APOCALYPSE NO: Population Aging and The Future of Health Care Systems

Abstract

Illness increases with age. All else being equal, an older population has greater needs for health care. This logic has led to dire predictions of skyrocketing costs “apocalyptic demography”. Yet numerous studies have shown that aging effects are relatively small, and all else is not equal. Cost projections rest on specific assumptions about trends in age-specific morbidity and health care use that are far from self-evident. Sharply contrasting assumptions, for example, are made by Fries, who foresees a “of morbidity” and falling needs. Long-term trends in health care use in British Columbia show minimal effects of population aging, but major effects, up and down, from changes in age-specific use patterns. Why then is the demographic apocalypse story so persistent, despite numerous contrary studies? It serves identifiable economic interests.

Beneath the calm surface: the changing face of physician-service use in British Columbia, 1985/86 versus 1996/97

“…[2][3][4][5] Our study has reinforced those findings but extended the earlier work in 2 ways. First, the British Columbia Linked Health Data (BCLHD) set 6 enabled the use of data for the individual, nonidentifiable patient rather than patient groups (e.g., age-specific) as our fundamental unit of analysis, which made it possible to do a more detailed exploration of the components underlying changes in aggregate expenditures.…”

Health expenditure growth: reassessing the threat of ageing

“…Evans et al [22] show that projections performed in the 70's or in the 80's greatly overstate the number of acute hospital days actually observed in 2000, and underestimate the use of physicians' service.…”

Economic Security in an Aging Canadian Population

“…In particular, we know that population aging per se accounts for very little of the increase in health care costs in the recent past and it will not be the key driving force over the next three decades (Evans et al, 2001). This myth that population aging is the key factor in rising health care costs is used by those who seek more funding for their part of the system.…”