We have yet to hear baby boomers Barack Obama and Mitt Romney outline solutions to the social upheaval that tens of millions of Americans living beyond 80 will bring.
As the nation awaits the Supreme Court's decision in June on President Obama's healthcare mandate, sociologists say we are entirely unprepared for the ramifications of people living decades longer with chronic diseases such as Alzheimer's, cancer, arthritis and diabetes.
The "age wave," a term coined by gerontologist Ken Dychtwald, will bring unprecedented change to society as one Social Security recipient is supported by only two workers, as the nation's resources are further strained, as politicians fear talking about the potentially frightening situation.
The nation is just beginning to deal with the fact of 80 million retiring baby boomers (born between 1946 and 1964). Ten thousand boomers are turning 65 every day. Every decade, life expectancy increases two and a half years. Dychtwald notes that two-thirds of those who ever lived past 65 in the history of the world are alive today.
The biggest factor in the downgrading of the U.S. economy by Standard & Poor's was the soaring cost of health care faced by an aging nation.
In a recent speech on Capitol Hill, Dychtwald (who pitches his worries to leaders from former President Bill Clinton to Nelson Mandela) says the "new old" want to stay engaged, reinvent themselves and live with purpose. But pensions and job opportunities are lagging. Even worse, as medical breakthroughs have made dying early from infection, polio or smallpox less likely, millions live in misery, suffering from chronic diseases that destroy an active life.
Dychtwald's friend George Vradenburg, chairman of USAgainstAlzheimer's, says if the nation spent $200 billion on Alzheimer's research instead of $500 million, Alzheimer's could be mostly eliminated by 2020.
The federal Centers for Disease Control and Prevention estimates that the 13 percent of the population that is over 65 accounts for 27 percent of visits to doctors and 38 percent of all hospital stays. But Medicare covers only about 50 percent of most beneficiaries' health-care costs and doesn't reimburse for long-term care.
"We are spending enormous sums of money on the wrong things and, not surprisingly, the results are both mediocre and costly," Dychtwald says.
Heart disease causes more adult deaths than all other causes and costs $500 billion a year. Half of all cancer patients are 65 or older; cancer costs $263 billion a year. Strokes disable more adults than anything else and cost $156 billion a year. Alzheimer's, which frightens more people than any other illness, costs $170 billion a year. The cost of caring for the bedridden elderly is $172 billion a year.
But Dychtwald observes that Americans have often overcome huge problems -- landing on the moon, turning HIV from an immediate death sentence to a manageable disease, eliminating the iron lungs that polio victims were condemned to inhabit.
Dychtwald has solutions. Americans must pay more attention to -- and spend more money on -- scientific research to cure, delay or eliminate diseases affecting the elderly. Healthcare professionals must become proficient in aging issues -- only 13 of 126 fully accredited U.S. medical schools have full geriatrics departments.
Americans must prepare for aging by not smoking and not becoming obese, and exercising and eating properly. Genetics is less important than personal behavior in living a long, healthy life.
Home-based care is better and less expensive than care in institutions. One-third of older Americans fall annually; Dychtwald suggests using Wii games to train them to improve their balance.
Dychtwald posits that if Americans do not develop a more respectful, humane and cost-effective approach to death and dying, the demand for euthanasia will certainly arise.
Obama and Romney should talk about these issues, not the strange topics we have heard debated so far this election year.
(Scripps Howard columnist Ann McFeatters has covered the White House and national politics since 1986.)