Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of BC’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $8 billion annually.
• If BC still had the same age structure it did in 1976, when boomers were young, the 2025 budget deficit would drop from ~$11 billion to $3 billion—without changing any spending or revenue policy.
• In short: BC’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger British Columbians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

BC should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each British Columbian age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, BC’s population was 2.5 million, with only 10 per cent over age 65. That age structure translated into the medical demand of 3.6 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, BC’s population had grown to 5.7 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 8.1 million under-50 patients—a 125 per cent increase in medical demand that tracks population growth.

However, one in five British Columbians is now over age 65, making actual medical demand far higher: 10.6 million under-50 equivalents. This represents a 194 per cent increase overall, with aging alone adding the equivalent of 2.5 million extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to BC’s population allows us to estimate the fiscal footprint of aging.

If BC still had just 10 per cent of its population age 65 and over – not 20 per cent – its 2025 medical-care expenditure plan would be $30.7 billion, rather than the $39 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of more than $8 billion, BC’s projected $11.6 billion deficit would drop close to $3 billion.

The implication is that BC’s deficit is primarily structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of Alberta’s current deficit.
• Medical costs linked to baby-boomer aging now reach $6 billion annually.
• If Alberta still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip a deficit of $5.2 billion to a $761 million surplus—without changing any spending or revenue policy.
• In short: Alberta’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Albertans’ now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Alberta should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each Albertan age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Alberta’s population was 1.9 million, with only 7 per cent over age 65. That age structure translated into the medical demand of 2.4 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Alberta’s population had grown to 4.8 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 6.4 million under-50 patients—a 162 per cent increase in medical demand that tracks population growth.

However, 15 per cent of Albertans are now over age 65, making actual medical demand far higher: 8.1 million under-50 equivalents. This represents a 233 per cent increase overall, with aging alone adding the equivalent of 1.8 million extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Alberta’s population allows us to estimate the fiscal footprint of aging.

If Alberta still had just 7 per cent of its population age 65 and over – not 15 per cent – its 2025 medical-care expenditure plan would be $24.5 billion, rather than the $30.5 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of nearly $6 billion, Alberta’s projected $5.2 billion deficit convert to a $761 million surplus.

The implication is that Alberta’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary reason Saskatchewan doesn’t report a sizable budget surplus.
• Medical costs linked to baby-boomer aging now reach $1.2 billion annually.
• If Saskatchewan still had the same age structure it did in 1976, when boomers were young, its 2025 budget would shift from a near-balance today to a surplus of roughly $1.2 billion — without changing a single tax or spending policy.
• In short: even in the one province not running a deficit, Saskatchewan’s almost-balanced books mask a structural gap created by earlier governments that failed to align medical-care revenue with an aging population — unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Saskatchewan should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province risks drifting towards deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each resident of Saskatchewan age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Saskatchewan’s population was 0.93 million, with 11 per cent over age 65. That age structure translated into the medical demand of 1.3 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Saskatchewan’s population had grown to 1.24 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 1.8 million under-50 patients—a 33 per cent increase in medical demand that tracks population growth.

However, 17 per cent of Saskatchewan residents are now over age 65, making actual medical demand far higher: 2.2 million under-50 equivalents. This represents a 64 per cent increase overall, with aging alone adding the equivalent of 411,000 extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Saskatchewan’s population allows us to estimate the fiscal footprint of aging.

If Saskatchewan still had just 11 per cent of its population age 65 and over – not 17 per cent – its 2025 medical-care expenditure plan would be $6.8 billion, rather than the $8 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of $1.2 billion, Saskatchewan would flip it’s nearly balanced budget into $1.2 billion surplus.

This reveals a structural risk for Saskatchewan. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits. Without a modernized approach to medical financing, the province risks drifting towards deficits, longer waits, and continued under-investment in other priorities.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of Manitoba’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $1.6 billion annually.
• If Manitoba still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip from a $794 million deficit to an $833 million surplus—without changing any spending or revenue policy.
• In short: Manitoba’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Manitoba should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, Manitoba will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each Manitoban age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Manitoba’s population was 1 million, with only 10 per cent over age 65. That age structure translated into the medical demand of 1.46 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Manitoba’s population had grown to 1.5 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 2.1 million under-50 patients—a 45 per cent increase in medical demand that tracks population growth.

