The Transylvania Times -

In 2018 Address Major Problems


January 1, 2018

A delicious dessert is quite pleasing, but only has a detrimental effect on one’s long-term health. Like a tantalizing dessert, the recent tax cuts may provide a little more money in Americans’ pockets for the short-term, but Congress and the president have failed to address some of our more serious and long-term issues. The trend for several years seems to have been addressing a few topics to appease voters while avoiding the truly difficult problems that must be addressed for the nation’s and state’s long-term benefit.

One of the most significant problems is our aging population. According to the Census Bureau, in 2014 there were five workers for every retiree. By 2030 there will be just three workers for every retiree. That could very well create a greater number of Americans receiving government health care and retirement benefits, create a shortage in the workforce, and put more pressure on those in the workforce to pay for programs from which retirees benefit.

The aging population also will place an even greater burden on our health care system. By 2030, there will be 69 million Americans who are 65 or older. By 2050, that number jumps to 88.5 million. Since 68 percent of today’s senior citizens have at least two chronic health conditions, the demand for health care services will increase dramatically.

But there is a growing concern that those health care needs may not be met due to a shortage of doctors and nurses. The Association of American Medical Colleges (AAMC) predicts a shortage of physicians in the U.S. ranging from 34,600 to 88,000 doctors by 2025. By 2030, the shortfall is expected to total anywhere from 40,800 to 104,900 doctors.

Restrictions on immigration could increase those numbers because one out of four doctors in the U.S. was born in a foreign country, and, according to CBS News, some 15,000 doctors were born in the seven countries included in President Trump’s initial travel ban.

The nursing shortage could be much worse. There are more than 3 million nurses in the U.S. and they comprise the largest single labor sector in delivering health care. More than 1 million of them are 50 or older. Thus, the Bureau of Labor Statistics had estimated 1.2 million nursing vacancies between 2014 and 2022. There is a direct correlation of nurses with a high patient workload to hospital readmissions and patient mortality.

And there is no quick cure for the nursing shortage because there is also a shortage of nursing schools. According to the American Association of Colleges of Nursing, “U.S. nursing schools turned away 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012 due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.”

A few of many other major items that need to be addressed are:

•High day care costs. In North Carolina’s larger cities, a family can pay up to $2,000 a month to send two children to quality day care. Unless day care becomes more affordable, more mothers may choose to remain at home, which means fewer women in the workforce to support our aging population or help mitigate the doctor and nursing shortage.

•Government pensions. The pension fund for the police and firefighters in Dallas, Texas alone reportedly is underfunded by $5 billion. According to the Manhattan Institute, pension funds for teachers across the U.S. are underfunded by more than $500 billion. To pay for these pensions, which are part of contractual agreement states have with teachers, a great deal of education funding is now being siphoned from the classroom to teachers’ pensions.

•Income disparity. The middle class is shrinking and the disparity in wealth is increasing more quickly each year. The recent tax cuts will only exacerbate that disparity. Eventually, countries with such disparities become socially, politically and economically unstable.

•The decline of rural America. North Carolina is one of the fastest growing states percentage-wise in the U.S. Yet, some 25 of the state’s 100 counties have lost population in the last few years. This trend is occurring across the U.S.

In 2018, leaders in all areas of life at all levels – national, state and local – need to begin addressing these problems. If not, the problems we face today will pale in comparison to those we will face in the future.


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