Globe & Mail: How younger Canadians end up paying more for boomers’ medical care

Originally published in The Globe & Mail on September 5, 2025

In a recent column, I argued that millennials and Gen Z are already conscripted into national service for their elders – no uniform required. Politics obliges them to pay more out of pocket in the housing market, government budgets, and the planet’s health to protect healthy retirements for an aging population.

The response from older readers was split. Some expressed appreciation, recognizing the load their children and grandchildren are carrying. Others dismissed the analysis as grievance politics.

It’s important to move past the latter reflex. Medical care shows why. It is one of the clearest examples of the service younger generations provide. Recognizing that is essential both to protecting universal access and to safeguarding the legacy of boomers.

Medical care is a big personal expense, even though we pay for it primarily through our taxes. It absorbs nearly half of the provincial revenues Canadians contribute. A typical Canadian who lives to 85 will accumulate about $524,000 in medical bills – more than half of that after age 65.

The arithmetic is straightforward – although some readers doubted the age-specific numbers I shared previously. These figures come directly from the Canadian Institute for Health Information, Canada’s official source for medical spending, published annually in its National Health Expenditures reports.

CIHI data confirm that medical costs rise steeply with age. A young adult in their early 20s uses about $2,600 annually. By the early 70s, costs exceed $10,000; by the 90s, they near $37,000.

The fiscal footprint of aging is dramatic. From year one through age 49, Canadians typically consume around as much medical care as a 20-year-old. In our 50s, costs nearly double. We almost consume the equivalent of two 20-year-olds. At age 65, we represent three 20-year-olds; at 75, five; at 85, twelve; and at 90, fourteen. (Full disclosure: As a Gen X, I just turned 51 and I’m now driving up the numbers myself.)

All told, medical expenses really begin to accelerate around age 65, when each senior represents the demand of several younger people combined. It reflects the natural course of aging: chronic disease, frailty, end-of-life care. But it also explains today’s strained hospitals, long waits, and provincial health budgets that always feel short. Our continuing search for efficiency in the medical system cannot offset the massive demographic shift.

In the mid-1970s, seniors made up less than 10 per cent of most provincial populations. Today, their share has roughly doubled. Newfoundland and Labrador is now nearly one-quarter seniors, Nova Scotia and New Brunswick exceed 22 per cent, and even Alberta – our “youngest” province – has seen its share double.

As the percentage of seniors increases, the share of working-age residents declines. In 1976, Ontario’s ratio was seven working-age people for every senior; today, it’s three and a half. Quebec has fallen from 8.2 to 2.9. In Atlantic Canada, the share is also at, or below, three. The pattern of falling ratios is repeated across the map.

This isn’t about blaming seniors for growing old – so older readers, please don’t get riled. The problem lies with provincial governments decades ago, which failed to prepare for boomers’ medical care. In the 1990s, Ottawa reformed the Canada Pension Plan, raising boomer contributions to cover the benefits they would later draw. Provinces made no comparable move for medical care, leaving today’s younger taxpayers to absorb predictably higher costs.

For younger Canadians, this larger medical bill comes on top of heavy burdens: higher rents and mortgages sustained to protect the home equity many older owners and governments fear losing, plus the looming costs of climate adaptation. Layered together, these added costs imposed by past and present fiscal choices leave millennials and Gen Z paying more for retirees than was expected of boomers.

The path forward requires honesty and reciprocity, not resentment. Acknowledging the service younger Canadians already provide should inspire policies that share responsibility more evenly: protecting vulnerable seniors while asking the financially secure among them to contribute more toward the care their generation consumes. Options exist – from modest surtaxes on high-value homes to modernizing Old Age Security for affluent retirees.

The choice is stark: Either let medical-care deficits swell and younger people’s standard of living erode, or share responsibility more evenly to protect access to universal care. Older Canadians should remember they helped build our medical system, but governments’ failure to prepare for boomer care now puts it at risk. Safeguarding it requires solidarity with – not condescension for – the children and grandchildren who are already conscripted to subsidize boomers’ medical care in retirement.

Dr. Paul Kershaw is a policy professor at UBC and founder of Generation Squeeze, Canada’s leading voice for generational fairness. You can follow Gen Squeeze on Bluesky, Facebook, Instagram, and LinkedIn, and subscribe to Paul’s Hard Truths podcast.