The Swamp
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Posted April 14, 2008 1:39 PM
The Swamp

by Frank James

The nation has had decades to prepare itself for the arrival of Baby Boomers into advanced middle age and senior citizenhood. But to probably no one's surprise, in true American let's-not-do-anything-until-the-crisis-is-on-us fashion, few preparations have been made for the inevitable healthcare needs of this aging wave.

In a new report, the Institutes of Medicine (IOM) spotlights the nation's continued unreadiness for the higher healthcare burden to result from graying of the Baby Boomers whose leading edge turns 65 in 2011.

In 2011 the first baby boomers will turn 65, ushering in a new generation of older Americans. The 65-and-older population of the future will be markedly different from previous generations, with higher levels of education, lower levels of poverty, more racial and ethnic diversity, and fewer children. Their most striking characteristic, however, will be their numbers. The aging of the baby boom population, combined with an increase in life expectancy and a decrease in the relative number of younger persons, will create a situation where older adults make up a much larger percentage of the U.S. population than has ever before been the case. Between 2005 and 2030 the number of adults aged 65 and older will almost double, from 37 million to over 70 million, accounting for an increase from 12 percent of the U.S. population to almost 20 percent. While this population surge has been foreseen for decades, little has been done to prepare the health care workforce for its arrival...

...This year marks the 30th anniversary of the first report published by the Institute of Medicine (IOM) on the health care workforce for older patients, Aging and Medical Education. That report and others have called for an expansion of geriatric training, but so far the geriatric discipline has grown little in numbers or in stature...

The report continues:

Besides being inadequately prepared in geriatrics, the current workforce is not large enough to meet older patients’ needs, and the scarcity of workers specializing in the care of older adults is even more pronounced. Among direct-care workers, nursing assistants provide 70 percent to 80 percent of the direct-care hours to those older adults who receive long-term care, but their shortage is well documented. Older adults account for about one-third of visits to physician assistants (PAs), but less than 1 percent of PAs specialize in geriatrics. Less than 1 percent of both pharmacists and registered nurses are certified in geriatrics. In 1987 the National Institute on Aging predicted a need for 60,000 to 70,000 geriatric social workers by 2020, yet today only about 4 percent of social workers—one-third of the needed number—specialize in geriatrics.

These shortages will only be worse in the future. By 2030 the United States will need an
additional 3.5 million formal health care providers—a 35 percent increase from current levels—
just to maintain the current ratio of providers to the total population. The Bureau of Labor
Statistics predicts that personal and home-care aides and home health aides will represent the
second- and third-fastest growing occupations between 2006 and 2016, which will exacerbate
current shortages.

As of 2007, there were 7,128 physicians certified in geriatric medicine and 1,596 certified in geriatric psychiatry. According to one estimate, by 2030 these numbers will have increased by less than 10 percent; others predict a net loss of these physicians because of a decreased interest in geriatric fellowships and the decreasing number of physicians who choose to recertify in geriatrics. According to the Alliance for Aging Research, by 2030 the United States will need about 36,000 geriatricians. It may well not be possible to reach this goal, but the projection underscores the need for immediate and dramatic increases in the numbers of workers who care for older patients in order to close the gap between current supply and future demand.

Judging from the relative lack of attention this issue has received so far during the presidential campaign, it doesn't look promising that this issue will get the kind of urgent attention the study says is required.

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Comments

The great thing about that is, they are a very active group of voters. So, watch the politicians, especially the Republicans, all of a sudden want to do great things for them. Oh, and watch how quick they disavow any intentions of privatizining Social Security, even though, you and I know, Wall Street and that gang , would love to get their hands on some more of our tax dollars. You go, Baby-Boomers!!
SUPPORT OUR TROOPS, BRING THEM HOME, ALIVE. NOW.


I like it when people like Republicans say they aren't racist but refuse to go to a doctor with an Indian name or Asian name.


Gosh. Hope there is still room for all of the illegal aliens to get their free healthcare.


