The Future Looks Gray

The Future Looks Gray

05.17.12 | By

[caption id="attachment_2269" align="alignleft" width="150" caption="Growing Global Populations of Elderly"][/caption]

Monday, I was privileged to sit in at the Council on Foreign Relation's David Rockefeller Studies Program panel discussion on Spending on Health as an Investment, Fiscal Sustainability and Aging.

The panel discussion, hosted by Mikael W. Hodin, CFR Adjunct Senior Fellow and Executive Director of the Global Coalition on Aging, included PhRMA's president and & CEO John Castellani and Dr. Bernard Merkel, Minister Counselor and Head of Food Safety, Health, and Consumer Affairs for the Delegation of the European Union here in the United States.

The discussion focused on the challenges both developed and developing countries face from growing global populations of the elderly, their susceptibility to numerous Non-Communicable Diseases (or NCDs) and the fiscal impact of meeting their health needs.

Certainly, seeing as there is great hunger for solutions, many of those potential solutions were touched on during the hour or so discussion. There was also, needless to say, a great deal to think about, especially when it comes to the healthcare challenges we face in the U.S. and around the world.

A couple of things that struck me and that I hadn't thought about before: First, we are living in a pretty unique time in history. By that I mean, historically, the percentage of any population that reached the status of "elderly" (essentially 65 years and older) was around three to four percent. That was true for much of human history. Today, in the west and in developing countries, as much as 15% of the population is elderly, and in Europe and Japan it is as high as 35% and 40%, respectively.

Second, it isn't just developed countries that are facing the challenge of growing elderly communities. In 1955, the average global life expectancy at birth, according to the World Health Organizations was around 48 years. By 2000, life expectancy increased to 66 years. By 2025, it could reach 73 years.

Better health, nutrition and economic progress are part of the cause for increased longevity. But, as populations live longer, as economic, nutrition and health conditions improve, so too does susceptibility to a host of non-communicable diseases - such as diabetes, cancers, Alzheimer's disease and others - as does the need for early identification, prevention and intervention.

Third, and, perhaps needless to say, meeting the healthcare needs generated by increased incidence of NCDs among this population will also come at a significant financial cost to global economies.

Thinking about these developments in their implications for policy and how we practice and finance healthcare, I was struck by something Dr. Merkel said about what is now happening in Europe.

There, four working-age citizens currently help support social services for every one senior and retired citizen. Within the foreseeable future, that ratio will become two for one. Clearly, this dramatic shift will require European governments to rethink and refocus on the whole issue of aging, how to help aging populations stay and keep healthy as well as the cost and services provided by healthcare and other social welfare systems.

One thing John Castellani said generated a lot of attention. Responding to questions about how we balance the healthcare needs of aging populations versus the imminent costs of meeting those needs, Castellani suggested that we must begin thinking about aging and the elderly in very different ways than we now do.

Specifically, he urged that we change our view of the elderly as economically dependent and un-productive and begin viewing the growing elderly population as an economic opportunity. To get there, we need to do a better job of helping everyone stay healthy, engaged and productive longer. In short, change our image of "retirement" so that reaching retirement age or 65 is seen as a new opportunity for individual growth and fulfillment as well as contributing to the larger community and economy.

As big as these challenges are, however, the discussion ended on a generally positive note. While emphasizing that efforts to better meet the healthcare needs of the elderly will be difficult and costly, all of the panelists agreed that awareness of the problems is stimulating new thinking and action. Dr. Merkel pointed out that - forced by its demographic shift - European countries are increasingly focused on the challenges and costs of aging and increasingly taking a long-view of efforts to meet the challenge.

From the standpoint of the biopharmaceutical research industry, Castellani noted that the sector is particularly creative at coming up with solutions when there is a clear target in-sight. Whether that is Alzheimer's disease - which, according to the Alzheimer's Association, could affect as many as 16 million Americans and cost $1 trillion a year by 2050 - or diabetes, already affecting more than 300 million people worldwide, investment in research and development of new treatments and medicines is critical.

But, everyone also acknowledged that there isn't a simple medical, financial or systematic solution. Meeting the challenge will come from both taking a long-view of the challenges ahead, changing the way we incentivize health, changing lifestyles (diet and exercise) and partnering in new ways - industry, governments, independent researchers, patients and healthcare professionals - to find workable solutions.

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