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Social Security and Medicare programs are contributing to the rapidly increasing public debt and continuous budget deficits. The extent of the fiscal imbalance attributed to these programs may substantially exceed the forecasts of the Social Security Administration (SSA) and the most aggressive projections of other organizations. The many advances in biomedical sciences may significantly extend the longevity of the aging population that will by far outpace the planned increases in the retirement age. In this article, we evaluate three hypothetical scenarios where all other factors affecting the demographic distribution remain unchanged, but the mortality rates are decreased taking into consideration the progress in science and technology. Our estimates reveal that if deaths caused by cardiovascular diseases and cancer are eliminated, the fiscal imbalance may be as high as USD 87 trillion in present value. Given the current pace of biological innovations, the likelihood of elimination of those diseases is not improbable, and if that happens the welfare programs may no longer be sustainable. We propose that the forecasting methods of fiscal imbalance should incorporate the progress in medical sciences. The US and other governments may consider proactively increasing the retirement age and accelerating research in biomedical sciences with the goal to extend healthy working life span to keep pace with the decreases in mortality.

pensions

Evaluating the impact of recent advances in biomedical sciences and the possible mortality decreases on the future of health care and Social Security in the United States