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BUSINESS OF
MEDICINE

Costly reflections in
the ‘Silver Tsunami’

By Dana A. Forgione, PhD, CPA, CMA, CFE

Ten thousand a day. My baby-boom generation is turning age 65 their cost begins to show in enormous economic terms.
and enrolling in Medicare at the rate of 10,000 a day. My parents’
World War II generation is dying at the rate of 1,000 a day. That’s ADD IT ALL UP
a 10-to-1 increase in new Medicare beneficiaries. Actually, I’ve only So how much are we talking about? The answer: five times the
got a little silver on the sideburns — mostly I think I’m losing my
hair at the rate of 10,000 strands a day. current national debt. That’s right. The national debt (when you
count all of it), is about $21.7 trillion. The present value of our fu-
And what is the cost of this great silver-haired tsunami? And why ture Medicare obligations at current benefit rates is $46 trillion
does it seem so unnoticeable right now? To address the latter first, no (that’s twice the national debt), and the present value of our Social
tsunami is noticeable as long as it’s out in the open ocean, or general Security benefits at current benefit rates is $64.3 trillion (another
population. It seems like just a slight rise and fall of the ocean level as three-times the national debt). So add them together, and they total
it passes by. But, when it reaches the shallows near land, it rears up in five-times the national debt. If you add a few other obligations, like
its devastating force. Such are the baby boomers. We hardly notice federal employee and Veterans Administration retirement and
their cost, until they hit the Medicare and Social Security rolls. Then health benefits, all 50 state Medicaid and employee pension, health-

34 San Antonio Medicine • June 2015