"AARP SPEAKS"

HEY WE HAD THAT, WE HAD "CHAMPUS CARE" NOT "BUSH/CHENEY CARE"

WE GOT BOUGHT OUT JUST LIKE EVERYONE ELSE.

SELL, SELL, SELL, SELL, SO WE DID. SO WE SOLD EVERY AMERICAN BORN EXCEPT "JOHN MCCAIN" HANS COLO SOLO, IN 1943 MEDICAL RECORDS. THEY WERE DATAMINED, MERCK DATAMINED THEIR "INTEGRITY" THEIR PORTAL INFORMATION.

SO WHAT IF ELDERLY PEOPLE PAY 250.00 A MONTH FOR MEDICAID, AND THE GOVERNMENT TAKES 100.00 A MONTH OF THEIR SOCIAL SECURITY FOR MERCK AND OUR PHARMACEUTICAL COMPANIES.

WE DIDN'T DO IT, WE WERE FORCED TO SELL THE ELDERLY.

"THE CHAIRMAN" DID IT!
"THE CHAIRMAN" DID IT!

NOT US! WE WERE BORN BEFORE 1944 TOO! WE ARE NOT THE "ELITIST" MERCK THE FERC IS!

DICK CHENEY, DID IT!

"FRISK CARE" IS AARP CARE!


I have a solution...ration healthcare based on wealth. If you're rich you get as much quality healthcare as you want. If you're poor, tough luck, just go off and die. That's the American way.


Only one candidate's healthcare plan effectively addresses this problem, John McCain's. An analysis by cnn/money and Fortune magazine says his plan is the best of the three. I encourage you to read it: http://money.cnn.com/2008/03/10/news/economy/tully_healthcare.fortune/


Pre-rebuttal to John E and Bill Hussein:

The Democrat proposals have some additional drawbacks. First, the Dems want to heavily regulate the insurance industry by limiting everything from profits to marketing expenses. If the earning power of insurers is determined by federal regulators, their pricing will be too, and thus they will evolve into the equivalent of public utilities. Would you rather have medical prices set by fiat or by nationwide market competition?

Second, the Democrat plan exacerbates the fundamental problem in the American health-care system, which is that no one has any incentive to care about price. (How much is that MRI center charging for your ankle scan? Who cares? Just hand over the $50 co-pay and never you mind.) Creating a huge new medical superstructure would shift far more spending to third-party providers, chiefly the federal government, giving consumers even less incentive to concern themselves with the price of an MRI - or any other service, from an elective wart-removal procedure to a life-saving heart bypass. "The Clinton and Obama plans would enormously increase total health-care spending, but disguise the extra costs by shifting them to taxpayers," says John Sheils of the Lewin Group, a research firm that does statistical modeling for health-care plans.


As a boomer myself, I've watched my generation become so focused on our own material success that we've ignored trying to create a more equitable quality of life for everyone in this once-thriving economy. And the people we've elected have--more often than not--reflected our self-obsession and greed.

Decades ago, most developed nations accepted that universal health care is vital to the health of a country.

We, however, are still struggling to accept this fact and now we, the people who had a chance to make real changes, are getting to the age where we're going to need those very things we were unwilling to give to everyone in this country.

Karma? Perhaps, but it's definitely ironic.


The government controls the price of services rendered for the elderly. Without a financial reward for their efforts they will look elsewhere. Rationing follows artificially low prices every time.
This isn't being mentioned because it is nothing new. Anyone remember the Gray Panthers?


Hey, let's just keep spending 12 million a week in Iraq while at the same time screaming Social Security
is going broke, old people will bankrupt the system, etc., etc. With the quality of health care in this country NOW, you got a better chance of getting out alive by going to a veterinarian! That's us! TEAM AMERICA!


From Jeff's own link....

