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With the many more healthy and vibrant older people in 2040 will come a matching population of frail and disabled elders.
When Congress signed Medicare into law in 1965, the life expectancy of the U.S. population was 70.2 years, the probability of a baby born in 1965 reaching age 65 was 71.3 percent, and among those who had already celebrated their sixty-fifth birthday in the year Medicare was enacted, 28.1 percent would survive to their eighty-fifth birthday. A century ago, Americans lived only about forty-seven years, and the probability of a baby born in that year reaching age 65 was only 39 percent (Bell and Miller, 2005). On the surface, these statistics are accurate-many Americans are living much longer and healthier lives than at any time in our history, and, for some, there is reason to be optimistic about the future (Olshansky et al., 2009).
However, the picture that these and other related statistics convey is only part of the story of our past and present. There is a unique "history" behind mortality and survival statistics that provides a full three-dimensional view of the forces that influenced past and current health and longevity attributes of the U.S. population ages 65 and over, and the factors most likely to influence cohorts reaching these ages in the future. The following seven major demographic events will influence attributes of the Medicare population in the future.
Event Number 1
Demography Is Destiny. The number of people surviving into the Medicare age window has risen steadily since 1965, and it will inevitably continue to do so for the next twenty-five years as a result of shifting demographics, and due to declining mortality at middle and older ages. This population's size will increase by at least 67 percent between now and 2040.
In 1965, the U.S. population was at 194 million. Having risen to 316 million by 2015, the U.S. Census Bureau projects it will rise to 380 million by 2040. The U.S. population was increasing at a rate of 2.4 million per year during the period of 1965-2015, but it is projected to experience an accelerated rate of increase to 2.56 million annually between now and 2040. The largest percentage increases will be in the population ages 65 and...