America's Aging Population and the Pro-Life Movement (with Patrick T. Brown)

MUSIC Thanks for joining us this week for Family Policy Matters.

As the American birthrate declines and life expectancy rises, our nation is the oldest it has ever been. This reality brings unique challenges for American citizens, families, communities, and governments. Joining us to walk us through these challenges and ways we can respond is Patrick Brown, a fellow at Ethics and Public Policy Center, where his work with the Life and Family Initiative focuses on developing a robust, pro-family economic agenda and supporting families as the cornerstone of a healthy and flourishing society. Patrick Brown, welcome back to Family Policy Matters.

Tracy, thanks for having me on. Explain to us just how aging is the American population. Well, everybody's familiar with the baby boomer generation, right? These are the folks who were born in the 60s and 70s that really changed America in so many ways, some for the good, some for the ill. And now they're reaching the end of their time in the workforce. They're hitting 60, they're hitting 70. A lot of them are retired or soon to be retired.

And so this is a massive shift. They were a big part of the American demographic picture. And so they're approaching their senior years, hopefully have many years ahead of them. But at the same time, we've had declining birth rates for a couple of decades now. And so the share of the population that is older is increasing and the share that is under 18 is decreasing. This leads to a pretty dire situation fiscally because our entitlement programs rely on current workers to pay the beneficiary that were yesterday's workers. We know that about one fifth of all Americans today are seniors. That's up from even about 12 or 13 percent just a couple of decades ago. And that fraction is only going to grow as people continue to age.

Time only goes one way and birth rates continue to drop. How dire is this? Are we in panic mode now or can we turn this around? Well, depends what you mean by panic.

I'm never in favor of panic. I am in favor of recognizing that there are huge challenges ahead of us. And, you know, we're familiar with some of the talk about low birth rates. You know, people at schools are closing, college are going to have a harder time finding students. We know that sort of in the short run, this is going to have some, you know, impact on some key sectors of the economy and key portions of our nation. Our economic growth is going to suffer if we don't have enough future human beings to continue to work and to invest. But it's especially concerning when we look at a growing senior population and we know that around one third of seniors in their 70s are going to require health services or home services to help just manage the daily realities of getting a little older, getting a little slower, trying to take care of everything that needs to be done. That's something that can't be automated away. And in an era where there's fewer workers to go around, that's going to mean fewer bodies to work at retirement homes or nursing facilities or home care aides, that sort of thing.

It's going to become a real challenge. OK, so what are some of the solutions? Increasing the birth rate? What about immigration? Yeah, those are both solutions and I support us talking about that.

I think, you know, the thing with humans is that they take 18 years to grow from infancy to anything close to resembling adulthood. And so that's a long term solution that can't be accelerated anytime soon. I do think, you know, there are sectors of the economy like child care and elder care where increasing immigration or having an eye towards the needs of those industries is going to become important because the reason why I think the pro-life and pro-family community need to be concerned about this is that the alternative to having enough people in the workforce to support our children and our elderly is not. You know, again, we don't have robots coming in to change bedpans or to help people remember to take their medicine.

These technological solutions are a long way off if they'll ever come. And so the concern that I have and I think a lot of people should have is if we don't figure out solutions in the short to medium term, we're going to be hearing pressure from those who would say, well, you know, you know, it's really cost effective. Canada's prescription of what they call medical assistance in dying or euthanasia should help seniors end their lives because they're just getting so dang expensive.

That's what really concerns me. And that's why I think that the pro-life pro-family movement needs to be thinking about the needs of our seniors and soon to be seniors. OK, so you brought up a couple of points I'd like to explore a little deeper, and one is just the pro-life voice regarding older Americans. And of course, when you look at their talking points, the older Americans are always included in that. But the reality is most of the emphasis is on babies. So how do we make a shift on that? Well, in some respects, it's a politically necessary one.

Again, seniors vote, babies don't. And so there's a reason for pro-lifers to think about ways to broaden our commitment to life across the spectrum. Right. From conception to natural death, as we like to say. And there's you know, it's hard because there's not a silver bullet approach.

