As most insiders will readily admit, the current model of public private funding of care, services and housing for the elderly is profoundly fragmented, dysfunctional and in need of a complete overhaul. The regulatory labyrinth is more complex than necessary and there’s no coordination between and among hospitals, skilled nursing, and home healthcare. What’s worse, there’s deep mystery shrouding housing and services for the elderly among most of the US population. The system is broken and there’s a widespread lack of knowledge (or even where to go to get the knowledge) among consumers.
So what does the future hold?
America can look to Texas for the imminent future of the social services contract – particularly regarding care and services for the elderly and disabled. Tyler Cowen in Average is over, makes a compelling case that the Texas model of care and services for the neediest among us, constructed by fiscal conservatives, is meagre, but popular. As other sates wrestle with demographics, economics and fiscal issues, compromises will become absolutely unavoidable. Forget the Grey Panthers! In 20 years when the leading edge of the Baby Boom generation reach 85 and begin to consume more and more services, for longer periods of time than any generation past, the slender working generation supporting this aging will be in no mood to hear whinging about how much prescriptions cost.
Chicken Little was an Optimist
And America can also look to Japan for a forecast of what our economy and job markets will be like by 2020. A recent article in The Economist about Japan, which in many ways augurs the future of the US population, (Japan’s demography: The incredible shrinking country), reviews the impact of low birth rates and immigration restrictions (sound familiar?). The US (as well as the UK and especially Germany) is facing a “demographic cliff” with a large, bulging population which will leave the workforce and require care and support to be delivered by a smaller working population. Kotlikoff (The Coming Generational Storm) and others have been predicting this and few if any of the necessary remedies / mitigations have been undertaken.
Where do we go from here?
A re-imagined post-acute system will take the best of what we have and reassemble the pieces into a functional, articulating array of housing and services which are easily accessed, understood by the public as well as more efficient and fair.
My plan is to explore these possibilities – join me in the dialogue!