Dr. Robert N. Butler is an engaging guru, well spoken and, with a shock of stunning gray hair, a good-health role model for those who are looking for some way to negotiate the turf between the American Association for Retired Persons recognizing your 50th birthday with a membership application by mail, and, of course, inevitable death.
As head of the International Longevity Center, he is on the cutting edge of a movement that is likely to be making more and more public noise as that vast collection of strivers called “the Baby Boomers” starts moving into officially recognized old age.
From birth to middle age, the boomers changed everything along the way. They are unlikely to go quietly into any stage of life and, hence, will have the noisiest old age of any generation.
Butler knows what there is to know at this point about aging, both as a life process and as a social phenomenon. He was the first director of the National Institute on Aging of the National Institutes of Health, founded the nation’s first department of geriatrics at the Mount Sinai School of Medicine and co-founded the Longevity Center in 1990.
His organization held a seminar in Milwaukee a week ago, a one-day fact festival for media in which a collection of speakers addressed the issues that will develop as the society ages.
The bottom line is that more and more people are going to be older older, and that will bring unprecedented change to a culture that simply isn’t very good at dealing with big, long-term challenges.
At least in addressing some social concerns, the track record in the United States seems clear to anyone with a grasp of history: Wait for a problem to bubble and pop and sputter until it becomes a crisis, then panic. Expect a government response and watch from the sidelines as the wrong parts of the broken machine get replaced and unintended consequences ultimately outweigh the problem that caused them.
That is how welfare got to be such a mess. It may be how welfare reform gets to be such a mess down the road. It has transformed Medicare and Medicaid into marathon problems. It has led to a health-care structure that seems to be universally disliked by doctors, patients and suppliers, a trifecta of disgruntlement about the way things have turned out.
Butler and his many followers believe it doesn’t have to be this way, that recognizing that a vast change is under way is the first step toward identifying the problems and opportunities of the future, addressing the former and exploiting the latter.
The sense one gathers about this change is that it would be nearly fatal to assume that today’s problems, today’s options, today’s lifestyles, define the future. Perhaps tomorrow’s 60-year-old worker will be performing at the level of today’s 45 year-olds. If retirement was a phenomenon of an industrial world that was not good for anyone’s health, maybe a world built on brain power will make the idea of stopping at 65 passe.
At the same time, Butler warns against embracing notions from the past that amount to little more than romantic myths.
He says longing for a return to the glory days of the extended family in 19th Century America makes no sense. A century ago, people lived for 45 years on average and then died. The era of the extended family is right now, he says, even though it doesn’t seem that way. The engine that makes it possible is longevity. The longer people live, the more extended their families can be. Give up on the myth and embrace the reality.
He is aware of the danger of prediction, knowing full well everyone was supposed to have a helicopter in the garage, a house of the future in the ‘burbs and endless amounts of leisure time by now. It didn’t happen. And none of this might happen either.
Still, he has his vision:
1. Social Security.
“Social Security will be there for the Baby Boomers if for no other reason than the fact that they will make up 20 percent of the population, 30 percent of the vote.” Butler’s thought is that no one will even be able to win a dog catcher’s job at the polls without significant Baby Boomer support.
But it will have to be fixed.
He suggests an increase in the wage base for payroll taxes. He also suggests people work longer. Social Security eligibility should be raised to age 70. In exchange for this spreading of pain, he believes the nation should create jobs, cut the cost of hiring the elderly by providing Medicare to employed workers over whatever the retirement age becomes, refine disability assessments to protect older workers and enforce age discrimination laws.
2. Everyday Life.
What is it going to be in 2030? That depends on what the society does about a collection of conditions that are apparent right now. Bill Gates’ net worth, he notes, is greater than that of the bottom 40 percent of the nation’s population combined. Something has to happen to spread the money a little thicker on most parts of the culture.
A little after 2030, half of America’s population will be made up of the groups today labeled “minorities.” The nation’s elderly population will be predominantly Caucasian. It makes abundant good sense to start addressing the gap between these two groups now, because the Caucasian-dominated elderly will be depending on these former minorities for all kinds of social support.
3. The Woman’s World.
Women will gain power and influence in the United States. They will have greater opportunities in their professions and in politics. They will continue to have fewer and fewer children. Older women will be less passive than older women of today. Because of what sometimes seems an inherent skill at problem solving and conflict resolution, they have the potential to address many of the age-old problems that plague society. Their challenge as they move into more positions of power will be to avoid acting like the men who preceded them.
4.The Wonderful World of Children
In Europe, Japan, China and the United States, there will be fewer children. Families will be richer and able to offer better resources to the individual child. Fewer people will be needed to produce the same goods and services, so this generation may actually get to experience a better quality of life.
5.The New World of Work.
As a strategy, getting rid of older workers may well disappear. The society will need more workers making good wages to support its social needs. Younger workers will find that the presence of older workers staying on the job longer inhibits their advancement, but there is a trade off. Because they are living longer, they will advance later in life. In the interim, they will be constantly retrained and educated.
6. New Citizenship.
In the Renaissance and the Reformation, societies moved from a connection with God through a priest to a more direct relationship. Because of technology, the possibility exists for development of a cyber-citizenship that cuts out the middleman and puts people in close contact with their governments. Dealing direct through technologies like the Internet could well change the very process of citizenship and governing. Why deal through a congressman’s office when you can connect directly to government itself? Why turn to media for interpretations of government actions? Education and good health will be important qualifications for the new citizenship.
7. New Science.
Molecular genetics and cell biology hold promise of tremendous changes in old age. The danger in this development is that people will come to be viewed as collections of genes. Genetic analysis could give people early warnings about how they should change behaviors to protect their health. Chemical interventions could do away with halfway technologies like transplants and coronary bypasses.
8. The Century of the Brain.
Look for developments in the area of regeneration, which will transform the way brain and nerve disorders are treated. But this work won’t be easy because of the complexity of the organ, with its high concentration of genes.
9. A New Stage of Life.
Modernized old age is not biological, fixed and immutable. It is plastic. The expectations and self-images of older persons are changing. Even now, older people suffer less oppression by disease, frailty, dementia, poverty, denigration and neglect. New roles and different conceptions of aging will evolve. Vigorous and healthy people will remain active in communities much longer than they do now. More will be expected of them.
10. End of Life.
Medical reforms and the adoption of palliative medicine is changing the way people die. Even now, few need to die in pain. Physician assisted suicide will be less necessary in the future. Spiritual needs at the end of life will become more important. The society itself will become more mature in the future, and that offers the chance for a greater sense of community and agreement in addressing the problems of inequality.
Each of these points is the gateway to a public policy debate, and there is no telling how these subjects will develop as time passes.
But there is a sense of portent in what Butler says, as though he is sending a hidden message: Talk about it now, or you’ll be unprepared to deal with it later.
