Maine has the oldest population in the USA, with a median age of 44.6 years, significantly older than the 38.1 median age for the country. According to Jeff Stein in The Washington Post, the state is being "hammered by two slow-moving demographic forces — the growth of the retirement population and a simultaneous decline in young workers."

The disconnect between Maine's aging population and its need for young workers to care for that population is expected to be mirrored in states throughout the country over the coming decade, demographic experts say. And that’s especially true in states with populations with fewer immigrants, who are disproportionately represented in many occupations serving the elderly, statistics show.

Maine recently became the first state to reach the "super-aged" threshold where 20 percent of the population is over 65; the whole country will reach that point in 2030. Health care is in crisis; finding in-home caregivers is almost impossible. Baby boomer kids are run off their feet taking care of their elderly parents. Nursing homes are closing due to lack of staff.

"The U.S. is just starting this journey, and Maine is at the leading edge," said Jess Maurer, executive director of the Maine Council on Aging. "As we are living longer, all the systems that have always worked for us may have to be changed."

No kidding. Bruce Chernof, who wrote a report about this for Congress, says "left unaddressed, this will be catastrophic. We as a country have not wrapped our heads around what it's going to take to pay for long-term care."

The other problem is what we see in Maine, writ large: no young people. Who's going to provide that care? According to The Week,

By 2025, U.S. health-care providers believe they will face a collective shortage of about 500,000 home health aides, 100,000 nursing assistants, and 29,000 nurse practitioners. Some are also bracing for a shortage of up to 122,000 doctors by 2032.

Here comes the Baby Bust

Those millennial kids aren't having any kids!. (Photo: Pew Research Center)

All of this wouldn't be so bad if people still had lots of kids to take care of their parents like they used to, but the birth rate has been declining since the Great Recession in 2008, in what is called the "baby bust." According to the Economist,

Many people lost their jobs or their homes, which hardly put them in a procreative mood. But in the past few years the economy has bounced back—and births continue to drop. America's total fertility rate, which can be thought of as the number of children the average woman will bear, has fallen from 2.12 to 1.77.

The Economist notes that young people like to move to cities where the good jobs are (part of the problem in Maine) and where housing is very expensive and raising kids is very costly. Church attendance is also declining, and "churches tend to be in favour of children — more so than the other places where people hang out on the weekend, such as gyms and bars."

The Wall Street Journal blames spendy, self-centered millennials for not having enough kids. "Americans now expect annual vacations or entertainment that not long ago were available only to the affluent ... The uncomfortable truth may be that the 'two-income trap' is more about maintaining a certain high living standard than it is access to a decent life in America." Or maybe it's all that avocado toast.

The baby bust is, in fact, a huge contributor to the problem of dealing with the baby boom; a shrinking population means a shrinking tax base, at a time when health care costs will be going through the roof. According to the Week, "American spending on health care is expected to rise from about $4 trillion a year to $6 trillion, or 19.4 percent of GDP, by 2027."

My late mom and her caregiver at our house for a party. (Photo: Lloyd Alter)

This is a problem in developed countries all over the world, and countries are taking different approaches to the problem. Japan is developing robots to take care of older people; my late mom and all her rich friends in Toronto had flying squads of Filipino caregivers, thanks to a special focused immigration program set up by the Canadian government that lets the caregivers eventually get citizenship once they have worked for a number of years.

Bruce Chernof was right; nobody is wrapping their heads around this problem. We have the baby boomers getting older; we have a baby bust, so nobody will be around to take care of them or generate revenue to pay for their care. We have governments that hate raising taxes and admitting immigrants, when two things we're going to need are lots of money and people, not something anyone wants to talk about these days.