However, 17 per cent of Manitobans are now over age 65, making actual medical demand far higher: 2.6 million under-50 equivalents. This represents a 78 per cent increase overall, with aging alone adding the equivalent of 484,000 extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Manitoba’s population allows us to estimate the fiscal footprint of aging.

If Manitoba still had just 10 per cent of its population age 65 and over – not 17 per cent – its 2025 medical-care expenditure plan would be $7.8 billion, rather than the $9.4 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of more than $1.6 billion, Manitoba’s projected $794 million deficit would convert into a surplus of roughly $833 million.

The implication is that Manitoba’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of Ontario’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $22 billion annually.
• If Ontario still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip from a ~$15 billion deficit to an ~$8 billion surplus—without changing any spending or revenue policy.
• In short: Ontario’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Ontarians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Ontario should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, Ontario will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each Ontarian age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Ontario’s population was 9.1 million, with only 9 per cent over age 65. That age structure translated into the medical demand of 11.4 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Ontario’s population had grown to 16.1 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 21.9 million under-50 patients—a 92 per cent increase in medical demand that tracks population growth.

However, nearly one in five Ontarians is now over age 65, making actual medical demand far higher: 29.3 million under-50 equivalents. This represents a 157 per cent increase overall, with aging alone adding the equivalent of 7.4 million extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Ontario’s population allows us to estimate the fiscal footprint of aging.

If Ontario still had just 9 per cent of its population age 65 and over – not 18 per cent – its 2025 medical-care expenditure plan would be $68.8 billion, rather than the $91.1 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of more than $22 billion, Ontario’s projected $14.6 billion deficit would convert into a surplus of roughly $7.7 billion.

The implication is that Ontario’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of Quebec’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $21 billion annually.
• If Quebec still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip from a ~$11 billion deficit to an ~$10 billion surplus—without changing any spending or revenue policy.
• In short: Quebec’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike the foresight that Ottawa showed when adapting CPP premiums for retirement income in the 1990s.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Quebec should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, Quebec will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each Quebec resident age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Quebec’s population was 6.4 million, with only 8 per cent over age 65. That age structure translated into the medical demand of 8.3 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Quebec’s population had grown to 9 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 11.8 million under-50 patients—a 42 per cent increase in medical demand that tracks population growth.

However, 21 per cent of residents in Quebec are now over age 65, making actual medical demand far higher: 17.4 million under-50 equivalents. This represents a 108 per cent increase overall, with aging alone adding the equivalent of 5.5 million extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Quebec’s population allows us to estimate the fiscal footprint of aging.

If Quebec still had just 8 per cent of its population age 65 and over – not 21 per cent – its 2025 medical-care expenditure plan would be $43.9 billion, rather than the $65.5 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of more than $21 billion, Quebec’s projected $11.4 billion deficit would convert into a surplus of roughly $10.2 billion.

The implication is that Quebec’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike reforms to CPP in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of Nova Scotia’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $1.7 billion annually.
• If Nova Scotia still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip from a ~$897 million deficit to a ~$805 million surplus—without changing any spending or revenue policy.
• In short: Nova Scotia’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

Nova Scotia should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each Nova Scotia resident age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, Nova Scotia’s population was ~835,000, with only 10 per cent over age 64. That age structure translated into the medical demand of 1.15 million “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, Nova Scotia’s population had grown to ~1.08 million. If the age structure had remained the same as in 1976, the province would have the equivalent of 1.49 million under-50 patients—a 29 per cent increase in medical demand that tracks population growth.

However, 22 per cent of Nova Scotia residents are now over age 64, making actual medical demand far higher: 2.08 million under-50 equivalents. This represents an 81 per cent increase overall, with aging alone adding the equivalent of nearly 600,000 extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to Nova Scotia’s population allows us to estimate the fiscal footprint of aging.

If Nova Scotia still had just 10 per cent of its population age 65 and over – not 22 per cent – its 2025 medical-care expenditure plan would be $4.3 billion, rather than the $6.0 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of $1.7 billion, Nova Scotia’s projected $897 million deficit would convert to a $805 million surplus.

