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Invest Now or Pay Later
The 2000 census figures are out and the predictions for growth in the population of older Americans is coming true as forecasted. By 2050 there could be as many as 31 million citizens over 85. The over 85 age group will be along with the over 95 the fastest growing groups of our population. This is, of course, not news but the implications of this are enormous and bear further consideration and action now.
In 1999 Edward Schneider wrote an editorial in the Science journal laying out the dire consequences to this country if the demographics of future America are to be ignored. He presented two simple future scenarios: in one we continue doing what we are doing with regard to investing resources both private and federal in health care research regarding the prevention and treatment of chronic disease that afflict the elderly - this is a modest (about 0.3% of what is spent on medicare each year) amount of funding. The second scenario was that roughly 2-3% of what is spent on medicare each year be invested in research that leads to significant improvement in prevention and treatment of the chronic diseases of us as we age. 
The rationale for investing more on research now is that it will prevent the enormous financial consequences to our children and their children who will face the future with a burgeoning population of people in this country over the age of 85. We have very good data that demonstrate that it is the decade beginning at 75 when health care costs begin to grow exponentially. It used to be 65, but the health of that decade has improved with our current knowledge and treatment to push back a decade the time when costs of medical, transportation and living accommodations (including nursing homes and assisted living) begin to balloon.
The risk of scenario one, no increased investment in health science research aimed at the elderly and their chronic and acute episodes of disease is that we will have so many infirm and fragile citizens in the future whose governmental support system (Medicare) is financially strapped because of the increase cost of care and housing, that we face the "gruesome prospect"(as Scheneider puts it) of seeing millions of older Americans living under the poverty line and increasing numbers without family, friends or other care givers becoming destitute street people. If we adopt scenario two and invest ten times the amount of resources now in research we will be able to delay the time that future octogenarians become infirm and dependent on society. We would then have future more like today where the oldest members of our society can be cared for in a dignified and compassionate way. Whether in this time of affluence our elected governmental representatives and our health policy leaders, not to mention all of us regular citizens with our own charitable donations, will plan for and support the research required to make this country safe for the older citizens of the future remains to be seen. There are some foundations in South Carolina, such as the Fullerton Foundation and nationally, like the Hartford Foundation that have seen this need, but our federal and state governments are slow to act. We will either pay now or pay much more in the future - it's that simple and that clear.  Back to Top
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