January 27, 2016

Silver Tsunami to Bring 25 Million More Medicare Beneficiaries by 2036

By Graeme MacKay, The Hamilton Spectator - Tuesday August 20, 2013 National health care strategy needed for 'silver tsunami' Most Canadians think this country needs a national strategy for seniors health care, believing such a plan would help keep seniors in their homes as long as possible, according to a new poll released by the Canadian Medical Association. The Ipsos Reid poll was released along with the association's annual report card on health issues. It found that nine out of 10 Canadians feel that the entire health care system could be improved by keeping seniors at home as long as possible, to help lighten the load on hospitals and nursing homes. It also revealed that only 37 per cent of Canadians have confidence in the ability of the current system to care for our aging population. As well, three-quarters of respondents said they were concerned for themselves about whether they would have access to high-quality health care in their retirement years. Almost 80 per cent said they were concerned about having access to an acute care system, such as good quality hospital care, while almost an equal number worried about finding home care and long-term care. Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, says sheÕs not surprised the poll revealed so few Canadians feel confident about how they will be cared for in their senior years. ÒIt shows thereÕs an anxiety about whatÕs happening now and whatÕs going to happen in the future about the availability and quality of the health care that weÕre expecting for our seniors,Ó she told CTVÕs Canada AM Monday. Meadus says there are a lot of vulnerabilities in the current health care system when it comes to seniors, including a shortage of long-term care beds in most provinces and an insufficient system of home care. (Source: CTV News http://www.ctvnews.ca/health/national-health-care-strategy-needed-for-silver-tsunami-cma-poll-1.1416932)
Cartoon by Graeme MacKay, The Hamilton Spectator

The Congressional Budget Office (CBO) projects that Medicare enrollment will grow by more than 30 percent over the next ten years. In fact the population of seniors in the United States will grow from 55 million today to more than 80 million by 2036. The huge growth in the senior population is called the Silver Tsunami, and that term is becoming popular on social media.

CBO included the Medicare enrollment numbers in a report released earlier this week. The numbers will clearly mean that major political and economic changes are in store for the country. Seniors have been an important voting bloc for years, and the retirement of baby boomers is making that truer than ever. The new numbers show that seniors will become an even greater force in future elections.

POLITICO Pulse notes that the report also contains important data concerning the Medicare Trust Fund, faster growth of Medicaid, and revised Obamacare enrollment estimates.

Taking the Silver Tsunami into account, CBO calculates that Medicare’s hospital insurance trust fund will be exhausted in 2026. That’s four years earlier than the program’s trustees projected last summer.

“The Alliance is working to strengthen Medicare,” said Richard Fiesta, Executive Director of the Alliance. “Giving Medicare the power to negotiate prescription drug prices is one way we can limit further out-of-pocket costs to seniors.”

The report notes that the number of Americans on Medicaid is also anticipated to grow faster. CBO previously projected that 11.5 million Americans would enroll in Medicaid through the Affordable Care Act by 2025. Its new projection is 14.5 million. In dollars, Medicaid spending will increase by 8.8% year-over-year, to $31 billion in 2016.

About 13 million Americans will enroll in Obamacare through the Affordable Care Act this year. Eleven million of that total will receive subsidies. That’s much lower than earlier CBO estimates. However, it is higher than the U.S. Department of Health and Human Services’ target of covering about 10 million people in the exchanges at the end of 2016.

Many policy experts believe that the new estimate is likely based on more of the 19 holdout states accepting the ACA’s Medicaid expansion.

The Silver Tsunami will also affect Social Security. Spending on Social Security reached $882 billion in 2015, up 4% from such spending in 2014.


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Topics: Affordable Care Act

One thought on “Silver Tsunami to Bring 25 Million More Medicare Beneficiaries by 2036”

  1. Long-term care must become a more prominent part of ARA Medicare advocacy
    comment by Henry Moss, PhD, retiree and ARA member

    We are facing a perfect storm. AARP’s Public Policy Institute points out that as boomers age into their 80s, there will be a sharp drop in available family caregivers due to the “birth dearth” following the postwar baby boom.
    At the same time, longevity is increasing due to effective treatments of heart disease, lung disease, diabetes, cancer, and other conditions. A longer life, however, will likely mean more years with severe disability for boomers due to the secondary effects of increased obesity, including high blood pressure, high cholesterol, and inflammation due to metabolic disorders.
    These secondary effects include damage to brain blood vessels and a likely increase in the incidence of dementia, including Alzheimer’s disease. We already know that the prevalence of dementia will grow due to the sheer size of the boomer cohort. In addition, however, it now appears that a recent steady decline in the incidence of cognitive impairment and dementia have ended and are starting to reverse.
    Dementia is by far the most care-intensive of conditions. More years with dementia (and other disabling conditions fed by the effects of obesity, including mobility disorders) will mean more need for 24/7 care in the face of declining numbers of family caregivers. Hence the perfect storm. Hence the “2030 crisis”. 2030 is when boomers start becoming the “oldest old” in large numbers.

    The boomer generation is defined by a dramatic rise in home ownership. This trend, coupled with real and perceived problems in nursing homes, means that home care has become, by far, the preferred approach to long-term care. With declining numbers of family caregivers, an army of personal care aides, well-trained and better-paid, will be needed to address the coming crisis.

    The Alliance for Retired Americans is not placing sufficient emphasis on long-term care and severely underestimate the costs associated with an aging population and declining numbers of caregivers. There is no way to separate long-term care and health care. Living at home alone with dementia, frailty syndrome, or a mobility disorder are an invitation to falls and other safety-related events, a major source of healthcare costs for older adults. Chronic conditions will be inadequately treated. Shortages of physicians, nurses, psychiatrists, and social workers with specialties in geriatrics and mental health will create serious concerns for elderly patients both in and out of nursing homes. Medication management will be severely compromised. The health of stressed family caregivers will also suffer.

    Over the course of its history, Medicare has added mental health services, prescription drug benefits, and hospice care. Long-term care is the next frontier and boomers and their future caregivers represent a massive potential constituency. It must become a prominent part of the single-payer campaign. More information about the emerging 2030 crisis can be found at http://www.2030caregivingcrisis.com.

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