A New Vista in the Land of Opportunity
We are all faced with a series of great opportunities--brilliantly disguised as insoluble problems.
--John W. Gardner
A while ago, I spoke about health and aging to an audience in Lexington, Kentucky. When I finished my remarks, a woman raised her hand to ask this question: "Do you know that women live longer than men?" I said that I did, to which she replied, "Well, what are you going to do about it?" Even if I could do something about it (which I can't), the fact is, both men and women are living longer. For the first time in history, long life isn't a rarity. Two-thirds of all the people who ever reached the age of 65 are alive today. What's more, 65 isn't even old anymore--most of us can count on another eighteen years or so after that, and more than half of us will live past 90. The fastest-growing segment of the population is those 85 and older.
All of this is good news for America's 78 million baby boomers, the oldest of whom just turned 60 this year and the youngest 42. As the boomers age--one reaches the age of 50 every 7.5 seconds, which adds up to 4 million every single year--the cascade of those over 65 will double over the next thirty years to 70 million. The first boomers turn 65just five years from now, in 2011. This age shift is having an enormous impact--from family life, work, and recreation to the economy, health care, housing, education, transportation, and technology. But we're beginning to realize--with a jolt--that society has not kept up the demographic shift, and we're certainly not ready for the onslaught ahead.
* boomers have not prepared adequately for their long futures;
* companies are rapidly shifting financial risks and responsibilities to workers and retirees without adequate preparation and safeguards;
* government programs are not working as well as they should, and many need to be modernized, better financed, and more engaging to the public;
* we have a health-care system that is designed to pay bills but doesn't promote health and wellness; and
* we have a growing older population that by and large is vital and active and possesses great intellectual wealth. But we have not structured a social model to optimize their continued involvement.
Many, in fact, fear this future. Who can blame them, given the alarmist tone of much of the discussion? We hear that Social Security is on the brink of collapse--that by 2020 each retiree will be supported by the payroll taxes of only two workers, far too little to keep the system solvent. Chicken Littles squawk that an army of "greedy geezers" will vote down school taxes but give themselves so many benefits as to bankrupt the country. Others imagine a nation of nursing homes filled with helpless, hopeless old folks.
In just one recent day's worth of articles from around the country I found these stories:
* "Boomers to Overload Health System: Rising Costs of New Treatments, Fewer Resources Seen as 'Disastrous'"
* "Think Social Security Is Secure? Think Again"
* "How Bedrock Promises of Security Have Fractured Across America"
* "Companies Are Discarding Traditional Pensions"
* "Medi-Cal1 Cut Threatens Poor, Disabled; More than 3 Million Patients Could Be Affected by a 5% State Reduction in Payments to Doctors, Who Say They May Phase Out Services"
And to add insult to injury:
* "Baby Boomers' Ears Paying for All Those Loud Rock Concerts"
No question, these are challenging times. And although these pessimistic prognosticators go too far, it's certainly true that there is plenty of reason for concern. David Walker, the comptroller general, has said the United States faces a long-term budget deficit "that will only increase as the baby boomers retire," leading to a "financial imbalance [that] will test the nation's spending and tax policies." He describes it as "a retirement tsunami ... that will never recede."
Clearly, our society needs to make some changes and we need to begin now. But I see that as a positive development, not a negative one, with boomers leading the way to a brighter future for all of us. At every step of their remarkable journey, they have transformed American life and culture.
The transformation began with the first wave of babies just after World War II. As hospital nurseries started filling up, schools were built, pediatricians were trained, and consumers bought the products and services they needed to cope with the deluge. In short, Americans rolled up their sleeves and did what they had to do.
When the baby boomers were still just that, babies, our leaders made a conscious decision to invest in research to develop vaccines and cures for childhood diseases. Consequently, afflictions such as diphtheria, whooping cough, smallpox, and polio--which once killed and maimed thousands of children every year--were all but eradicated. Vaccinations for chicken pox, measles, and mumps became standard practice in this country. And as the babies grew, we built whole new suburbs to house them, fast-food restaurants to feed them (a mistake, perhaps), and schools and universities to educate them. As a result of all this change, the United States became a better, more productive society.
Now even the youngest boomers have passed 40 and are moving into middle age. When they were kids, 50 was considered old. But perceptions have changed. It's a sure sign of progress when, instead of "old folks' homes," specially tailored recreation facilities and new communities are springing up across the country. And just as when the boomers were young, the research and medical community is focused on attacking their health problems, this time the ones associated with aging. This effort alone may make a huge difference. Disability among older people is already decreasing, and if successful treatments for Alzheimer's disease, arthritis, incontinence, and osteoporosis are discovered, the nursing-home population--which is already declining--could be cut even more, possibly in half. The millions of Americans freed from these debilitating diseases would enjoy a much-improved quality of life, to the great relief of their families and friends.
