The real Reagan story? Aging society

0 Comments | Oakland Tribune, Jun 14, 2004

THE all-news TV channels (the cable stations that formerly carried news) missed the Reagan story I'm most interested in: I had quite enough of Ronald Reagan, the extraordinary; what about Ronald Reagan, the ordinary?

Reagan the ordinary is the story about a 93-year-old man living with Alzheimer's disease for more than a decade. Reagan the ordinary is the story about families that must cope with intense medical demands. Reagan the ordinary is the extraordinary demographic trend that's changing America.

Like so many older people these days, Reagan kept working long after the so-called "retirement" age; he worked a dozen years past age 65. He then retired to California where more than 400,000 people are older than 85.

We are in an era when people live longer -- and that has many ramifications for the way we live, fund government and design our medical system.

There are now four former presidents alive; the oldest is another "ordinary" Californian, Gerald Ford. He will be 91 next month. In some way Ford represents another aspect of this extraordinary demographic trend because his lifestyle remains so active. He could live to be 100 -- and even that is less extraordinary.

A Census Bureau report estimates there are some 72,000 Americans now over the age of 100 -- and by 2050 that number will climb to more than 850,000 (even that number is at best a guess because, as the Census Bureau puts it, "if we see even more rapid increases in life expectancy the number of centenarians could be substantially higher").

That's a very different population picture than when Reagan, Ford and other ordinary older Americans were born. At the turn of the past century, life expectancy was under 50 years old.

Ordinary Reagan and Ford are the beginning of the curve; they're not the baby boomers. It's when people my age reach the age of 65 -- starting in 2011 -- that the ranks of the elderly will really swell to more than 20 percent of the country (from about 13 percent now). In sheer numbers it's a jump from some 35 million Americans to more than 70 million or more by 2030. The population of those over the age of 85 -- the folks who most likely will need long-term medical care - - will be more than four times as large as it is now.

The ordinary American is aging -- and this country is not ready for that.

Every day some 6,000 Americans have a 65th birthday (while 10,000 boomers a day celebrate their 50th).

"It is no secret that the size of the over-65 population is growing," Daniel Perry, the executive director of the Alliance for Aging Research, testified to Congress two years ago. "What is much less well known, and underappreciated, is that our health care delivery system is woefully unprepared to meet this challenge. Out of more than 650,000 physicians in the U.S. today, only 9,000 have certification in geriatric medicine and the number is actually shrinking."

That number has not improved since the report was issued.

Perry said this country is dealing with "age denial." We have not, either as a nation or as individuals, come to grips with our aging. We haven't even started talking about what this means (unless you count the demographic fears raised about Social Security and Medicare).

Take the stem cell debate, for instance. Would it change the politics if folks thought it was about their future well-being?

Perry has described stem cell research as a possible "magic" that could fine-tune the aging process so people can delay the ravages of age-related diseases. If nothing else, consider the savings.

"Postponing physical dependency among older Americans by just one month would save the U.S. at least $5 billion a year in health care and nursing costs," Perry said. "Postponing the average onset of Alzheimer's disease by five years would, over time, save $50 billion a year in health care costs. A five-year delay in the beginnings of cardiovascular disease could save $69 billion a year."

I often disagreed with the politics of the extraordinary Ronald Reagan. But ordinary Ronald Reagan is someone I readily identify with because he could help our nation understand aging. Ordinary Ronald Reagan could yet add to the legacy of extraordinary Ronald Reagan.

Mark Trahant writes for the Seattle Post-Intelligencer.