The retirement of the baby boomers will have an unparalleled impact on the delivery of health-care services in the United States. The anticipated explosion of costs, the bulk of which will be shouldered by taxpayers, was a key driver in the development and implementation of health-care reform, and it continues to be an issue of paramount concern to legislators and providers alike.
Richard Gunderman, MD, PhD, says, “It’s going to challenge us even further to attract more resources to health care—in this case, health care for the elderly—or to find ways to achieve further reductions in costs and increase the efficiency with which we work.” Gunderman, a bioethicist and vice chair of radiology at the Indiana University School of Medicine, is a professor of radiology, pediatrics, medical education, philosophy, liberal arts, and philanthropy.
Demographically, the baby boom covers a broad swath of the population, Louis G. Pol, PhD, stresses. He is coauthor of The Demography of Health and Healthcare (Plenum Press, 2013) and is John Becker dean of the College of Business Administration at the University of Nebraska Omaha.
“A lot of people think of the baby boom as a group of people who were born around the same time and who have very similar ideas and preferences,” he says. “That couldn’t be further from the truth.”
He notes that the baby boom following World War II is actually defined as including those born from 1946 through 1964, and that 1964 was chosen as the cutoff date because 1965 was the first year since 1954 in which there were fewer than four million births in the United States. “Some baby boomers are just turning 50, while some are getting close to 70,” Pol says. “That makes them a very diverse group, when it comes to health-care needs.”
Nonetheless, many demographers, futurists, and physicians agree that the baby-boom generation can be expected to bring with it more obesity- and smoking-related chronic conditions, cancers, dementia, and bone loss than previous generations brought to their golden years. Some of these conditions are partly attributable to lifestyle, while others are the result of increased life expectancy. “Not only will we see more cases, or at least a higher number of studies per patient, but the mix of cases we see is likely to change,” Gunderman says. “It will be more weighted toward the diseases of the elderly.”
Jeff Goldsmith, PhD, coauthor of The Sorcerer’s Apprentice: How Medical Imaging Is Changing Health Care (Oxford University Press, 2010) and associate professor of public health sciences at the University of Virginia, anticipates certain general trends from the retirement of the baby-boom population—currently numbering 77.3 million people—as it unfolds over the next 15 years. “A third of us are obese, and another third are overweight,” he notes. “That’s really the overwhelming difference between us and prior generations. We have a cluster of risk factors that are really quite unique.” As a result, he anticipates a higher incidence of diabetes, as well as an increased demand for joint replacement.
Complex comorbidities, though, are not the only changes for which health-care providers should be bracing themselves. Leon Rybak, MD, assistant professor of radiology and vice chair of operations, radiology department, at NYU Langone Medical Center (New York, New York), has observed significant differences in attitude between this generation of incumbent retirees and the generation that preceded it.
“It’s not just that the population is aging or that life expectancy has increased,” he notes. “It’s that members of this generation have greater expectations of what life should be. They’re active. They play sports. I’ve had older patients undergoing ultrasound-guided shoulder injections whose biggest concern is getting back out on the tennis court or golf course. They expect to live an active life into their later years. It’s a whole different ball game.”
Robert Vogelzang, MD, an interventional radiologist at Northwestern Memorial Hospital (Chicago, Illinois), concurs that the baby-boom generation’s lifestyle expectations will be elevated—and that radiology stands to be disproportionately affected. “We’ve been really exceptional at developing image-guided, minimally invasive procedures, and this generation will be seeking those,” he says. “Quality of life is going to be a big issue, and minimally invasive procedures offer that—in everything from cerebrovascular treatment to interventional