Most people want to live to a healthy and productive old age, and increasing numbers of Americans are achieving that goal, at least in part. The Census Bureau now counts 3 million people who are 85 or older. In the next quarter-century, thanks to healthier lifestyles and advances in medical knowledge and technology, that number is expected to more than double. And there's no reason to think it won't go on rising. The coming 25 years will see an aging population of baby boomers swell the ranks of those who are 65 or older by 20 million, an increase to 53 million. In 1900 one American in 25 was 65 or older. Today one in eight is, and by 2020 it will be one in six.
Greater longevity has its costs. Nearly a fourth of today's "oldest old," as gerontologists call those past 85, live in nursing homes, with Medicaid paying much of the bill. A large number suffer from Alzheimer's disease. One-third of the nation's $1-trillion health bill is accounted for by the one-eighth of the population that is 65 and older.
The share of the national health tab accounted for by the older population is projected to keep on growing. Economists, demographers and other social scientists have long called attention to the demands presented by a fast-growing elderly population. Politicians have preferred to avoid dealing with those challenges, even as costs soar. Last year 40% of non-interest federal spending went to entitlements for older people, chiefly Social Security and Medicare. Under current laws and at projected rates of growth, financing entitlements by the year 2030 could require either massive tax increases or deficit spending of staggering proportions.
Certainly something unique in America's history is rapidly approaching. Economist Lester C. Thurow of the Massachusetts Institute of Technology sees the demand by the growing population of elderly Americans for unabridged entitlements as threatening to destroy government finances and robbing society of the investments it must make to assure a successful future. Columnist Robert J. Samuelson argues that it's time for a "new generational compact" that will recognize that the elderly are living longer and usually more active lives than ever before and that as a class they are economically better off than at any time in our history. "Government programs should be revised accordingly," he writes. In other words, spending and benefits for the elderly will have to be reined in.
But don't expect to hear much talk along those lines from presidential or congressional candidates this year; politicians don't seek votes by calling notice to uncomfortable truths. Adjustments in social thinking and revisions of entitlement programs will take years to negotiate and probably decades to phase in. The effort will have to wait until next year. It shouldn't wait much longer than that.