My conversation with Lars centered around a subject I had written about recently: America’s declining birth rate. I explained that this isn’t just a demographic shift—it’s an economic crisis in the making. Social Security relies on younger workers funding retirees, and with fewer births and earlier retirements, we’re running out of workers to sustain the system.
The solution? There are two options: increase immigration, since immigrant families tend to have more children; or create policies that make it easier to raise kids—like the provision of parental leave and better housing. Neither is a perfect fix, involving more government intervention than either of us would prefer.
Lars questioned whether endless population growth is sustainable, but history shows that technology continually improves productivity and efficiency. The real challenge is ensuring a skilled workforce to drive that progress.
That led us to immigration policy. I pointed to Japan’s dilemma: an aging population with little immigration and no one left to care for the elderly. It’s a warning we’d be wise to heed.
Here is the complete discussion
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Henry I. Miller, MS, MD
Henry I. Miller, MS, MD, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. His research focuses on public policy toward science, technology, and medicine, encompassing a number of areas, including pharmaceutical development, genetic engineering, models for regulatory reform, precision medicine, and the emergence of new viral diseases. Dr. Miller served for fifteen years at the US Food and Drug Administration (FDA) in a number of posts, including as the founding director of the Office of Biotechnology.
