The US healthcare system must prepare for an older, aging population

Om Sakhalkar is a medical student at the Medical College of Georgia. He is President of the American Medical Association – MCG Chapter and Clinic Coordinator at the Asian Clinic.

Over 54 million. This is the number of Americans over the age of 65 in 2019, or more than 15% of the population. Here in Richmond County we have about 30,000 seniors. The number of Americans over the age of 65 is expected to accelerate to 80.8 million Americans by 2040 and 94.7 million Americans by 2060, representing an astounding 75% increase in number of older Americans over a period of just 41 years.

The U.S. Department of Health and Human Services Administration for Community Life is responsible for kicking off Older Americans Month each May, with a different theme for each May. This month of May, the theme is “Age My Way”. The aim of this year’s theme is to focus on how older people can live independently for as long as possible.

Living independently for as long as possible is a great goal for seniors. However, chronic illnesses can make this goal difficult, if not impossible. The National Council of Aging states that 80% of older Americans have at least one chronic condition, with 68% having two or more chronic conditions. Having so many older Americans with chronic illnesses will add pressure to our health care system and prevent older Americans from living long and fulfilling lives.

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The impact of aging goes far beyond the elderly, placing an enormous burden on our healthcare system. Medicare spending will grow an average of 7.2% a year this decade, hitting the $1 trillion mark for the first time next year.

Older Americans use health services at a much higher rate than the rest of the population. Meanwhile, between physician retirements due to the COVID-19 pandemic and older physicians approaching retirement age, our healthcare shortage is about to get much worse, with a national shortage of 54,100 to 139,000 physicians by 2033.

On top of all of this, marginalized minority populations, rural populations, and uninsured populations have more barriers to accessing health care, and addressing these barriers while addressing our aging population could increase the doctor shortage to 180,400 doctors.

The increase in future demand for healthcare services coupled with a decrease in the number of doctors will have a negative impact on our healthcare system. We need to rethink our health care system to make sure older Americans get the care they need while providing health care to other Americans and expanding health care to those with barriers.

Educating and training more doctors is the best first step. Medical schools in the United States increased enrollment by 52% from 2002 to 2019. However, the number of residency positions, training positions required after medical school, has remained roughly stable since the end of the 1990s, increasing at an annual rate of only 1%. Increasing the number of residency positions is necessary to increase the number of physicians in the United States.

The American Medical Association (AMA) supports the Resident Physician Shortage Reduction Act of 2021, bipartisan legislation to gradually create 14,000 new residency positions. We also need to do more to emphasize preventive health care services, which have been largely ignored in the COVID-19 pandemic with record obesity rates and fewer primary care visits for “no essential”.

Om Sakhalkar is a medical student at the Medical College of Georgia.  He is President of the American Medical Association - MCG Chapter and Clinic Coordinator at the Asian Clinic.

Counseling a 55-year-old man on smoking reduces the likelihood that he will present to the ER at age 70, have a pulmonary embolism or bladder cancer. We must also try to provide health care providers with mental health resources, especially many older physicians who are exhausted by the COVID-19 pandemic and wish to retire before traditional retirement. The Lorna Breen Healthcare Provider Protection Act approved by the AMA is a big step forward in addressing these concerns.

Our population is aging. The Administration for Community Living’s goal for older Americans to age independently is a noble idea, and we must provide older Americans with the physicians and preventive health care resources they need to age.