Demographics, aging and health care: is there a crisis?

Will the aging of Canada's population bankrupt the health care system? In this issue (see pages 1555 to 1560) Dr. Marie Demers reports that the increase in physician service costs for elderly people in Quebec from 1982 to 1992 resulted primarily from increased utilization and only secondarily from the growth of the elderly population. In this editorial the author argues that the common perception that masses of elderly people will soon swamp the system deflects attention from the crucial issue of utilization. Although a wide range of interventions for elderly people have demonstrable benefits, more research is needed to ensure that intensified services, especially for elderly people in good health, are effective and well targeted. It is not the aging of our population that threatens to precipitate a financial crisis in health care, but a failure to examine and make appropriate changes to our health care system, especially patterns of utilization.