Nearly everyone agrees about the impact of the boomers and our increased longevity. What's lacking is a consensus on how we should adapt to the new realities. The collective "we"--individuals, institutions, communities, businesses, and government--don't share a common vision of the life we want or the changes we will have to make to achieve it. Many boomers are already experiencing the future by caring for aging parents. And, as they do, they're beginning to weigh in on what works and what doesn't. By and large, they're seeing a whole lot that needs to be changed.
So what some see as insoluble problems are, to my mind, great opportunities--opportunities, as this book spells out, to make us healthier and transform our health-care system, to rethink our retirement expectations, to extend our productive, creative lives, to build more livable communities, to change the culture so the country can actively profit from a still vital population, and to leave lasting legacies that improve the lives of others and strengthen the country for future generations.
OPPORTUNITIES FOR CHANGE
This increase in the life span and in the number of our senior citizens presents this Nation with increased opportunities ... . It is not enough for a great nation merely to have added new years to life--our object must also be to add new life to those years.
--President John F. Kennedy, special message to the Congress on the needs of the nation's senior citizens, February 21, 1963
Many boomers approaching their landmark sixty-fifth birthdays dream of active, productive, and well-financed years ahead. Yet we know from the experiences of older people today that shortsighted public policies and private-sector practices coupled with imprudent personal behaviors threaten to smother these ambitions.
For example, our health-care delivery is based primarily on providing acute care, while more and more people are living with chronic conditions such as high blood pressure, diabetes, and heart disease. Over 45 million people are uninsured. Our society is aging, but our new doctors are not studying geriatric medicine. While the cost of health care goes up, the quality of care is going down. At the same time, people are being asked to take more personal responsibility for their own health-care costs. Yet the expense of health care makes it less affordable for many. Out-of-pocket spending on prescription drugs and long-term care represents the greatest health-related financial risk for older Americans.
Even many of those who have access to affordable health care are in danger, although largely through their own fault. While legions of fit and healthy people 50+ run marathons, swim, dance, garden, and beat younger opponents on the tennis court, a multitude of others are shortening their lives with sedentary lifestyles. In other words, being couch potatoes. Poor physical fitness (along with smoking) puts people at greater risk for potentially fatal diseases such as high blood pressure and heart disease. And the increasing incidence of obesity among all age-groups in this country threatens to reverse many of the strides made in health and longevity over the past decades. As chapter 2 points out, we must change our focus from providing acute care for long-established problems to intervening early, before people's health is compromised.
Meanwhile, retirement is being reinvented right before our eyes. As more people live longer and healthier lives, they are searching for ways to continue contributing to society while finding personal fulfillment in their own lives. Many are volunteering, going back to school, spending more time with grandkids, or caring for an elderly parent or relative. Regardless of their activities, they don't see life after 50 as a time to shift into neutral ... it's full speed ahead toward an active lifestyle of involvement and engagement. But far too few boomers are saving enough to finance the lifestyles they want. For members of the so-called sandwich generation, the demands of raising their children even as they care for aged parents make it hard to put aside what they'll need for retirement. At the same time, businesses are scaling back traditional pensions in favor of tax-advantaged saving and investment plans that make retirement income less secure. They are also trimming or even eliminating retiree health care. Even people who have planned well for their retirement are only one major medical episode away from seeing it all go up in smoke. In short, as chapter 3 discusses, retirement planning has not kept up with the startling increase in longevity or the expectation of an active lifestyle.
Making it easier for older people to find and hold on to jobs is one part of the solution. Many people want to or need to work into theirso-called retirement years. And with all the hand-wringing in anticipation of the baby boomers' retirement, it's seldom mentioned that just six years from now, in 2012, the "baby bust" generation that follows the boomers will, in all probability, be unable to fill all the available jobs. Some enlightened companies, aware of the looming shortfall and eager to retain the skills and experience of their more mature workers, are encouraging the 50+ generation to stay on the job. But, as chapter 4 indicates, others are still pushing the notion of early retirement or simply saying good-bye to older employees. This myopia is bad for all those who want to continue working, contributing, and earning the money they need to live comfortably in the next stage of their lives, and it's detrimental to the well-being of our country as a whole. Fortunately, change is afoot as self-interested employers increasingly understand the folly of denying themselves the value that older workers add to the workplace.
"Aging in place" is the dream of most people--and enabling older people to remain in their communities as they age can benefit the communities as well. The wit and wisdom that comes with a lifetime of experiences enriches life for everyone. To help 50+ Americans achieve their dream, chapter 5 explains, we must design age-friendly living arrangements and better transportation options.