The implication is that Nova Scotia’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of New Brunswick’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $1.2 billion annually.
• If New Brunswick still had the same age structure it did in 1976, when boomers were young, the 2025 budget deficit of $549 million would convert to a $680 million surplus—without changing any spending or revenue policy.
• In short: New Brunswick’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

New Brunswick should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each New Brunswick resident age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, New Brunswick’s population was ~689,000, with only 9 per cent over age 64. That age structure translated into the medical demand of 932,000 “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, New Brunswick’s population had grown to ~854,000. If the age structure had remained the same as in 1976, the province would have the equivalent of 1.2 million under-50 patients—a 24 per cent increase in medical demand that tracks population growth.

However, 23 per cent of New Brunswick residents are now over age 64, making actual medical demand far higher: 1.7 million under-50 equivalents. This represents an 80 per cent increase overall, with aging alone adding the equivalent of over half a million extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to New Brunswick’s population allows us to estimate the fiscal footprint of aging.

If New Brunswick still had just 9 per cent of its population age 65 and over – not 23 per cent – its 2025 medical-care expenditure plan would be $2.9 billion, rather than the $4.1 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of more than $1.2 billion, New Brunswick’s projected $549 million deficit would become a $680 million surplus.

The implication is that New Brunswick’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.

Summary

• New analysis from the University of British Columbia shows that population aging is the primary driver of PEI’s current deficit.
• Medical costs linked to baby-boomer aging now exceed $278 million annually.
• If PEI still had the same age structure it did in 1976, when boomers were young, the 2025 budget would flip from a ~$184 million deficit to a ~$95 million surplus—without changing any spending or revenue policy.
• In short: PEI’s current deficit reflects a structural gap left by earlier governments that did not align medical-care revenues with an aging population—unlike Ottawa’s foresight in adapting the CPP for retirement income.
• Younger Canadians now contribute 20 to 40 per cent more of their income taxes toward seniors’ medical care and benefits than boomers did at the same age. Contemporary fiscal policy therefore obliges Millennials and Gen Z to subsidize their aging loved ones’ healthy retirements, even as they face far higher housing costs and greater financial insecurity than earlier generations.

Recommendation

PEI should launch a “Better Late Than Never” task force to design a generationally fair financing plan for medical care. Without a modernized approach to medical financing, the province will drift toward larger deficits, longer waits, and continued under-investment in other priorities. Any new revenue systems must protect vulnerable seniors, stabilize provincial finances, and lighten the load on younger generations whose wellbeing is deteriorating.

Key Evidence

Medical spending rises steeply with age: roughly $3,000 per person under 50, about $10,000 by age 70, and close to $37,000 by age 90. Each PEI resident age 65 and older represents about four under-50 patients in terms of medical demand.

This ratio allows us to estimate the impact of population aging on provincial medical spending, independent of overall population growth.

In 1976, PEI’s population was ~119,000, with only 11 per cent over age 64. That age structure translated into the medical demand of 170,000 “under-50 equivalent” residents. Boomers therefore grew up in a younger province with correspondingly lighter medical demands.

By 2024, PEI’s population had grown to ~179,000. If the age structure had remained the same as in 1976, the province would have the equivalent of 256,000 under-50 patients—a 50 per cent increase in medical demand that tracks population growth.

However, one in five PEI residents is now over age 64, making actual medical demand far higher: 334,000 under-50 equivalents. This represents an 97 per cent increase overall, with aging alone adding the equivalent of 78,000 extra younger and middle-age patients beyond population growth.

Applying this “under-50 equivalents” framework to PEI’s population allows us to estimate the fiscal footprint of aging.

If PEI still had just 11 per cent of its population age 65 and over – not 20 per cent – its 2025 medical-care expenditure plan would be $963 million, rather than the $1.24 billion forecasted in the 2025 budget.

Without these additional aging-related expenditures of $278 million, PEI’s projected $184 million deficit would convert to a $95 million surplus.

The implication is that PEI’s deficit is structural. Decades ago, successive governments understood that population aging would increase medical costs but did not modernize revenue systems to keep pace—unlike the federal government’s CPP reforms in the 1990s, which anticipated boomers’ increased use of public pension benefits.