Right. As I've said, these are complex generational challenges that are only going to get tougher with declining birth rates. And so we need to be creative thinking about some of these solutions and realizing that some of the easy answers aren't always as easy as they sound.

And there's real challenges ahead of us. About a half of adults in their 40s are what's known as the so-called sandwich generation. You have a parent who needs some assistance, some care in their elder years, as well as having a child at home. That's a tremendous burden on a lot of families that I think it's probably tied to some of the decline in birth rates as well. So if we're concerned about families and we're concerned about parents, we need to have an eye towards what can we be doing to shoulder the burden of, you know, making sure that grandma and grandpa have somebody there to help them just get by and meet their daily necessities, even if it's not, you know, full on, you know, nursing home or assisted living type care.

Oftentimes it's much lighter touch than that, but it requires a person. It requires a level of trust and intimacy that maybe, you know, other sectors of the economy don't necessarily. So you also mentioned assisted suicide, and I'm sure this is complicated by the fact that we're hearing of Americans, older Americans who support legalizing assisted suicide. Why is this problematic, do you think?

Oh, man, where to begin? I think that any time that you have a culture which tells the elderly, you know, you've contributed the most you're ever going to contribute and you are now a net drain on society, the best thing you can do for the rest of us is to go ahead and kill yourself. I think that is such a front to human dignity and a really utilitarian view of life and of the human person and what the elderly can still teach us and still contribute to communities, whether as a storyteller or as a caregiver or as just, you know, someone to share life with. I think one tragedy of declining birth rates of thinner family trees is that we're going to see more and more older Americans facing the end of life alone without relatives to care for them. Their older relatives will have already gone on.

They won't have children or nieces or nephews to care for them. And that to me is a real challenge. We have to be creative with the ways that we are integrating the elderly into society, because, again, if we don't, there's going to be continued pressure to say, look, these people's lives aren't worth living. We should just help them end it now. And that to me is a grievous assault to what it means to be human, to build a community which all are welcome and essential. I think that is going to be one of the biggest challenges for us going forward.

All right. So what about older adults? Do we need to I put myself there. I'm not elderly by any means, but still, do we need to think differently about aging? Are we willing, I guess, older adults willing to be put on the shelf, so to speak?

I mean, do we need to be speaking up for ourselves? Man, I don't want to tell my elders what to do. I think there's a lot of American politics in American society. Again, the baby boomers were such an influential generation. They were able to kind of, through force of sheer numbers, orient so much of our policy apparatus, whether that's housing, whether that's health care, whether that's so many sectors of the economy, senior discounts at restaurants.

Right. There is so much that we've done to support seniors in their senior years or silver years. And that's great.

That's wonderful. I'm glad that the rates of senior poverty are at an all time low and all this kind of stuff is wonderful. But we also have to have the longer term perspective to say we can't be funneling so many of our resources, as a society, towards things like entitlements without an eye towards investing in children and families. And so I think as older Americans face the back half of their time here on Earth, what are the political priorities we should be pursuing? Is it continuing to expand coverage of things on Medicare and reducing costs for seniors and cutting property taxes for seniors and all these sort of things that sound good and nice and fuzzy, but they're political choices, they're fiscal choices.

And any billions of dollars that you're spending on expanding access to prescription drugs for Medicare is billions of dollars you're not able to spend on things like the child tax credit or childcare assistance or that sort of thing. I think, you know, unfortunately, it can be it doesn't happen, but it sometimes can be a political battle between generations. And it would behoove us all to think about the continuum of the lifespan. Not just everyone sticking up for their own generation, but recognizing, look, we benefited from programs at a certain time in life.

It's time for us to get back and for, you know, younger people to recognize, look, our commitments to our older Americans are important and we want to fulfill them. We shouldn't be out there slashing and burning entitlements, but we should be prudent about the ways that we're expanding them or asking people to share some of the costs in some of those things. I think there's ways to square the circle, but it has to be part of the conversation. Are you beginning to develop some of your favorite ways for tackling this? I've always got ideas up my sleeve.

