Rewriting the Social Contract for Aging
Imagine you had a magic wand, and with a quick flip you cast America with an aging “social contract.” One in which few go to college and most would retire by age 65. Many of whom stay withdrawn and dependent until their passing.
Would you be shocked that nobody noticed? Many Americans and hundreds of millions of others throughout the developed world still adhere by this contract. The problem? This “aging” contract is not suited to fit today’s society – one which scientific progress has yielded longer, healthier lives, and an urbanized world, with a steadily declining birthrate.
We must develop a new social contract, recognizing that population aging is about more than retirement, hip replacements, and senior healthcare. Today, wealth creation, global competitiveness, economic growth, and the sustainability of political systems depend as much on capturing the power of a nation’s over-65 population as any other factor on the global agenda.
For America, a new aging strategy could be a transformative instrument of national leadership. As the entire world struggles to manage the unstoppable demographic shift and to pioneer models for a multigenerational active society, we are already late to act—but not too late to chart a leadership course.
A decade ago, former Intel CEO Craig Barrett delivered the keynote address at the White House Conference on Aging. Barrett addressed what strategies could be deployed to care for the tens of millions of boomers about to turn 65. At that time, we were all still firmly committed to our 20th-century assumptions about what it means to age, which wasn’t about driving economic growth, but rather, about avoiding risks. Today, things have changed.
When living in China, I saw firsthand how long-enduring social and family structures are upended by aging. As one of the world’s most rapidly aging populations, China understands the issue isn’t just “more old people.” It’s about establishing an entirely different life course and reconsideration of the many assumptions that shaped life in the 20th century. It’s about social, political, and economic well-being.
We need to spark a serious dialogue on how to design an American aging strategy that enables and supports an extended healthy, active, and happy life course. This debate must be framed as a search for American global competitive advantage in the 21st century. Unless we stop scientific discovery in its tracks, we must frame the debate to proactively focus on achieving and harnessing the lifespan of 100 healthy, active years that humans will enjoy by the end of this century.
We have barely begun to prepare; our policies and institutions must adapt. To achieve this goal, a new social contract must answer these three overarching questions.
1. How can the United States reframe aging to regain global leadership and competitive advantage?
Traditional thinking positions old age as a time of dependency, inactivity, and disengagement, when today’s breakthroughs in technologies and health sciences rewrite aging as a process that is healthy, active, and productive.
The new national aging strategy must recognize aging in terms of millennials and their children as much as boomers and their parents. The basic tenets of society—education, work, and healthcare—must be cast as lifelong questions, not as issues only relevant to certain age groups. If it matters to older people, it will be a concern to all generations.
Technology helps break down old barriers. Every country in which Intel has a presence is working mightily to make healthcare smarter, more efficient, and available to more people than ever before. Only through the total digitization, decentralization, and personalization of healthcare can the accessibility, economics, and capability of the system hope to meet the growing need.
Technology is also opening new opportunities for education. Countless college courses are available online and enable “mature” students to continue their educations, despite unforgiving schedules.
A lifelong approach to education will serve a multigenerational workforce that can reignite and sustain American economic growth.
The metric for success is ultimately economic growth and job creation, which will open opportunities for all generations, including those who need sustained care and support.
2. What are the game changers? How do we implement them?
It’s important to realize that “retirement age” is an arbitrary construct left over from a bygone era. What relevance does the 65-year-old retirement age have today? Not much. Many countries have raised the age, and at least one, Singapore, replaced its Retirement Age Act with a Retirement & Re-employment Act in 2012 that requires a company to make an offer of post-retirement employment.
“Retirement” needs to be retired. Health policy must be a tool to enable healthier and active aging. When reframed along these lines, the money spent on healthcare is not a cost, but an investment. The logic for strategic investment is well understood in other facets of life. Consider, for example, how society views spending on childhood education. No one will argue childhood education isn’t an investment in the future.
There are a number of critical, age-related health conditions that stand in the way of active aging, such as skin and muscle deterioration or vision and hearing loss, but the keystone is Alzheimer’s disease. Alzheimer’s is correlated to age — with the risk elevating to about one in two for ages 85 and over. The disease already consumes 1 percent of global GDP per year, roughly $ 604 billion. With the number of people with Alzheimer’s expected to double to 75.6 million by 2030, the human and economic costs are incalculable. We must control or cure Alzheimer’s.
Sizable efforts are underway to better understand, treat, and ultimately cure neurological diseases, but the complexity is enormous. Advances in technology; high performance computing and “big data” analytics are propelling the speed at which scientists gain understanding of the composition and interactions of the tiny genes and proteins in our bodies.
One such development comes from a collaboration between the Michael J. Fox Foundation and Intel Corporation, which combine wearables, apps, and big data analytics to provide tremor, sleep, gait, and balance monitoring Parkinson’s data to researchers. Technology allows researchers to shine lights on the dark corners of scientific knowledge to enable new discovery.
In his presidency of the G7, former British Prime Minister David Cameron made beating Alzheimer’s a priority. Japanese Prime Minister Shinzō Abe supported this goal during the G7 in Tokyo in 2016. Now, it’s time for the United States to step up.
3. How can we leverage our homes, communities, and cities for real results?
In the years since the launch of the World Health Organization’s Age-friendly Cities and Communities Network, the organization has proved to be an important public policy structure for positive and active aging. Across the United States, a number of high profile cities have become age-friendly, providing essential services like education, health, and transportation for older citizens, with public, private and technology capabilities to enable and drive change. Think wearables and connected sensors.
This is only one way health delivery and social welfare systems are starting to use technology to “place shift” care to the home for substantial reductions in cost, working to avoid hospital-acquired complications; to coordinate efficient service delivery horizontally across the health and social welfare silos.
America can still capture the opportunity within an aging population to pave the road for national prosperity, competitive advantage, and ongoing innovation. Aging is about the future of all generations, and our duty today is to design the new 21st-century social contract for the new normal — 100 years of active and healthy life.