Health Care of the Aging: Trends, Dilemmas, and Prospects for the Year 2000

  • Robert H. Binstock
Conference paper


Improvements in mortality are not being accompanied by comparable improvements in morbidity among older persons. Consequently, increased longevity is sharply exacerbating a number of trends—in public policy, social structure, and particularly the costs of health care—that make it highly probable that the financing, delivery mechanisms, and use of health care resources in the United States will be drastically altered by the year 2000. As these alterations in the health care system unfold, old age is highly likely to be a focal point for a number of moral, financial, and social dilemmas. These dilemmas and their societal implications are explored in this chapter.

During the past few years the media dramatically focused public concern on the so-called crisis in Social Security. Our attention was drawn to both short-term and longer-term issues. We were confronted with the immediate fact that the Social Security payroll tax was not yielding enough revenue to pay the Old Age and Survivors Insurance (OASI) benefits that were due during 1983. At the same time the public began to appreciate some of the possible implications of the “graying of America”—the demographic trends through which our populations will have increasingly larger absolute numbers and higher proportions of older persons in the years ahead. In particular, these demographic projections generated anxieties about our societal capacity to sustain Social Security retirement benefits in the 21st century when the “dependency ratio”—the proportion of workers to retired persons—is expected to fall sharply.


Social Security Health Care Expenditure Health Care Resource Gross National Product Home Equity 
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© Springer-Verlag New York Inc. 1985

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  • Robert H. Binstock

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