we can unleash our greatest growing natural resources that are hiding in plain sight: experience, skills and wisdom.
1. Transform today’s well-meaning but youth-centric volunteerism offerings (both tasks and timing) to better leverage the advanced talents, experience and skills cultivated over a lifetime.
2. Help our communities become more “age friendly” through the encouragement of a wide range of inclusive local intergenerational programs, activities and housing.
3. Mobilize a national Elder Corps in which tens of millions of older adults share their values, knowledge, skills and wisdom with youth in need.
An “age wave” is coming that could either make or break America. Are we prepared? No. Just as society’s institutions were grossly unprepared for the baby boom, we have done far too little to prepare for the coming “age wave.” Do we as a nation have the guts and wisdom to ask — and answer — these questions? I believe we do. Time and time again Americans have proved that we are a creative, industrious nation with tremendous capacity for improvement and transformation. The next eight years will be the turning point. I surely hope that President Trump is prepared to address these critical issues and boldly make the course-corrections necessary to usher in a healthy and purposeful future of aging.