There have been countless recent articles analyzing the millennial generation and its distinctive characteristics, but too many are ignoring an upcoming conflict that could define the generation: the aging baby boomers are going to be a big problem for millennials and their parents in the coming decades. In the U.S., the baby boomers are nearing the end of their lives while birth rates are simultaneously decreasing. With people living longer than ever and needing evermore costly end-of-life medical procedures, we are looking at an incredibly difficult next few decades for the younger generations. It's hard to see any alternative to a future of generational strife.
John Jay Institute Fellow and my friend Ken Connor has written on this topic for years, warning of the coming "senior tsunami" of aging baby boomers. The youngest boomers turn 50 this year, and the oldest are 78. The cost of caring for all of these people is going to be astronomic. As of 2010, the average person who makes it to 65 will live to 84, and that number is going up rapidly. High-cost diseases like Alzheimer's are dominating the end-of-life conversation. In our increasingly atomistic society, you can bet that many of these boomers will not have a robust social network of family and friends to care for them as they age, and with the decline of other intermediary institutions like churches that may have cared for an aging population in the past, these boomers will be looking to government to provide for their needs. Add on top of this the hit some boomers took to their retirement savings a few years back along with the rapidly-rising costs of healthcare and the future is looking pretty grim.
We are beginning to see proposals for possible "solutions" to this eldercare problem, and they aren't fun. Over in the U.K., nonprofit health care policy group The King's Fund recently released a report with recommendations for the future of eldercare. The conclusion won't make younger generations happy: "The commission has concluded that this vision for a health and care system fit for the 21t century is affordable and sustainable if a phased approach is taken and hard choices are taken about taxation." [Emphasis mine.] The commission's recommendations would increasing NHS costs from 9.4% of GDP to 10.9% by 2025. The commission proposes a variety of options for funding this increase, but they predominantly come back to levying taxes and fees on younger generations (as they logically must - what other options are there at this point?).
The financial pressures will be significant, but prospects for nursing home care are even more challenging. In the U.S. in 2011, nursing homes were at 83% capacity, and the number of nursing homes had actually dropped compared to the previous three years. Capacity is not ramping up to deal with the growing elder population.
In this context, it's hard to imagine a future scenario that won't involve significant generational resentment by the younger generations as they are forced to spend more and more of their own paychecks to support the elderly, whether through private payments for their own parents and grandparents or increased taxation. When faced with a generation (some of whom proudly declared that they were "spending their children's inheritance") not able afford their own end of life care, how can the younger generations help but feel burdened and resentful? The world imagined in the 2007 satire Boomsday begins to look almost prescient. This resentment may be particularly true of millenials who have recently graduated college in a tough financial hole, with large student debts and poor immediate job prospects. Their near-future outlook is already poor. Now tell them that they'll need to spend a portion of their potential future gains on the very grandparents who told them "it would all work out." Sure it's possible that things will work out fine for most millenials in a few years and they'll come into great wealth and stability, but the picture right now is far from rosy.
So what's to be done? The elderly will surely be cared for, one way or another, and this will likely involve significantly increased taxes. This seems unavoidable. Unfortunately, the higher bill is almost certain to produce significant resentment, which can trigger a push to legalize assisted suicide in more states and start talking to grandpa and grandma about their "quality of life."
The only way around the resentment is to cultivate a moral obligation in younger generations to care for their aging family members personally and at home, regardless of their elders' lack of foresight and responsibility. By extending the length of time care may be administered to the elderly in their own homes or the homes of their family members, we can reduce our reliance on expensive nursing home care and perhaps reduce the overall burden on an industry not currently equipped to handle the boomers. Finding creative ways to fund professional at-home help will also be essential. If the at-home care industry is encouraged by personal spending and government payments, we may be able to reduce a steep increase in taxes.
Without these moral pressures and creative solutions, however, we may be headed towards a dangerous, uncertain future for our elderly. It's hard to see how generational resentment can be avoided, and there may be a tragic increase in the idea that the expensive ailing elderly have a "duty to die" for the sake of their cash-strapped children.