VITAL STATISTICS

Increase in seniors could be bad for business

SEACOAST VENTURES: How is the older demographic affecting the way medicine or medical care is delivered?

PETER FRANCESE: Since the 2000 census the total population in the Seacoast areas of Maine and New Hampshire has increased between 7 percent and 8 percent, or roughly 1 percent per year. The number of residents under age 45, however, has actually declined on the Seacoast. But the area's older population is rising fast: ages 55 to 64 have jumped 46 percent and residents 65 and older have increased 14 percent. The extraordinary increase in residents in their late 50s and early 60s means even higher growth over the next decade among residents ages 65 or older.

These widely differential growth rates by age mean that a rising percentage of patients will be Medicare or Medicaid insured, with consequently lower average payments to all medical care providers and likely greater cost shifting to privately insured patients.

SV: Preventive medicine has long since become a primary focus for older and younger consumers. Do you see this having a greater role or emphasis in the work place, especially as businesses look to help keep employees healthy and help maintain their labor force?

FRANCESE: There is no question that preventive medicine will play a greater role in the ongoing efforts of all employers to control the fast rising cost of health insurance and sick days for their workers. We will see the day quite soon where it will be routine for employers to charge more for health insurance for workers who have what used to be called bad habits but which are now referred to as simply unhealthy lifestyles.

SV: Government statistics indicate a continued expansion of medical-related jobs. What is the economic impact of this industry as it relates to the state and region as a whole?

FRANCESE: The economic impact is positive in the sense that a rising need for medical care will create thousands of jobs on the Seacoast and throughout the state, many of them well paying. The downside is that the rising cost of employee health insurance may make our state and region much less competitive when it comes to attracting or retaining both large and small businesses.

SV: As the popularity of 55-plus communities has hit the region, older people are living a far more active lifestyle than a generation ago. How are towns and cities handling the growth in this demographic and what stresses does it place on local government?

FRANCESE: Besides being obviously discriminatory and unbalancing of the region's demography, age-restricted housing will cost towns and cities dearly. Such housing increases health care costs for towns and all employers by accelerating the aging process. It decreases support for work force housing, which is so desperately needed on the Seacoast. It also increases voter support for more generous senior property tax rebates, which raises those taxes for other home owners. But the biggest stress will be caused by the rising exodus of young workers to more welcoming states.

SV: Corporate America has its share of mergers, consolidations and buyouts. Are local hospitals feeling as much of the financial pressure?

FRANCESE: There is no doubt that area hospitals will be under rising financial pressures caused by the aging of the region's population (intensified by age-restricted housing) and the greater difficulty in finding workers due to the lack of work force housing. How that will play out in terms of mergers or buyouts remains to be seen. But the status quo is clearly not sustainable.