The Horizon: the grey tsunami is coming? Are we ready?

As we grow older, the clearer our perspective becomes, on just about everything. We learn through experience to differentiate between the important stuff and all the rest, all the noise in a very noisy world.

Part of well-earned perspective is that we are more aware of the horizon, of the inevitability of life and death. To shuffle off this mortal coil, to head toward the sunset, to cue the big fade-out: they’re all euphemisms for the same thing. Some people chose to adopt an attitude of “whatever happens, happens” (which is fine as long as by doing so, you’re not leaving future burdens to others, be it a spouse or your children or society as a whole). Others take comfort in the spiritual belief of an afterlife, and there are even relatively-lucid people trying to use technology to bargain with the boatman.

We all know the horizon is there, but as long as you maintain your health, you can do what you want, at your own pace, for a long time. The ‘maintain your health’ part – particularly the things you can’t control – can be challenging, as many of us have already found out. And even before Covid hit – remember that life? – we were dealing with crowded ERs, long wait times, and a lack of beds for long-term health issues (all three of which are directly connected). Our abysmal handling of Covid in Long Term Care facilities highlights how little we care. Sounds harsh, but ask yourself- if we really did care, would we have let it happen?

So - if these problems exist today, what’s going to happen when the grey tsunami hits big time, which is a given in the years ahead? And here’s a related article that addresses the question: if we start getting sick, will our health coverage be adequate? What impact will it have on our finances, and ultimately the finances of our estate?

In 2021, the youngest boomer is 58, the oldest 76. By 2031, all boomers will have turned 65, which means we are only in the middle stages of the great retirement shift. The majority of older Canadians are relatively healthy, but what happens when all those people need increasing levels of medical care?

It doesn’t look promising.

Right now, today, you can read any number of stories about an acute lack of long-term health care beds in Canada. Increasing health-care costs and crowded ERs are directly attributable to that lack of space in acute-care facilities. Overall health care spending in 2017 hit $242 billion, almost 12% of Canada’s GDP. Those figures obviously don’t include the massive tally from Covid, but it seems a certainty that the percentage of GDP related to health care will increase as the population ages.

If the lack of long-term health care is a problem now –and we know that for a fact - what’s going to happen in 10, 20 and 30 years? Even prepandemic, much had been written about crowded ER conditions, long wait times for medical procedures, and the lack of long-term beds (and now we have to add this modifier: the lack of proper long-term beds). But here’s the big question: if these problems exist today, with the (relatively) small number of older Canadians seeking enhanced health care, what’s going to happen when the real grey tsunami hits? The number of patients struggling with health care today is insignificant compared to the numbers that will flood the system in the very foreseeable future.

What’s the plan, Stan? Short answer: there really isn’t one.

Just read this prescient article by Elizabeth Payne of The Ottawa Citizen outlining issues with long-term health care beds in the National Capital area, and in Canada in general. Payne describes a “system that is straining to meet the demand”, a system with endemic staffing and funding shortfalls. This article was written two years before Covid made its appearance, and it highlights the demographic time-bomb that is slowly tick-tick-ticking away.

In a report released before Covid, the Canadian Medical Association says that there will be “a pressing shortage of long-term care beds if steps aren’t taken to nearly double the number of existing beds by 2035.” (Sobering fact: that ‘pressing shortage’ has been with us for awhile. Pre-pandemic, the wait list for long-term care beds stood at 25,000).

All you have to do is listen to neighbours and read tweets and articles about crowded Emergency Rooms to know there are problems. People dying in waiting rooms in Canada because they are too crowded? What’s that all about? One of the reasons ERs are crowded is that many people use them for primary care, because they don’t have doctors. Equally important, ERs remain jammed because there are no beds available to admit them- and there are no beds available because patients in need of specialized care can’t find beds in long-term residences. (It also doesn’t help that crowded ERs mean that ambulance workers often stand around for hours, waiting to be processed)

The odd thing is that bright people are in charge of what’s happening in our hospitals. So why are we in this situation now, a bad situation which will become catastrophic when the grey tsunami hits? The Payne article ends on a hopeful note, with the NDP health critic suggesting that boomers will make change happen.

That’s a little bit fuzzy.

Boomers - well, anyone who cares, really - have to get their collective butts in gear to make it happen. Money – yes, tax dollars - obviously plays an important role, but so does knowledge. Arm yourself with the latest info, and then start agitating. That means calling/emailing/writing/bugging your MP, MPP or MNA to address ER issues, to address a lack of long-term care beds, to address wait times, to address the sometimes sorry state of health care in our advanced country. In short, demand a plan.

Demand a Plan

The Canadian Medical Association has a ‘Demand a Plan’ initiative designed to press government on the issue of a national seniors’ strategy. The website has information and lists ways to get involved. 

To be sure, it’s not as if the ‘grey tsunami’ will hit all at once. Evidencenetwork.ca argues that if action is taken now, boomers won’t bankrupt the healthcare system (but other medical practices might). They acknowledge that more healthcare will be needed to serve the boomer bulge, but that “it exerts only a small and predictable pressure on health care spending (less than one per cent annually from 2010 to 2036)”. They have useful information about mitigating health care costs as society ages.

The key phrase, though, is ‘if action is taken’, which is why a plan must be developed. And it’s not all fiscal doom and gloom - the CMA, for instance, suggests that “freeing up hospital beds currently occupied by seniors and the associated economic benefits will more than offset the cost of constructing and operating the new long-term care facilities”. 

We’ve all seen what happens when the ‘do-nothing’ mentality – kicking the problem down the road – takes root.  When that happens, people die. Look no further than the almost criminal lack of preparation for a pandemic which was anticipated by many bright people over the years.  

Tom New, October 2021

More info:

Read Elizabeth Payne’s Ottawa Citizen article:

See a global study of long-term care issues, referencing Canada:

See what your Local Health Integration Network is, or isn’t doing.

See what the Ministry of Health and Long-term Care is, or isn’t, doing.

Read this Toronto Star article about beds occupied by patients who don’t need to be there.

CBC take on what boomer retirement means for Canada.

An American take on boomer retirement, with Canadian resonance