There are plenty of stories about the financial stability of social security and medicare, the impending caregiver ratio crisis and the business opportunities of the longevity economy. A couple things are often missing from the stories. One is a bold enough statement describing the scale of the problem. The second is solutions that stray from the story focus. No coloring outside the lines.
The quote below, from Federal Reserve Board Chairperson Jerome Powell makes the scale of the increasingly aging population problem loud, clear and significant:
“Longer term, it is widely understood that the United States is on an unsustainable fiscal path, largely due to … an aging population.”*
Problems of that scale cannot be solved by isolating and separating issues. They are too large, too complex, too interrelated. Grasping issues at this scale requires a broad contextual view to search for solutions. That is hard because achieving expertise is so often about a narrowing focus. Organizational missions are often, not unthoughtfully, crafted to narrow the focus in order to be effective, to communicate succinctly, and to select measurable goals. But this also keeps them viewing the trees instead of the forest.
Those of us working in related fields have seen the beginnings of the broader exploration under the banner of ‘social determinants of health”: Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health.
And though there is growing recognition, there is not yet sufficient practice, especially around regulation and policy, that incorporates this approach. Engaging the social determinants of health within government spending is really hard because governmental spending flows from established, regulated silos that are difficult to change let alone integrate. (medicare, medicaid, housing, SNAP, CACFP, and many more) This is about turning a huge ship. It doesn’t happen fast.
This makes the private pay and private delivery sector an important incubator for new delivery models. Innovative interventions coordinated through high tech monitoring, management and evidence gathering is in the near future. Aspects are already being deployed in wide ranging demonstrations. Private businesses can try new things because they are nimble. A business operator can try new ideas in their operations, experiment in partnerships with colleagues, and abandon or scale up as appropriate.
Some articles and some experts will tell you our aging population is a cliff we are about to fall off. Recognizing the scale of the problem and looking for sector/silo/expertise crossing innovations that can scale up is an important strategy to look for solutions.
*Federal Reserve Chair Jerome Powell, in an interview with Marketplace’s Kai Ryssdal on July 12, 2018