It’s been several years since Boomers began reaching the age of retirement, and the reality of our society’s lack of preparedness to deal with the influx of retirees over the next decade has become impossible to ignore. This issue has come to be known as “The 2030 Problem,” and one of the main points of concern is the ability of our medical system to address the needs of so many seniors. So what are the current and impending problems with the availability of senior health care services?
We’re already facing a shortage of primary care physicians in the United States, and the issue is only going to get worse according to the Association of American Medical Colleges. By 2030, we could be facing a shortfall of as many as 43,000 primary care physicians across the country, and the problem is expected to be worse for people living outside large population areas and patients using government health care assistance programs such as Medicare and Medicaid.
On top of this, it’s not only primary care where shortages are projected, but also specialized healthcare professionals such as surgeons and geriatricians. Demand for specialty healthcare services is projected to require as many as 61,000 more physicians than will be practicing in 2030, an even steeper disparity than primary care.
Not only are healthcare professionals going to be in short supply, the number of both professional and unofficial caretakers may not be sufficient for the rising senior population. Many seniors rely on a network of family and friends to help with activities of daily living as they age, but research from the AARP reports that the ratio of potential caregivers to retirees will fall from 7:1 in 2010 to 4:1 in 2030. Soon-to-be retirees planning to rely on family for care may not have as much success as they hope, and will most likely need turn to assisted living or another formal care option as they find they need more assistance with activities of daily living.
Formal care faces its own challenges in this new population of retirees, however. The United States is projected to become majority minority by 2043, and the current generation of soon-to-be retirees is certainly more diverse than their predecessors. However, projections in senior health care professions speculate that formal caretakers are not on a course to become similarly diverse. Fortunately, studies on the implementation of cultural competency training in senior care settings have shown that culture barriers can be overcome.
Diseases and Conditions
There has been a dramatic shift in the leading causes of death in the last century. From the early 1900s to now, infection-caused diseases such as influenza and pneumonia have given way to noncommunicable, chronic conditions such as heart disease and cancer as the leading causes of death in the United States. Elderly populations are at high risk for both of these conditions, as well as other conditions that fall into the ten leading causes, such as stroke and Alzheimer’s disease, simply due to the way the human body ages. And while rising life expectancies are a triumph for medicine, longer lifespans do present the need for a change in our approach to healthcare.
The issue is that many of these diseases and conditions don’t have cures, and in some cases, don’t even have effective research-based treatments. So, even if the barriers to senior health care access were to be removed, retiring adults are facing the issue of manageable, but not treatable, chronic illnesses.
Related but not synonymous to the shift in prevalent diseases is the focus of healthcare in senior populations. According to the CDC, about half of all adults in the United States are managing one or more chronic health conditions, with one in four living with at least two. Known as comorbidity, the presence of two or more chronic diseases or conditions presents a unique challenge to healthcare providers, as they need to understand not only how to treat the diseases separately, but also how the diseases present, interact, and even worsen when experienced simultaneously.
This shift in focus to comorbidity requires a much more consistent and frequent approach to seeking and obtaining healthcare, as opposed to the reactionary model experienced by many US adults. While ongoing healthcare may be a better model, the associated costs of frequent physician visits may be prohibitive to seniors who may already be facing a crisis of affordability.
According to a report by Fidelity, healthy, retirement-aged couples can expect to spend $245,000 on healthcare costs over the course of their retirement - and other sources suggest that this estimate may be conservative. Baby Boomers have an average of only $147,000 saved for retirement, leading to natural concern about the high cost of retirement living, and experts suggest that government assistance programs like Medicare will not be able to sustain the retiree boom.
The picture of senior health care in the coming decade looks bleak, but it’s important to remember that our society faced similar questions of economic strain when faced with caring for the Baby Boomers as children. While it’s important to keep the challenges of retirement in mind as we move towards 2030, it’s also important to not lose sight of the joy that the Golden Years can bring. By facing projected issues now, we can prepare for the needs of seniors for years down the line.