By 2050, one in five US residents will be of retirement age. As we hurtle headlong toward this reality, we face a choice: we can either invest public money in comprehensive long-term care for seniors, or not.

If we don’t, the consequences will be grim. The average annual cost for a home health aide tops $50,000. The annual cost of a private nursing home room now exceeds $100,000, and it’s rising. At present, Medicare does not cover most long-term care needs; seniors often find that their best option is to deplete their life savings so they can qualify for Medicaid. But even then, benefits are limited, and the costs of home health aides and institutional care are not fully covered. Private insurance that covers long-term care is too expensive for many seniors, leaving them at the whim of the threadbare social safety net.

Over the next decade, ten thousand baby boomers a day will turn sixty-five. Most of these people will need some kind of long-term care at some point. That means that tens of millions of people will soon be left to their own devices as they scramble to secure arrangements for themselves. Tens of millions more will be on the hook for figuring out how to care for them, or how to pay for somebody else to care for them. Baby boomers and their children will soon become preoccupied with the question of long-term care provision — and if we proceed apace, the system will prove impossibly expensive, endlessly difficult to navigate, and ultimately inadequate for nearly half the population.