March 2000

Grant Results


From 1997 to 1999, William Styring and Donald K. Jonas wrote the book Health Care 2020: The Coming Collapse of Employer-Provided Health Care.

Key Results

  • According to the Hudson Institute, which published the book in June 1999, "In the year 2011, the United States will begin to experience the biggest age-driven demographic upheaval in its history, as the first baby boomers reach age 65.In 2010, the ratio of adults in prime working years, ages 25–64, to those 65 and over will be 4 to 1. By 2020, it will fall to 3 to 1. By 2030, it will drop to almost 2 to 1.

    "The ratio of potential workers to potential retirees will be cut in half in only two decades…. The social and public policy consequences of this 'graying' of America are hard to overestimate. Social Security and Medicare will have to be cut back through some combination of reducing benefits and raising normal retirement ages; otherwise, the tax rates on the young are politically unthinkable.

    "Above all, the health care system will have to change. The book argues that the current system of tax-driven preference for receiving health insurance through employers will be shattered by the coming old age of the Baby Boom generation.

    "The book lays out the political coalition which will come together to make that a reality. Cheaper but effective ways of caring for the elderly, short of costly institutionalization, will be imperative. For example, current attempts to curtail home health care programs are not the way to go. The large numbers of baby boomers will radically change health insurance, and Health Care 2020 tells what health care will be like in the next century."

See the Bibliography for a full citation on the book.

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $198,820.

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Book Exploring Future Models for Health Insurance Coverage


Hudson Institute, Inc. (Indianapolis,  IN)

  • Amount: $ 198,820
    Dates: October 1997 to April 1999
    ID#:  032127


William Styring, Ph.D.
(317) 545-1000

Web Site

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(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books and Reports

Styring W and Jonas DK. Health Care 2020: The Coming Collapse of Employer-Provided Health Care. Indianapolis, Ind.: Hudson Institute, 1999.

News Conferences

Briefing: Findings from Health Care 2020, Indianapolis, Ind., August 9, 1999. Attended by health care executives, insurance executives, and reporters. Moderator: L. Ben Lytle, chairman and CEO of Anthem, Inc.

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Report prepared by: Marian Bass
Reviewed by: Molly McKaughan
Program Officer: Pamela S. Dickson