The Silver Tsunami: States Have a Fairly Long To-Do List to Get Ready for the Health Care Needs of an Aging America

By Comlossy, Megan; Walden, Jacob | State Legislatures, December 2013 | Go to article overview

The Silver Tsunami: States Have a Fairly Long To-Do List to Get Ready for the Health Care Needs of an Aging America


Comlossy, Megan, Walden, Jacob, State Legislatures


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Americans lucky enough to be growing old in the 21st century are living longer than ever before. Thanks in part to advances in medicine, more Americans not only will reach retirement age, they'll spend several years there. Those who live to age 65 can expect to live another 19 years, according to the U.S. Depart merit of Health and Human Services' Administration on Aging. That's nearly five years longer than people who turned 65 in 1965, the year Congress created Medicare and Medicaid.

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"The good news is that we're living longer," says Washington Representative Steve Tharinger (D), "but are we ready for the wave that's coming?"

Compared to Japan and Europe, the U.S. population is relatively young. But our adolescent country will be catching up soon as baby boomers--those born between 1946 and 1964--grow older. More than one in eight, about 41 million people, in the United States today are over age 65. By 2030, that number is expected to increase to 72 million, boosting the elderly population from 13 percent to 20 percent, according to the Administration on Aging.

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The addition of 31 million seniors will strain the U.S. health care system as never before. A long life often comes at a cost, as the aches, pains and chronic afflictions of old age require more and more expensive care. Medicare and Medicaid will assume increasing responsibility for this growing population's health-providing care for their complex, costly, chronic conditions and other long-term care needs. "I'm not sure that we've planned-as states, communities or individuals--especially for the financial part," says Tharinger.

In 2012, the public cost of Medicaid and Medicare was at least $997 billion, according to the Centers for Medicare and Medicaid Services. By 2022, the total public cost of these programs is expected to reach $1.96 trillion. The federal government is primarily responsible for funding Medicare, to the tune of $580 billion in 2012. The cost of Medicaid, however, is shared by states and the federal government.

Faced with the health care needs of graying baby boomers, state lawmakers will be asked not only to ensure health care providers receive proper geriatric medical training, but also to support innovative ways of improving the quality of care for aging Americans at a lower cost. How best to prepare for this silver tsunami will be debated and decided in legislatures in the years to come.

Racially and Ethnically Diverse

America's future elderly will be more racially and ethnically diverse than ever before. Today, 21 percent of Americans over age 65 are from racial or ethnic minorities, groups that historically have experienced poorer health than their white counterparts. By 2050, it is estimated they will comprise 42 percent of the elderly. As people age, differences in life expectancy rates among races disappear.

The health care industry and state and federal governments will need to become more adept at providing relevant care to diverse groups, which often hold different values and beliefs about aging and caring for the elderly. Addressing the need for more primary care doctors with cross-cultural training and language skills is critical. Hiring a more diverse health care workforce, expanding the use of community health workers, and supporting community- and family-based care also have helped bridge current cultural gaps in health care and may be useful with the incoming wave of aging boomers as well.

Lawmakers will continue to debate whether to offer loan repayments and other incentives to encourage providers to practice in underserved areas; how to support culturally competent health-care teams--such as those in community health centers; and the value of having cultural competency guidelines for health care providers.

Medical Home-Sweet-Home?

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