Who will take care of us when we’re old?
A long time ago when I was young, old people often lived their last years with their offspring or offspring raised their children in the home that grandma still lived in. “We need to have children to take care of us in our old age,” people often said. “We need children to help on the family farm.” “Our children will help grow the family business.” The people who said these things went ahead and had said children, children like me and my three siblings or Mary and her six siblings.
Social security, as it was first designed, paid enough so that grandpa could retire and live with his kids without being a net burden on the family finances. Needs-based benefits to those over 65 who retired before they had a chance to contribute to the system were capped at $30/month (about $620 of today’s dollars). It was partially meant as an inducement to get older people out of the depression-era workforce so that younger people could be employed.
No matter what our parents’ plans were for us, starting with my war baby generation it became less and less common for adults with children to also take in or live with them. Many people did – and do – contribute money and time to eldercare. We have also taken collective responsibility for older people with vastly increased social security payments and Medicare. Our children go to daycare and our parents go to eldercare or get home health care. We took collective if not individual responsibility for our parents. The collective responsibility was affordable because there were a lot of us thanks to the baby boom and relatively few of them.
We also had fewer children, in part because we had no grandparents living with us to share their care and in part because we “knew” that whatever we needed beyond our retirement savings would come from social security and Medicare. We weren’t counting on only our own kids to take care of us, our care would be the collective responsibility of our childrens’ generation. Mary and I each have 2 biological children; that’s below the rate of childbearing needed to keep the population from shrinking. Current lifetime births per woman in the US are 1.789, about half of the 3.5 births per woman at the height of the baby boom in 1950. Were it not for immigration and the fact that us geezers are living longer, total US population would be shrinking.
We know that this shrink will continue for at least a generation because the birthrate has been below the replacement level since 1973. We not only have a shortage of workers but also a shortage of women of child-bearing age to give us more workers even if the fertility rate increases.
Who will take care of us?
We shifted the eldercare burden from individual families to society as a whole. It seemed like a good idea at the time. But, since we didn’t need to have lots of children individually to provide for our old age, we had less children collectively. No matter how much they may want to, the skimpy number of successors we raised is going to have a very hard time caring for us collectively or individually. There aren’t enough of them to staff nursing homes or home health. There aren’t enough of them to keep the social security and Medicare trust funds topped off. There aren’t enough of them either to pay for or provide the increasing amount of hospital care we want to prolong our lives.
Some things could go right here in the US.
- Artificial Intelligence will both increase the productivity of essential workers and reduce the number of white-collar workers necessary to deliver services. My smarter car is already helping me drive; I’m counting on self-driving for the time when my kids would otherwise feel obliged to take my keys away. Other automation will make up for human aids we can’t get.
- We geezers in the US have accumulated a lot of wealth, much of it in our houses. For the first time in decades interest rates are substantially higher than inflation so our own savings will stretch further. And we have less kids than our parents did to include in our wills.
- World population probably won’t peak until sometime in the 2080s. There are millions of would-be immigrants who want to work in the US. As more places, like Vermont, suffer a shortage of workers, a political solution to the immigration impasse could provide a legal path to increase the number of people available to work directly for us geezers and to help support us by paying taxes. AARP should lobby for that!
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