I’ve been invited to give a talk on the topic of challenges posed by an ageing population. This issue has been around ever since I can remember and, in a literal sense, it’s one I am pretty concerned about. Throughout my life I have, like the rest of the population, been aging at a rate of one year per year, and this poses plenty of challenges. On the other hand, as someone said recently, getting older may have its unpleasant aspects but it’s a lot better than the alternative.
Of course, when pundits talk about an ageing population, they do not mean that we are individually getting older but that we are not dying as soon as we used to. The result of this (and subject to demographic fluctuations) is that the average age of the population is increasing.
While I was a little snarky in my opening para, this is, in fact the correct way to think about things. We are, mostly, living longer and this creates a bunch of individual and social opportunities, choices and challenges. The two big ones are:
* How should the extra years of life be allocated between additional education, additional years of work (including household work most notably childraising) and additional years of retirement?
* What are the implications for our personal health and for the health care system.
I’ve looked at the first of these questions on quite a few occasions and concluded that the problems, if any, relate to the way the labour market works (or rather fails to work) for older worker
On the second, the operating assumption in much of the discussion seems to be that people will live longer, but that their health, at any given age, will be much the same as that of previous cohorts. This is obviously nonsensical. The reason the previous cohorts died earlier (on average) is that their health was worse. If people live longer, this will mostly mean more years of healthy life.
One possible exception I’ve been concerned about is dementia caused by Alzheimer’s and related diseases. Perhaps that’s inevitable deterioration rather than a product of ill health. But the news here is good. Age-specific rates of Alzheimers have been declining for the past 25 years as general health improves.
One remaining issue is that people with severe dementia are surviving longer than they used to, as a result of improved care, and this is socially costly. However, this is a once-off shift that has already happened, so the extra cost has been incurred already. Increases in lifespans associated with improvements in general health, including reductions in the age-specific frequency of dementia should not have any additional cost.
This is, in fact, an illustration of a more general point. The increase in health care expenditure we observe is the result of the development of new, and costly treatments. Unsurprisingly people want these treatments and are willing to pay for them, either privately or through the public health system. To regard this as a problem is like complaining about the availability of flat-screen TVs on the basis that buying them will increase our entertainment costs.