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Americans Are Generally Living Longer, And There Are Increasing

Numbers of Older Americans Due To Improved Treatments, New
Technologies, And The Health Care Reform law. What Do You Think Will
Be The Challenges Of U.S. Health Care In The Decade 2010-2020?

Margaret Agwuocha
Saint Leo University

That Americans are living longer is evident in the large number of older
Americans in the society. This can be attributed to the improved treatments,
new technologies and the health care reform. Following research and break
through into disease prevention and treatment, people have better chances of
surviving ailment that have killed a lot of individuals in the past and new
technology have also afforded a lot of people good quality of life. The health
care reform can be called the icing on the cake as it made it possible for a lot of
Americans to have access to quality health care.
According to Shi and Singh (2010) the determinants of health have
made major contribution to the understanding that a singular focus on
medical care delivery is unlikely to improve the health status of any given
population. A more balanced approach must emphasize health
determinants at an individual level, as well as broad policy intervention at
the aggregate level. The leading determinants of health are
Environment physical, socio-economic, socio-political and
socio-cultural dimensions.
Behavior and lifestyle diet, exercise, stress-free lifestyle,
promiscuous sex, and smoking
Heredity genetic factors
Medical care access to adequate preventative and curative health
care services.

With this increase in the senior population, the Institute for Future (2010) said
that we face a crushing disease and demographic burden. The global
population of people age 65 or older has hit an all-time high, and as we
age, more of us are suffering from chronic illness and obesity. Health
challenges are not however confined to the aging: childhood obesity has
hit record levels around the world. Yet despite these circumstances, we
are striving to find new ways to improve our individual and collective
wellbeing, and developing new conceptions of what it means to live
strong and resilient lives. By improving health, reducing fragility, and
perceiving critical risks ahead of time, we cushion against the
catastrophe of illness. In order to build resilience and move toward
wellbeing we must create the conditions in our lives for health.
With this influx of senior citizens, the health care service utilization will be
greatly impacted and the need for more home health care agency will also been
seen to increase. The 2008 annual report of the Medicares board of trustees
states that in 2007, there were 44.1 million enrolees (36.9 million elderly and
7.2 million nonelderly) in all U.S states, territories, and in the District of
Columbia. With (increase in) the aging population, the Medicare programme is
expected to grow to 61 million enrolees by the year 2020. This poses the single
greatest future challenge to taxpayers of all government programs.

According to the Centre for Retirement Research at Boston College, in

the 1983 Report, the Trustees projected a 75-year actuarial surplus of
0.02 percent of taxable payroll; the 2012 Trustees project a deficit of 2.67
percent. Table 4 shows the reasons for this swing of 2.69 percent of taxable payroll. Leading the list is the impact of changing the valuation
period. That is, the 1983 Report looked at the systems finances over the
period 1983-2057; the projection period for the 2012 Report is 20122086. Each time the valuation period moves out one year, it picks up a
year with a large negative balance.
Table 4. Reasons for Change in Social Securitys 75-Year Deficit as a Percent
of Payroll, 1983-2012
Item
Actuarial balance in
1983
Changes in actuarial balance due to:
Valuation period
Economic data and
assumptions
Disability data and
assumptions
Methods and
programmatic data
Demographic data and
assumptions
Legislation/regulation
Other factors*
Total change in
actuarial balance
Actuarial balance in
2012

Change
0.02

-1.68
-0.75
-0.72
-0.19
0.39
0.30
-0.04
-2.69
-2.67

* Discrepancies due to rounding.

Source: Authors calculations based on earlier analysis by John Hambor, recreated and
updated from 1983-2012 Social Security Trustees Reports.

The 2012 Trustees Report confirms what has been evident for two
decades namely, Social Security is facing a long-term financing
shortfall which now equals 2.67 percent of taxable payroll or 0.9 percent
of GDP. To put the magnitude of the problem in perspective, defense
outlays went down by 2.2 percent of GDP between 1990 and 2000 and up
by 1.7 percent of GDP between 2000 and 2010.
While Social Securitys shortfall is manageable, it is also real. The longrun deficit can be eliminated only by putting more money into the system
or by cutting benefits. There is no silver bullet. Despite the political
challenge, stabilizing the systems finances should be a high priority to
restore confidence in our ability to manage our fiscal policy and to assure
working Americans that they will receive the income they need in
retirement.

References

Alicia H. Munnell (2012) Social Securitys Financial Outlook: The 2012

Update in Perspective. Centre for Retirement Research at Boston College
Retrieved from http://crr.bc.edu/wp-content/upload/2012/04/1B_12
Institute for the future (2010) Health Horizons' 2010 Research Agenda:
Resilient Bodies and Lifestyles. Sausalito, California
Retrieved from www.iftf.org
Shi, L., & Singh, D. (2010). Essentials of the U.S. health care system (2nd
Edition) Mississauga, Ontario