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Thursday, February 7, 2013

Will boomers bankrupt the medical system?

This post was knocked off far too quickly and the well-thought out comments appeared to punch holes in my position. I admit, I was far too quick out of the gate. I made the mistake that newspapers make daily. I am now in the process of taking another look at rising health care costs and the part played by the rapidly growing senior segment of the population.

In the meantime, here is an article worth a read despite being a little stale dated: What is driving health care costs? And here is anothe: The Costly Paradox of Health-Care Technology.

The problem appears complex -- this should come as no surprise -- and the media's immediate scapegoat, seniors, may be wrong. For an example of a well written but quite possibly wrong-headed take on seniors and their affect on the healthcare system, read this piece by Larry Cornies which ran in The London Free Press: Boomers duty-bound to reduce health-care footprint. Compare the Cornies article with this one from The Economist with a section titled: Money and mortality: the implications ofaging on healthcare costs.
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According to The London Free Press reporting on a talk by David Foot, the demand for health care in Ontario will ramp up sharply when baby boomers hit their senior years. Foot believes, "We have about a decade to get health care right before it hits the fan."

Many would agree with Foot that there is a growing problem, but many would argue that the health care issue is not driven by the increasing costs associated with health care for the elderly. The Globe and Mail, a competitor to The Free Press in their home market, carried a story with quite a different slant. Globe writer Andre Picard wrote:

"This alarmist view of our aging society is challenged in a thoughtful new report from the Institute for Research on Public Policy.

"Instead of falling prey to ageist fear-mongering, Neena Chappell, the Canada research chair in social gerontology and a professor in the Centre on Aging of the University of Victoria, takes a level-headed look at the data and offers up practical solutions for meeting the health needs of the baby boom generation."

The Globe piece goes on to argue a position that I have seen in print many times. I wondered why The Free Press reporter didn't question Prof. Foot on this point. The Globe accurately reported the following:

"There have been, of late, a number of studies debunking the notion that seniors are principally to blame for spiraling health costs. In fact, it is new technologies, new drugs and higher wages for health professionals (physicians in particular) that are pushing up costs."
 To read the two stories, here are the links:

This is an issue that is very important to me. I am a senior and a baby boomer. I watched as my maternal grandparents aged and finally slipped away. Both lived into their 90s and neither was a big drain on the health care system. They lived in their own home until their mid 80s and then they moved in with my mother and me for their remaining years.

When my mother found herself on her own after the death of my grandparents, she moved in with my sister. After more than a decade living in Oakville, she packed her bags and moved in with me in London. When I got married my mother was part of the package. She lived with me and my new family until she died at 89.

Families taking care of loved ones in their final years are more common than you might think. The government should encourage families and support them in their efforts to take care of aging parents and grandparents.

In one area both The Globe and The Free Press reports agree: We, as a society, need a plan as we prepare for the dramatic growth in the number of seniors. What we don't need are scare stories.

7 comments:

  1. I suspect the problem is l two-fold. Of course Foot is right. The next piece in the rise in Health Care expenses (drugs getting more expensive) Why are drugs getting more expensive? Supply and Demand... and leaps in medical innovations. Guess who is using the majority of new expensive drugs... yes you guessed it, seniors. Nothing wrong with that, just the way it is. Illnesses that used to kill you, now take drugs and live 10 years longer, of course financially that causes stress.

    As well, have you seen the study of how much the cost is to the health care system in the last years of life? HUGE. If you have more and more people in their senior years, it just means you'll have more in their last few years... simple math really.

    I agree families should take care of each other... that is sort of what family is... Good old fashion values, but not everyone shares those values. Values have really disappeared and that is extremely sad.

    I agree we don't need a scare, we need a leader with a plan. To me the answer is obvious (not easy, but obvious). The tax revenue pie is only so big and I firmly believe there is little appetite to grow that pie (more taxes)), so we need to face what is coming. Have a leader with the courage to share those findings with Canadians and make some decisions. Perhaps even survey the people? I know it's crazy to ask your constituents what they actually feel/want. What % of National revenues (aggregate taxes) should go to what program? Once that is determined, prioritize. Explain to Canadians (over and over) that this is what they have said is their priorities (their values) and the only way we can increase the Canadian values (revenue pie) is to increase taxes. Let's actually be honest with people.

    This may actually gives us a much needed identity... this is what it means to be Canadian... these are our core values and what we believe in. How many times do we hear/see reports that say what exactly does it mean to be Canadian?

