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Comment by rayiner | Hacker News Reader

The dwindling ratio of workers per retiree (from 16 to 1 in 1950 to under 3 to 1 today) is a real thing. The right wing runs with it because it plays into their politics, for the same reason the left runs with climate change. But that doesn’t make it a manufactured problem.

Working young people have to take care of non-working old people. That’s true in a Bangladeshi village and that’s true in America. There’s no policy knob you can turn to make that fundamental dynamic go away.

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Policy knobs can be used to determine how resources are allocated and, perhaps most importantly, the kind of resources.

There's a lot of elder-care that is fundamentally non-scalable and non-automatable. But there's also a lot that is. Policy can both incentivize development of / investment in the latter and paying people competitive wage and benefits to step up and work the former.

Meanwhile, with productivity per person higher than it's ever been thanks to general industrial and service automation, there should be more GDP than ever free to invest in such social programs.

> Working young people have to take care of non-working old people

> There’s no policy knob you can turn to make that fundamental dynamic go away.

Are all the productivity increases in the past century completely meaningless?

To take the most facile, direct example possible, if all the fast food jobs are automated, can't we train those people to take care of the elderly? Not medically, but as orderlies and other employees in nursing homes?

> Are all the productivity increases in the past century completely meaningless?

Based on the change in prices for long term care and skilled nursing facilities, the productivity increases due to automation/outsourcing have not offset supply and demand in labor for elder/disabled care.

It is highly undesirable work, plus medical advances keep people alive longer and longer who need assistance to live. Even during my life, the past 30+ years, these jobs were almost always done by immigrants because they were willing to accept low wages. It is not something an American with options is going to opt for without higher pay.

It'll have to be some combination of wages going up and other options shrinking for workers.

Of course people can be trained as nursing home workers. The problem is who is going to pay for all the nursing homes as our population ages? Most nursing homes charge more per month than the maximum Social Security benefit. And many elderly people have minimal other retirement income or assets. So nursing homes constantly squeeze their workers on pay, especially in HCOL areas. There doesn't seem to be any politically acceptable way of closing this gap.

> who is going to pay for all the nursing homes as our population ages?

The increased productivity from the economy. The money is there. It's obvious it's there because we produce way more than ever before with far fewer workers.

Just stating that the money is somewhere out there in the economy is rather facile. It's not as if there's some big vault full of cash that we can draw from to pay for nursing homes. That money is currently being spent on or invested in other things. Consumers are already tapped out. On the government side, there is no political will to drastically cut other spending or raise taxes to pay more nursing home workers. The industry is also not very amenable to automation.

> It's not as if there's some big vault full of cash that we can draw from to pay for nursing homes.

I'm talking about productive capacity in the economy, not cash in a vault. It exists. Instead of battering workers with higher taxes, try taxing companies more directly. They're the ones benefiting the most from productivity increases. Tax land value, since real estate prices also benefit from productivity increases in rich metro areas.

> That money is currently being spent on or invested in other things

If you pay care workers more money, they will also spend or invest it. It's not just stacks of dollar bills going into a furnace.

It's not as if there's some big vault full of cash that we can draw from to pay for...

The money is out there. The wealth generated by all that increased productivity is just being captured by a small group of ultra-wealthy.

We could "easily" tax those massive accumulations of wealth to fund societal needs. We only need to convince all the temporarily embarrassed millionaires that doing so is in their own best interest.

It's unpleasant but there is a policy "knob" you can turn, which is to just let people die when they can't support themselves in the society we've built. We already do it for large sections of the population and there's no reason to suppose we won't do it to grandma and grandpa when the SSA coffers are empty. It's much harder to do this in a village society, where you literally see people starving as you have your lunch, but in an industrialized, atomized western society it is extremely easy because you never even have to think about it.

It’s math. Imagine you are the SSA. There is tax revenue, and there are payouts.

Both are controlled by policies enshrined into law by congress.

One of the things that can and has been done to control expenses is raising the retirement age.

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