The Challenge of an Aging Society: The Future of U.S. Health Care Must Involve Some Form of Rationing, Argue a Former Governor and a Medical-Policy Scholar. the Problem Is Not Simply How to Control Costs, but How to Achieve Social Justice

By Lamm, Richard D.; Blank, Robert H. | The Futurist, July-August 2005 | Go to article overview

The Challenge of an Aging Society: The Future of U.S. Health Care Must Involve Some Form of Rationing, Argue a Former Governor and a Medical-Policy Scholar. the Problem Is Not Simply How to Control Costs, but How to Achieve Social Justice


Lamm, Richard D., Blank, Robert H., The Futurist


One of the great challenges in America's future is to retire the baby boomers without bankrupting the country or unduly burdening future generations. This crisis could soon overwhelm American public policy, as yesterday's baby boom becomes tomorrow's grandparent boom.

[ILLUSTRATION OMITTED]

This demographic revolution raises some awesome challenges:

* How can we continue to fund present programs for the elderly and also expand those programs for the aging baby boomers?

* How can we fund retirement as well as general health-care programs in an America with ever more older citizens and ever fewer children?

* How do we provide the social infrastructure for an aging society?

* And finally, how can we do politically what needs to be done while being fair to both the present generation and the future generations who will fund these programs?

If we act soon, we can answer these questions rationally, prepare for our future, and avoid steep economic decline. But if we wait, the decisions we will be forced to make will be truly draconian. Age could well be as divisive in the next 40 years as race and sex have been for the last.

There are basically two ways to provide health care and retirement benefits for the elderly: Society can prefund these programs, much as most private-sector retirement programs are funded today, or it can develop a social-insurance scheme. The United States chose social insurance, and it has worked well so far, but how long can it continue?

The U.S. retirement system is now actuarially unsustainable, and health-care expenditures in the nation have grown over the past 40 years at about two and one-half times the rate of inflation, now consuming more than 15% of GDP. Thoughtful people are coming to realize that, given science's seemingly endless production of new miracle treatments, the efforts expended to maintain our own aging bodies can bankrupt our children and our grandchildren.

Today's elderly account for approximately 13% of the U.S. population, yet they get more than 60% of all federal social spending. Americans spend about three times more taxpayer funds on the elderly than on children; the federal government's spending is even more disproportionate. It is not a workable nation-building strategy to spend significantly more on the last generation than we do on the next generation. We must rethink many of our basic public-policy assumptions, because the status quo in health care and retirement spending is no longer an option. The only question is how much and what type of reform we need.

[ILLUSTRATION OMITTED]

The Next New Deal

To admit that the current system of funding health care is unsustainable requires us to give up a cherished dream: the dream of total, universal care for any ailment freely available on demand. Like the "take backs" some employers now demand from union members, many Americans find it unacceptable to even consider renouncing benefits they have enjoyed, or expected to enjoy, no matter what the reason.

Reform will thus require leader-ship--strong bipartisan leadership, which so far has been lacking. The public already distrusts the political process, and individual citizens are wrapped up in their own needs and lives. With the nation now politically split almost down the middle on many issues, it will be hard to prepare the public for the type and magnitude of change necessary.

The dominant issue in American medicine for the immediate future will be how we adjust to the demographic realities of an aging society. It will be politically and professionally painful. It will cause much agony in a medical profession trained to assume that there are virtually unlimited resources available and that cost is never a consideration. It will be a seminal issue, causing as much unsettling change as did the reform of medical education early in the twentieth century. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

The Challenge of an Aging Society: The Future of U.S. Health Care Must Involve Some Form of Rationing, Argue a Former Governor and a Medical-Policy Scholar. the Problem Is Not Simply How to Control Costs, but How to Achieve Social Justice
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.