Yesterday evening I returned from the workshop "Visions towards ICT Supported Health", organized by the Hermes Partnership, with very mixed feelings. Don’t get me wrong here; the workshop was reasonably well attended and well organized with lots of interesting talks, but I cannot help myself thinking back over and over again to the pictures sketched by a.o. Felix Harpe and Piet Verhoeve of the healthcare and wellbeing crisis the world is facing today. And almost all governmental bodies and insurance companies are just sleeping on it!
To make it a little more concrete for you; the population is graying all over the globe, not only in western Europe (as I initially thought), with some countries lagging only a little bit behind, such as those in Latin America, Africa and China; the latter catching up quite rapidly, by the way. Soon there will be more people that are either not yet working (as they are still in their nappies, at school, etc.), have retired already or are chronically ill than there will be people that participate in the work force.
As a consequence, healthcare costs, already the highest expenditure of governments, are likely to increase dramatically as the population ages. This will either lead to higher taxes, if the government is willing to sustain its role in providing healthcare, or to a reduced government role in providing health care. In both scenarios we will live longer, but poorer, either moneywise or healthwise.
Another effect of the graying population is on education, currently the second largest expenditure of most governments. These expenses will tend to fall with an ageing population, especially as fewer young people would probably continue into tertiary education as they would be in demand as part of the work force.
In the Netherlands, we used to have and still have one of the world’s best pension systems. However, our pension system is also experiencing sustainability problems due to the increased longevity. Even by going to a retirement age of 67, the extension of the pension period due to our longevity will not be in the right balance with this extension of the active labour period.
On top of that healthcare costs will rise, not only as more people will require healtcare, but also as more specialistic care will be needed to deal with the whole spectrum of diseases. On top of that, relatively new diseases, e.g., caused by obesity, such as Diabetes Type II and Hypertension, are on the lookout for more victims. According to the National Institutes of Health, more than 65 (!) percent of American adults are overweight or obese.
About 10 years ago, Taeke van Beekum, lecturer of the course Healthcare Systems (ET4-128) and working at TNO Prevention and Care, showed the group of interested students the changing demography of the Netherlands and already predicted many of the above. At that time, it was already quite late to take anticipative action by making regulatory changes and starting the development of new products for healthcare and wellbeing. Now, after 3 more governments, this action is still not taken and I am afraid we are simply too late. And the worst is still to come, in about 15 years. The Mayas indeed made a calculation error. Doomsday will not be in 2012, but in 2026.
Wouter
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