Personally, I think dire predictions about the “silver tsunami” will turn out to be wrong, thanks to a combination of medical science and free-market forces. I think researchers will figure out how to prevent or cure Alzheimer’s disease and many other conditions that affect many of us in old age. 

I think that employers will discover that 80-year-olds can be just as productive as 30-year-olds, and that policymakers will revamp benefits programs to keep them from promoting ageism.

Most of us will work until we’re 80, because, if we’re healthy, why the heck not?

But I have no psychic powers whatsoever, and I could be wrong. Maybe the percentage of baby boomers who suffer from severe dementia will turn out to be higher than expected. Maybe typical workers will still expect to retire by 70, or even by 65.

Maybe ageism will be so resistant to change that even 60-year-olds will continue to have trouble keeping and finding jobs.

If so, and if we want to have a society that continues to function, we’ll need to be able to get through big changes.

See also: Accounting rule to force U.S. cities to report health care bills

That’s why I think a recent board meeting document posted by the managers of Nevada’s state-based Patient Protection and Affordable Care Act (PPACA) exchange is relevant to long-term care (LTC) planners and anyone else with an interest in the United States sticking together.

Bruce Gilbert, the executive director of that exchange, pointed out that even the state-based public exchange programs have trouble getting the consistent, up-to-date, comprehensive information they want from the U.S. Department of Health and Human Services (HHS).

See also: Nevada exchange head: HealthCare.gov costs too much

In other words: Not even the state-government chartered entities that are going through fire to keep a program that HHS allegedly loves alive can trust HHS to give them honest answers to their questions.

If that situation persists: Think of how that will cripple our efforts to deal with massive waves of social change.

Paul Krugman, the Nobel Prize winning economists, makes great persuasive arguments that, in the short run, at least, government deficit spending is not a big deal. Maybe that’s true.

But, however the government spending system works, in the long run, if the 80-something boomers of the 2030s look like the 80-something people of the 2010s, we’re going to need more long-term care (LTC) facilities, more LTC workers (or more LTC services robots and more LTC services robot managers), more medical services capacity and more ability to provide food and other necessities for older people who are no longer working.

See also: Public LTC costs may threaten states’ credit ratings

If we haven’t defeated ageism by then, we’re also going to have to find a way to jam older workers into the workforce, meet private and public retirement income obligations, and persuade older people (and their children, and grandchildren) to grin and bear it when retirement benefits resources fall short of expectations.

However nice short-term government budget deficits may be for our current unemployment rate, our ability to pay for restaurant meals, our skin, our hair and our bad breath, it looks as if, over the long-term, we’ve probably promised to give the same jobs, the same LTC beds, the same LTC services worker (or robot) time, and the same capacity to pay for food and other essentials to two or three different people.

Whether we’re Republicans or Democrats, capitalists or socialists, we’re going to have to have enough goodwill not to get into physical fights when we find out that, no, all that money we saved so carefully away, at the expense of our ability to enjoy ourselves, will not actually guarantee us the ability to tell “The Man” to take that job and shove it when we’re 62.

Our society will probably still be rich, all things considered. We’ll find a way to keep frail and disabled older people in reasonably suitable accommodations. But, chances are that nothing will turn out to be quite the way we expected it.

Even if we do eliminate dementia and do eliminate ageism, we’ll probably maintain a high standard of living by having people work longer, not because Social Security, Medicare or private pension plans make good on promises uttered at a time when safe government bonds were paying an interest rate 4 percentage points higher than the inflation rate.

The only way I can imagine we’ll be able to maintain social order after dealing with all of the promises that will break is if we have a reasonably high level of trust in one another, and we understand that the promises are breaking because the people who made the promises had unrealistic expectations, not, in most cases, because they were greedy, evil crooks.

We’ll have to have a basic level of trust in the Medicare program managers when they explain why they have to make drastic changes in how Medicare works.

Meanwhile, today, we can’t even trust HHS to give us a straight answer about how many employers have PPACA exchange Small Business Health Options Program (SHOP) plans, or to tell Nevada what’s going on with open enrollment this week.

This is not good.

See also:

Here’s why you should be talking to millennials

When should you talk to millennials about LTCI?

 

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