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  2. I like the above comment. When I get a chance I may make a reply. Ken (Rockinon).

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  3. If the report in The London Free Press is accurate, Prof. Foot sounded pretty flippant when he made his claim that aging baby boomers would cripple Canada's health care system.

    As a senior and one concerned by just the stuff brought up by anonymous, I have noticed that many experts who have examined the problem of rising costs in the health field have not found seniors to be the big driving force.

    Steve Morgan, an associate director at CHSPR and an associate professor in the School of Population and Public Health, examined total health care spending in British Columbia. He found:

    "Population aging caused expenditures on acute hospital care, medical care and prescription drugs to grow by less than one per cent a year, and despite the aging of the baby boom generation, its impact will remain the same through 2036, according to Morgan’s projections. “Such growth is well within the reach of expected economic growth and productivity,” Morgan says."

    Yet, if you read the report, the door seems to have been left open for shifting some of the costs to the seniors. Getting a good understanding of all the associated problems is still out of reach -- at least, for me.

    As a boy I was lucky enough to benefit from Windsor Medical, a system in place in Canada's Motor City before the coming of our present government run system. I often wonder if there is something to be learned from studying that early attempt to provide affordable health care to all.

    I believe Windsor Medical was run by doctors and this brought certain benefits to the table that are missing today.

    Rockinon

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  4. Interesting stuff.

    I still believe that is your population is aging (which it clearly is) and that as we age we use more and more meds (which I can't imagine someone arguing) and if you'll have a higher % of your population in older cohorts (which we will) how this does not translate into a larger demand for meds/health care. The fact that we now live longer, due to hygiene and medical advancements and that the fact we live longer, we use more meds/require more health care than we use to (as a society) and many of those meds/health care costs are extremely pricey and after 65 the government cover much of the cost (Trillium in Ontario)...

    For me to say that all this is true, but that does not mean we will put more pressure on health care... just does not add up.

    I think Morgan is somewhat crazy to believe what he believes but then again there are some scientists that say we are not going through Global warming and still Americans believe that having easy access to guns (and automatic rifles and large round of bullets) is not the reason the country has gun problems... to them the solution is more guns. I have not studied Morgan's theory, but for me at least it does not pass the smell test.

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  5. I agree with you. Seniors require more health care than any other segment of the population. ICDs, pacemakers, knee surgery, hip surgery, many different cancers and the list goes on and on.

    But, the title of my post was: "Will boomers bankrupt the medical system?" It was an honest question. I used to work at the local paper. Between my job and my personal life I saw a lot of waste in the health care system. A lot of what I saw was the result of mismanagement.

    I read this in Canadian Business: Though the system tracks health inputs, such as the number of doctors or surgeries performed, there is next to no information on patient outcomes, leaving basic questions like "how effective was the treatment?" unanswered . . . we simply don’t know whether we’re getting much value out of the health-care spending we’re putting in.

    eHealth Ontario wasted $1-billion on out-of-control consultant costs and untendered contracts. When I was in Oregon I met a programmer who worked in the medical community software industry. He told me U.S. government funded freeware was available to solve the eHealth problems. He said the reason this software wasn't gaining traction in the health care community was that that using this code wouldn't make software industry CEOs billionaires. This fellow was disgusted.

    I googled his story and found his take had a lot of support. (I may put up a post at some point detailing this fellow's argument.)

    Still, all things being equal, even if seniors may not be responsible for bankrupting the system, they will still consume the biggest piece of the health care pie.

    Cheers!

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  6. If the question is will boomers bankrupt the system... that is a very deceiving question. The short answer is of course not. The long answer is they will put extremely pressure on the health care system and it will not be the same as it is today.

    You already see that in Ontario, with huge wait times, the $200 health care tax (or whatever it's called) and you will continue to see major changes to the system. So sure, they may not technically bankrupt it, but they will certainly have a major impact on it and force significant changes.

    You comment about freeware is exactly why we need good leaders (which I already mentioned) and politicians that are actually out to help people. As I said, they would likely create a Canadian identity as well... one that the country desperately needs.

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  7. Dear Anonymous:

    I do so hope you return and find this. You win. Thank you for your comments. Please follow this link to a post that refers to you and continues with some info that you might find interesting. (I've sat on the VistA story far too long.)
    rockinontheblog.blogspot.ca/2013/02/could-vista-solve-ehealth-problems.html

    Have a nice day,
    Cheers,
    Ken.

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