"The problem with McCain's approach - and it is a huge problem - is that McCain ventures so far toward total laissez-faire liberty that he risks leaving the poor and sick behind. Here's why. Perhaps his most drastic proposal is allowing the same insurance products to be sold across state lines. That seems to make sense, and maybe it does: Look what interstate banking has done for pricing and choice in financial services. But in health care, the upheaval would be so brutal that it scares even the most ardent free-marketer. Many states have some form of what policy wonks call "community rating." Under pure community rating, insurers must charge all customers the same premium no matter whether they're 20 or 55, or whether they have cancer or are models of good health. McCain is targeting community rating for good reason. It forces the young and healthy to pay far more than their actual cost by making them subsidize the elderly and sick. Like the mandated benefits, it's pushed millions of Americans in their 20s to drop their health insurance.

But under the McCain plan, states with no restrictions - Pennsylvania, for example - could sell policies for 25-year-olds that cost around $1,200 a year, one-third the price in New York. Young New Yorkers would drop their plans in favor of Pennsylvania providers, forcing New York insurers to jack up premiums for people in their 50s or early 60s, who need those rich, community-rated plans that cover as many procedures as possible - but who no longer benefit from the excessive premiums paid by the youngsters. It gets worse. Anyone with cancer, diabetes, or other pre-existing conditions will see their premiums multiply too."

McCain's healthcare plan will solve the healthcare problem...except for those who really need healthcare, the sick and the elderly. They pay the price. Apparently they are expendable to Jeff and his messiah, John McCain.


Michael, read further in the article and my earlier post. The problem isn't nearly as bad the ones with the Hillarbama plans. I requote for you and all the other slow people:

"the Democrat plan exacerbates the fundamental problem in the American health-care system, which is that no one has any incentive to care about price. (How much is that MRI center charging for your ankle scan? Who cares? Just hand over the $50 co-pay and never you mind.) Creating a huge new medical superstructure would shift far more spending to third-party providers, chiefly the federal government, giving consumers even less incentive to concern themselves with the price of an MRI - or any other service, from an elective wart-removal procedure to a life-saving heart bypass. "The Clinton and Obama plans would enormously increase total health-care spending, but disguise the extra costs by shifting them to taxpayers," says John Sheils of the Lewin Group, a research firm that does statistical modeling for health-care plans."

Like I said earlier, McCain's plan is the ONLY one that addresses the fundamental problem of our healthcare system, the fact that costs aren't related to care. That's got to be the first step to fixing our broken system. If you want to see how simply moving the payment role from private insurance companies to the government works (as would happen with the Hillarbama plan) I suggest you look at the population numbers cited in the Swamp item: " The aging of the baby boom population, combined with an increase in life expectancy and a decrease in the relative number of younger persons, will create a situation where older adults make up a much larger percentage of the U.S. population than has ever before been the case."


jo,

I like it when Democrats post comments on blog threads about how all Republicans are racist or sexist or homophobic or stupid or uneducated – you know, like those who claim that Democrats "tend" to be Rhodes Scholars? Do you know anyone who would say something like that?


Just remember; when the only people that have medical insurance are the healthy ones that don't need it, then the cost of medical care will plummet and everything will be wonderful again.
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In any kind of free market model you can imagine, old people are bad risks to insure. That's why we needed Medicare in the first place, for god sakes.
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We need single payer national health insurance.


"As a boomer myself, I've watched my generation become so focused on our own material success that we've ignored trying to create a more equitable quality of life for everyone in this once-thriving economy. And the people we've elected have--more often than not--reflected our self-obsession and greed."

MikeL,

Way to generalize.
Thanks a lot.
Speak for yourself.


"Like I said earlier, McCain's plan is the ONLY one that addresses the fundamental problem of our healthcare system, the fact that costs aren't related to care."

Yes it does Jeff, by making healthcare unaffordable and, as a result, unavailable for the elderly and sick. McCain's plan doesn't address what happens to them. Apparently healing people who need help isn't a priority in McCain's "healthcare" plan, nor are the sick and elderly. It's more like a "lack of care" plan.

I think most Americans are looking for a way to make sure that nhe elderly and sick have better access to healthcare, not less access.


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