January 1, 2011 -Yes, yes, it’s true. Today 79 million baby boomers, born from 1946 to 1964, start turning 65.
Yes, yes, it’s true. Boomers begin qualifying for Medicare.
Yes, yes, it’s true. If my math is right, this means some 12,015 boomers each day over the next 18 years will enter the Medicare ranks.
That’s the biggest news this New Year’s Day. The second biggest news is the information technology boom, triggered by IPad, Kindle, and the social media. The third biggest news, connected to the first two, is the health reform law and its impact on our unsustainable entitlement programs.
Let’s take these pieces of news, one by one.
Boomers, whether by Botox, cosmetic surgery, exercise, antioxidants, tobacco cessation, or life-style and life-savings medical technologies, plan to maintain their youth, and to cede nothing to generations that precede or follow them. That’s if things do well. Otherwise, aging boomers who become ill, may ask , “Why me? What the hell happened?”
It’s hard to generalize about this largest and richest generation ever. Some say boomers are too demanding. Others say boomers are the children spoiled on the principles of Dr. Benjamin Spock and have been coddled by their parents and the rest of society. Still others may say, What do you expect? Boomers cut their teeth on television, and get their information bit by bit through media sound bites and Internet bytes.
Boomers revolted against the Vietnam war, fought and died in it, and, on the domestic front, weighed on the civil rights of blacks, other ethnic minorities, the disabled, women, gays, and lesbians.
Boomers have reshaped politics. The last three presidents – Clinton, Bush, and Obama – are boomers, and now many of the anti-establishment Tea Partiers are boomers, upset by the collapse of our economy and the skyrocketing national debt. By the time the last of boomers turn 65 in 2029, they will comprise 18% of the U.S. population, compared to 13% now. By then, health care may consume 30% to 40% of GDP, compared to 17% now.
They are an outspoken lot, these boomers, and they are likely to rage longer into that long night, demanding their share of a shrinking pie. Whatever happens, they will live longer, work longer, stay younger longer. The destiny of the U.S. and its health system is in their hands.
Information and Social Technologies
This year, IPad and other mobile devices; Kindle, Nook, and other e-readers; and the social media and connection sites (Facebook, Twitter, and U-tube) will boom and will transform our culture. We will move more on Internet time, personal privacies will be eroded, and shopping, business, health activities will become decentralized, and we will seek ways around the establishment toward more individual connections.
New mobile computers, like IPad, will be easier to use than current desktops and laptops. Mobile wireless devices will give people the tools to do things they want to accomplish, whatever and wherever they are, and to create, enjoy, and gather content, to communicate, to let the applications do the work, and to avoid all those obstacles inherent in using present computers. The power of the computer will become available to everyone.
E-readers will compete with and compliment mobile computers. They will put many publishers, newspapers, and independent booksellers, and main street businesses out in the retail cold, but they will not replace books, and they may even enhance readership.
Social media membership will grow, but its hazards – loss of privacy, wikileaks, identity theft, internet-based bullying, and pornography proliferation – will become more evident.
Health Reform and Entitlement Programs
The arrival of boomers into Medicare and the boom of simplified electronic access will profoundly affect the politics and shape of entitlement programs. Some of the changes in the new reform law will take effect in 2011. These include partial closure of the donut hole with 50% discounts on brand drugs, “free” prevention services like colorectal screening and mammograms, coverage of young people up to 26 under parents’ plans and those with preexisting illnesses.
Most of the big ticket cost impacts, like covering 32 million of the uninsured, will not kick in until 2014 – two years after the presidential election of 2012.
Between now and 2012, Republicans will seek to delay, defund, and displace some of the existing provisions of the law, and they may fail because of Obama’s veto power.
If President Obama is re-elected in 2012, Obamacare will survive, albeit in an altered form. If a Republican is elected President in 2012, the health reform law may die. It might die anyway, if the Supreme Court strikes down the individual mandate as unconstitutional.
Based on what has occurred since the law’s passage in March 2010, health costs will increase by 13% in 2011 and by another 10% in 2012. These cost increases are likely to run into a political buzz saw of protests, as the budget deficit grows, the economy remains stagnant, and access to doctors shrinks, and doctor shortage grows.
In 2012, the good news will be if the bad news is wrong.
Richard L. Reece, MD, is pathologist, editor, author, speaker, innovator, and believer in abilities of practicing doctors and their patients to control and improve their health destinies through innovation. He is author of eleven books. Dr. Reece posts frequently at his blog, Medinnovation.