Time to Stop Blaming Boomers for Health-Care Costs

By Charlotte Bumstead
Aging baby boomers have taken a lot of heat for being the expected cost drivers of our health-care system. It turns out there are multiple culprits threatening Canada’s medicare system toward bankruptcy, and the “silver tsunami” is only a fraction of the issue. Evidence shows those with chronic illnesses to be the biggest users of health services—and these patients are not being managed cost-effectively. Seniors, who contribute to 13 per cent of the population, are associated with about 44 per cent of health spending; while patients with chronic conditions are responsible for about two-thirds. According to recent studies, it is time to change the mindset that aging means illness. It is time to reassess the attributes of spending increases.

There is no denying the assertion that per capita health spending increases steadily with age. Starting from a low of $1,223 at age 5, costs rise to $3,772 at age 65. From there, it doubles every decade, reaching $8,425 at age 75 and then $16,821 at age 85. However, new research published Thursday by the Canadian Institute for Health Information (CIHI), explains health-care use illustrates similar and steady patterns at ages 45, 65 and 85 for those free of chronic health conditions.

Conclusions clarify it is the rise in the number of people living with chronic health conditions, like hypertension, diabetes and depression, which is forcing health costs to climb—not aging per se. The more chronic illnesses a person suffers from, regardless of age, the more health services they utilize; such as visiting a specialist, consulting a pharmacist, going to emergency and being admitted to hospital. The report confirms people with three or more chronic conditions make, on average, six times the number of health-care appointments than those with no chronic conditions.

Director of primary health-care information at CIHI, Greg Webster, notes while aging is not the primary cost driver, the probability of a person suffering from a chronic health condition does increase with age. Of Canadians over the age of 65, three in four are averaged to have at least one chronic illness, in comparison to one in five people under age 24.

However, new data proposes patients undergoing multiple chronic conditions are not properly handled, specifically in regards to medications. It appears one of the keys to controlling health utilization and spending is in preventing the arrival of chronic illnesses.

A second report, this time from the Urban Futures Institute, has examined factors relating to provincial health spending over a 30 year span, from 1979 to 2009. Public health spending during that period has grown from $13.6 billion to $118.6 billion across Canada, as a result of the following contributors:
* Population growth – by 7 per cent;
* Aging of the population – by 14 per cent;
* Inflation – by 19 per cent;
* Increased utilization – by 59 per cent.

According to the analysis, though the aging population plays a part, the largest dollar-eater is, undoubtedly, utilization. This is a result of new drugs, enhanced technologies, new hospitals, more doctors and nurses (with advanced incomes), further administrative structures and so on. Governments have expressed little concern regarding the eagerness for increasing health spending well beyond the rate of inflation. During the period between 1979 and 2009, the average rate of increased health spending was 8 per cent a year. That is a much quicker growth rate than inflation (3.4 per cent), the 65-plus population (2.9 per cent) and population growth (1.7 per cent).

Therefore, fingers should not be pointed at aging baby boomers. Accusing eyes should shift their glance toward what’s fixable. Aging is inevitable. Careless health inflation is not.