Intergenerational Conflict Over Rising Elderly Healthcare Costs

Introduction: The Scope of the Problem

For many years, there has been ongoing discussion about the best ways to deal with the rising costs of medical care for the elderly. Many argue that those expenditures should be reduced so that the same money can be directed toward other purposes, including education and expanding other sectors of the economy. There is no doubt that the figures involved are alarming.

Consider just a few key projections:

The Census Bureau estimates that the elderly population will more than double by 2050, reaching 80 million people as the baby boomer generation continues to age. Medicaid currently spends roughly $60 billion on long-term care, and the Congressional Budget Office expects that figure to rise to more than $75 billion by 2020. Private long-term care insurance expenditures are expected to reach little more than half of Medicaid expenditures — approximately $36.2 billion (Fox-Grage).

However, it would be the worst sort of shortsightedness to try to reduce the medical expenditure burden by denying services and care to the elderly. Instead, we should attempt to address the current — and future — medical cost dilemma by improving our commitment to healthier living, many strategies for which are already known, and more of which will emerge as science investigates the costly problem of aging. We should also work to mitigate the costs of eldercare when it is inevitable by creating more organic, community-based programs in response to the problem.

Why Cutting Elder Benefits Is the Wrong Solution

Rather than sparing the current generation the burden of paying for eldercare, cutting Medicare and Medicaid benefits would ensure several very undesirable outcomes.

First, human suffering would intensify, and it would be the parents and grandparents of today's young, working generations who would bear that suffering. This alone would cause intergenerational stress of extreme proportions. Even when an elder is being cared for in some relatively acceptable fashion, it generates generational stress. The Washington Times writer Adrienne T. Washington reports visiting a relative in a nursing home and being appalled when a stranger she was helping broke down crying because she had not been treated kindly in a very long time. Moreover, most people assume the government will cover nursing home care if they need it — but they would be wrong. Medicare and Medicaid pay very little toward long-term care, and only about 4 million of the wealthiest seniors can afford supplemental insurance policies, which cost between $900 and $2,400 per year (Fox-Grage). If the government withdrew from long-term care and left it entirely to individuals, the financial burden could conceivably fall on the younger generation.

Conclusion: A Sustainable Path Forward

It is clear that medical costs in old age begin with the choices we make when we are younger, and putting a short-term stop to rising costs by denying care to current elders would do nothing to solve the problem in the long term — and would heap even further generational stress on both the young and the old. It is unreasonable to penalize elders for failing to heed health warnings that younger generations are still failing to heed today.

The long-term solution to elder medical costs must begin now: by finding more community-based and less expensive alternatives to nursing homes; by encouraging insurance companies to pay for addressing the root causes of illness — such as smoking and obesity — rather than treating only their consequences at enormous cost; and by encouraging all generations to engage seriously with the science that can not only reduce elder medical costs, but make us all healthier and more capable of aging well.

References

Caring for elderly parents is a health wake-up call. (2002, March 19). The Washington Times, p. B05.

Fox-Grage, W., & Shaw, T. (2000, April). The crisis ahead in long-term care. State Legislatures, 26, 30.