You know that, Tracy. I think that the challenge that lies before us is that both political parties, in my opinion, have built political coalitions that, again, cater to seniors. And again, there's nothing wrong with them. I don't want to blame seniors as being, you know, self-interested in the way that we all are. But just because baby boomers have been such a huge chunk of the American electorate for so long, they're used to having political parties fight for their votes. And I think it would be great to see a movement across generations to be saying, look, you know, parents bear the cost of having kids. We need these kids, again, both for the sort of dollars and cents, you know, dorky economics way of thinking about, you know, future workforce participation, but also just we need kids to have a happy and healthy society and to bring life into our towns and communities. We should be not solely focused on one end of the spectrum versus the other, but thinking about ways that we can build that political agenda. I've obviously got ideas, but, you know, it requires a little bit of political courage for our elected officials, too, to say not every spending on older Americans is necessarily always worth it. We should be thinking about, you know, ways to do this in a way, but again, also recognizing these challenges are only going to get worse as we continue to age as a country. And we can't treat it all as a matter of green eyes, shades, dollars and cents, because that's when the euthanasia advocacy forces are going to say, well, you know, you know what's really cost effective here. And that just that can't be the answer.

We have to be more creative than that. Talk about the long term care insurance. We see these ads all the time.

It certainly makes a lot of sense. But what's going on in that industry? It's an industry that has its problems. Long term care insurance is, again, paying for that sort of home health aid that, you know, somebody to come by to check in and make sure sometimes helping go to the bathroom or take your pills or prepare food, that kind of thing that just gets harder as you get up in years. And with an aging population, with life expectancy ever increasing, a lot of the long term care insurance in the marketplace is struggling. We used to have over 100 long term care options available to individuals as recent as 2005. The last couple of years has been down to just over a dozen.

Right. So if you're trying to find this in the private market and be able to afford it, this is something that you're going to be really paying through the nose for. And you're seeing some states like Washington State try to be creative. Can we have a public option for long term care insurance that has not worked as well as I think they were hoping it would? And some people say, well, why don't we just have Medicare paid for? Medicare already pays for so many things for our seniors. Why don't we just pay for long term care insurance? But it's really expensive when you talk about, again, the majority of seniors needing some kind of assistance once they turn 70, that is tremendously increases the load on the federal budget. And so, man, you know, in some respects, it's a really challenging problem to know what to do with.

I think there's some combination of, you know, I don't want to get too into the weeds here. You can talk about reinsurance or cross subsidization, some of these really technical things that can make it a little more affordable. But again, the fundamental driver of this is Americans are living longer than ever. That's great. That's wonderful.

We should celebrate that. But they're also being supported by a smaller and smaller chunk of America demographically. And so that is going to end up putting the squeeze on these programs because we're going to be robbing Peter to pay Paul in the sense that you can't support a growing senior population, the shrinking, what we call primate population of working adults.

The math just doesn't work. And over the long term, we're going to see that play out. Well, we're just about out of time. Before we go, Patrick Brown, where can our listeners go to read your recent article on this and follow all the other good work that you do there at the Ethics and Public Policy Center? Well, our website is always a great place to start, EPPC.org.

I'm on the website formerly known as Twitter and have a sub stack. Feel free to follow along and read what I write on our family stuff. But the thing that I work for has a whole host of scholars working on these and other issues, really trying to think about how to support families as the cornerstone of a healthy society. Patrick Brown, thank you so much for being with us today on Family Policy Matters. Thank you for listening to Family Policy Matters. If you enjoyed this episode, please subscribe to the show and leave us a review. To learn more about NC Family and the work we do to promote and preserve faith and family in North Carolina, visit our website at ncfamily.org. That's ncfamily.org and check us out on social media at NC Family Policy. Thanks and may God bless you and your family.