APOCALYPSE NO: Population aging and the future of health care systems

Illness increases with age. All else being equal, an older population has g reater needs for health care. This logic has led to dire predictions of sky rocketing costs apocalyptic demography". Yet numerous studies have shown th at aging effects are relatively small, and all else is not equal. Cost proj ections rest on specific assumptions about trends in age-specific morbidity and health care use that are far from self-evident. Sharply contrasting as sumptions, for example, are made by Fries, who foresees a "compression of m orbidity" and falling needs. Long-term trends in health care use in British Columbia show minimal effects of population aging, but major effects, up a nd down, from changes in age-specific use patterns. Why then is the demogra phic apocalypse story so persistent, despite numerous contrary studies? It serves identifiable economic interests.