The 1976 film, “Logan’s Run”, depicts a futuristic world where population and consumption of resources are managed and maintained; doing so simply and expediently by killing everyone who reaches the age of thirty to prevent overpopulation.  

The plot focuses on the main character, Logan 5, who chooses to run from the ritual of "Carrousel" - Where those reaching age 30 are vaporized and ostensibly "Renewed."   While the story’s premise was science fiction nearly forty years ago, Americans may begin experiencing not so subtle versions of the storyline in the future.

Obamacare & the Independent Payment Advisory Board

According to Wikipedia, film critic Roger Ebert gave Logan’s Run “a three-star rating, calling the film a vast, silly extravaganza, with a plot that's a cross between Arthur C. Clarke's The City and the Stars and elements of Planet of the Apes.”  

It would be interesting to get the late Mr. Ebert’s thoughts as we approach the full implementation of the Affordable Care Act (Obamacare)…..

One of the more controversial aspects of Obamacare is the creation of the Independent Payment Advisory Board (IPAB) – an unelected 15-member agency with the explicit task of achieving cost savings for government healthcare programs.  Surprisingly, many on both ends of the political spectrum are opposed to this piece of the healthcare law.   

According to an article by Elise Viebeck, of The Hill, “Former Democratic National Committee Chairman Howard Dean drew attention to the board designed to limit Medicare cost growth when he called for its repeal in an op-ed late last month.”   

Sen. John Cornyn, a Republican from Texas, even introduced legislation to prevent the creation of the IPAB, and was quoted in a 2010 editorial in the Washington Post saying, "America's seniors deserve the ability to hold elected officials accountable for the decisions that affect their Medicare, but IPAB would take that away from seniors and put power in the hands of politically appointed Washington bureaucrats."   Consider the recent situation with 10-year old Sarah Murnaghan fighting Cystic Fibrosis and you’ll see this isn’t just an issue for the elderly.

In Sarah’s case, it took an emergency motion in federal court to get around a controversial transplant rule which was preventing her from getting new lungs.  The little-known organ transplant policy had effectively pushed Sarah to the bottom of the adult transplant waiting list because it mandates adult lungs be offered to all adult patients before they can be offered to someone younger than 12 years old.  It took a lawsuit to prevent Secretary of Health and Human Services Kathleen Sebelius from enforcing the policy; as Sebelius would not make an exception for Sarah. 

Sarah is expecting a gradual recovery, but what about those towards the end of life or those with chronic Long Term Care needs?   Glad you asked.....

Grandma is taking a cruise.....On a freighter??

In 2012, the United States exported nearly $18 Trillion in goods, and according to the statistics those figures don’t include a single human being.  However, as 75,000,000 Baby Boomers approach retirement, we (probably) won’t vaporize them as was done in Logan’s Run.....maybe we’ll simply export them. 

Sound farfetched?  Think again.....it’s already a reality in other countries!!

According to Kate Connolly, reporting for The Guardian, a “growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centres because of rising costs and falling standards in Germany.”   She goes on to write that Germany's population is “expected to shrink from almost 82 million to about 69 million by 2050, one in every 15 – about 4.7 million people – are expected to be in need of care, meaning the problem of provision is only likely to worsen.”  

When you examine the statistics in the United States, it’s simply frightening to even compare them to that of Germany.   Of the 75,000,000 boomers, 40% will require Long-Term Care for more than 2 years and nearly 25% of those will require that care in a nursing home setting.  

Break down even the most modest government stats and that equates to nearly 10,000,000 Americans who will need facility-based Long-Term Care, yet there are just 1.6 million Long-Term Care beds available in the ENTIRE country.   These stats merely paint the picture of the availability of care; paying for that are is altogether another question.   

Looking across the Atlantic once again, The Guardian article “found a variety of healthcare providers were in the process of building or just about to open homes overseas dedicated to the care of elderly Germans in what is clearly perceived in the industry to be a growing and highly profitable market.   According to Germany's federal bureau of statistics, more than 400,000 senior citizens are currently unable to afford a German retirement home, a figure that is growing by around 5% a year.”

Again, the metrics are even larger here in America and the looming crisis for Long-Term Care in our country is one which eventually is going to affect you, your family and/or your clients.   Maybe it time to consider the “Future of Aging in America” and begin planning proactively.