There is no doubt about the Constitutional significance of the Supreme Court’s ruling on healthcare reform. But the whole ordeal is just a bunch of smoke and drum-beating without any real fire, from a healthcare point of view – because our system remains completely ill equipped to meet the demographic realities of the 21st century.
Most Americans get this. Very few see “Obamacare” as the solution to either their individual needs or the overall woes of the American healthcare system.
Right now, there’s a level of anxiety much more profound than a national plan that emphasizes “individual mandates,” “cost containment,” or “coverage.” It’s why Americans have never really embraced any “Inside the Beltway” solutions. They get that reforming a system that was made, literally, for a different time just doesn’t cut it. They get that there’s been huge transformational changes, which the Affordable Care Act ignores.
A new wave of demand has been created by the aging of both the American and global population. With 77 million baby boomers in the U.S. “getting old” along with 450 million of their peers worldwide, there’s fresh need for health products and services. Far more than any other population segment, “seniors” often juggle multiple conditions and will require an unprecedented quantity of healthcare system over the coming years. And with America and the world experiencing a birth dearth, societies will continue to age well into this century, challenging the traditional model of “enough [people] under 60 to take care of those over that age,” as Stephen Philip Kramer writes in the current issue of Foreign Affairs.A few decades ago, when America’s boomers were young, education and infrastructure build were the focus. But now, with the risk of cardiovascular disease doubling for each decade of life after age 55 and Alzheimer’s affecting almost one in two people over age 80, health reform needs to meet the needs of aging populations. Prevention, cures, effective management – these are what animate, not “coverage.”
Our greatest fear is not that we won’t be able to afford Alzheimer’s (which might be true); it’s that we’ll actually get it. Do something about that and you’ll start to address today’s very real health needs.
Then there’s the explosion of new technology – innovative breakthroughs in medicine, surgery, technology, diagnostics. Americans expect to have it all, and they expect all of it to work. This causes fear and anxiety. Americans have sky-high expectations, perhaps understandably, for what medical technologies can do, but the Affordable Care Act does nothing on this point.
Medical information has been so democratized now, and while there are tremendous upsides to this, there are also unrealizable, unrealistic demands on our healthcare system. Between Google, medical journalism, and new platforms like Alliance Health Networks that enable social networking, people have access to information once held privately within the circles of science and medicine. So how do we align the democratization of information with what our medical institutions can actually deliver?
The Supreme Court’s decision won’t be much more than a blip on the healthcare radar for most Americans. It does not solve, nor did it promise to address, the underlying worry and disappointment that population aging, the availability of new innovative technology, and the information revolution all bring. It’s why most Americans have viewed the reform initiatives with a cynical shrug. The real issue is how to make the 20th-century institutions and structures of healthcare relevant to today’s realities.
With new demands pressing on the health system, we must figure out how to reconfigure supply and demand. If we don’t, baby boomers in the U.S. and around the world will be prevented from aging in healthy, active, and economically and personally productive ways.
Michael W. Hodin, Ph.D., is Adjunct Senior Fellow at The Council of Foreign Relations and Executive Director of The Global Coalition on Aging.