The way the members of the 50+ generation are portrayed in the media and other parts of society often bears little or no resemblance to the healthy, active, fun-loving people most of us know and interact with every day. Many people have enough disposable income to enjoy travel, dining out, new learning experiences, and wide-ranging entertainment options. The economic power and vitality of those of us 50+ gives us an opportunity to change the culture of the marketplace and propel an economic boom. Moreover, great rewards await those businesses that have the ability to see through the misconceptions and take advantage of the opportunities, as chapter 6 demonstrates.
The active lifestyle that people 50+ want also encompasses being active citizens. Chapter 7 explores the role that people play as advocates for national, state, and local causes. We know that people50+ vote in large numbers, but most don't view their duties as citizens as just a one-day commitment. As youth, they led a revolution to change America by becoming citizen activists and advocates. Now they have that opportunity to do it again ... to lead another revolution to reinvent America as our population ages.
One of life's greatest satisfactions comes from giving back to society. For the boomer generation, as well as for people already in their later years, the opportunities to leave a legacy and enrich their communities and country are limited only by their imaginations. The idea of service is nothing new. Many years ago, my mother took me along when she taught handicrafts in a Boys Club in Carnegie, Pennsylvania. I've never forgotten it. The challenge is to multiply the joy of serving others by enlisting greater numbers of people and getting them thinking about the innumerable ways in which they can give back, as chapter 8 makes clear.
REALIZING A NEW VISION
If I'd known I was going to live this long, I'd have taken better care of myself.
I hope the prospect of increased longevity will cause us to view our lives differently from an earlier age and influence our decisions along the way. As Eubie Blake suggested, maybe if we know we are going to live so long, we'll take better care of ourselves.
This, however, is a book less about aging than about social change and what each of us can do to advance it. It's a call to action about you and your life and this country. By seizing the opportunities that accompany aging, I believe we can begin to shape a common vision of the lives we want for ourselves and for future generations. After all, as the ancient proverb says, "Where there is no vision, the people perish." We can engage people in the quest to realize their own goals anddreams and to make life better and society stronger for everyone in the years ahead.
Congresswoman Barbara Jordan once said, "What the people want is very simple--they want an America as good as its promise." And achieving an America as good as its promise depends on the balance between what society can do and what we must do ourselves as individuals, exercising personal responsibility. We may have to pay a little more; we may have to exercise a little more; we may have to save a little more; we may have to work a little longer. But we can do it. We can make our lives, our communities, and our country better.
And now is the time to do it. The longer we wait, the harder these problems worthy of attack will fight back. And the sooner we take on our problems and challenges, the less likely it is that we will leave them for the next generation to solve.
George Bernard Shaw put it this way. He said that "we are made wise not by the recollection of our past, but by the responsibility of our future." The responsibility of our future tells us that we must all join together to create a country
* where government stands sentry over vital social programs such as Social Security, Medicare, and Medicaid and takes reasonable and responsible steps to strengthen them for generations to come;
* where corporate giants and small businesses alike prize the experience of older workers and reject age discrimination as bad business;
* where people of all ages can receive quality health care that they can afford;
* where older people can remain in their homes for as long as possible and continue to be active in their communities; and
* where all Americans can achieve independence, choice, and control in ways that are beneficial and affordable for them and society as a whole.
We can make our lives and our families' lives richer. And we can create a society where all people can afford to grow old with dignity and purpose and have the opportunity to continue chasing their dreams. Our ability to achieve all this is limited only by our lack of imagination and creativity. Two hundred years ago, if a farmer were asked what could be done to improve his life, he might have said, "Give me more horses." He would not have thought of a tractor or a combine. Today when we ask, "How do we capture, as AARP's founder, Dr. Ethel Percy Andrus, put it, 'the accumulated experience, the knowledge, wisdom, and skills of all older adults and the increased longevity of our population'?" the answer is not to put up more nursing homes or build a better wheelchair. We need to think about changing ourselves, the environment we live in, and how we interact with it.
Back when I was working at Porter Novelli on health and other social programs, a man who believed that I knew something about social change came to my office and asked me, "How do you start a groundswell?" I didn't have a good answer then. But today I would respond by saying this: "Watch us and join in, because that's just what we're doing, creating a powerful groundswell on behalf of 50+ Americans."
We can't leave the future to chance. We must learn, educate, and create change. This book aims to jump-start the process by getting everyone started thinking and talking about living long, healthy, and engaging lives. After all, from the day we are born we become a part of the aging population. And when people of every age understand what it means to grow older, we will be on our way to changing society. We will improve our own lives and those of generations to come. And we will not only fulfill our responsibility to future generations; we will also create an America as good as its promise.
50+: IGNITING A REVOLUTION TO REINVENT AMERICA. Copyright © 2006 by AARP. All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles or reviews. For information, address St. Martin's Press, 175 Fifth Avenue, New York, N.Y. 10010.