The world's population is aging. Many more people will need long-term care in the coming decades. The United States, like most countries, doesn't even have preliminary guidelines on how best to accomplish this. Below is some background information. Health at a Glance 2023: OECD indicators (November 2023), specifically “Chapter 10: Aging and Nursing Care”
As a starting point, here is a diagram showing the percentage of the population aged 80 and over. We present actual data for 2021 and then projections until 2050. These predictions should be considered fairly solid. After all, anyone who will be 80 years old, who will be older in 2050, will already be able to predict the life expectancy of the group born before 1970, and who are already in their 50s. is very simple.
Across OECD countries, the proportion of people aged 80 and over is expected to roughly double, from around 5% today to around 10% in 2050. In countries with very low birth rates, such as South Korea and Japan, and in Italy, which has the highest birth rate, the proportion of the population aged 80 and over will be even larger, reaching more than 15% of the total population. The United States will also roughly double the proportion of its population aged 80 and older, but from a lower base than the average country listed here.
Current models of long-term care in different countries vary considerably. To illustrate this point, consider current spending on care as a share of GDP. In the Netherlands, Norway, Sweden and Denmark, total spending on long-term care already exceeds 3% of GDP.
The OECD explains these differences as follows:
This variation partly reflects demographic differences, but also reflects the stage in the development of formal LTC systems, as opposed to more informal arrangements based primarily on unpaid family-provided care. There is. …Across OECD countries, $4 out of every $5 spent on LTC comes from public funds. Across OECD countries, around half of health and social care costs in 2021 were incurred in nursing homes. …In most OECD countries, these providers account for the majority of his LTC spending. On average, about one-fifth of all caregiver spending was on providing professional (medical) care at home. Other care service providers include hospitals, households (where care allowances exist that reward the informal provision of such services), and care service providers with an explicitly social focus. Masu. Each of these service providers accounts for about one-tenth of his total LTC spending across OECD countries. …Without public financial support, the total cost of LTC would be higher than the median income for older people in most OECD countries. On average across OECD countries, institutional care for severe needs costs more than twice the median income of older people…
Once a certain percentage of older adults require long-term care, a rough measure of the capacity of a country's long-term care system is the number of beds. This figure shows the number of long-term care beds per 1,000 people aged 65 and over. In some countries, such as Japan and South Korea, they account for a large share of long-term care beds in hospitals. However, in most of the countries shown here, including the United States, most long-term care beds are not located in hospitals. The number of beds in the United States is well below the international average.
Compared to these other countries, the United States spends less of its GDP on long-term care, has far fewer Americans over age 65 who end up in long-term care, and has fewer long-term care beds per capita. few. Medical institutions: The average for the OECD 28 countries is 11.5%, but the US share is her 1.7%.
These differences appear to be too large to reflect differences in underlying health status. Rather, they reflect a combination of societal expectations and the design of government programs to support older adults. The United States, like Canada, Japan, and several other countries, has so far succeeded in housing only a small number of older adults in long-term care facilities.
Of course, many older people want to live at home as long as possible before moving to a long-term care facility, and many countries have policies that support this option. In reality, the option of staying at home may also depend on whether a family member provides regular weekly or daily care. As birth rates have declined in recent decades and women's representation in the workforce has increased, relying on family care may become more difficult in the future. As the U.S. population ages 65 and older, and especially those 80 and older, increases in the coming decades, the nation's existing underutilized long-term care facilities are likely to come under severe stress.