To the Editor:

This essay reflects the aging of American society as the most powerful, if underrecognized, trend of the 21st century. The longevity miracle bequeathed to us from 20th-century advances in medicine, sanitation and technology is joined by stunningly low birthrates.

We can no longer pretend to merrily glide along without huge economic, social and political consequences. So, three changes:

Employers should lead in getting rid of mandatory retirement and let people work as long as they want and can.

Start spending our health care dollars on prevention to keep older Americans healthier and therefore less of a burden on everyone else — adult vaccines, cardiovascular screening and second fracture prevention programs would change the game.

Reimagine Medicare and Social Security through the lens of 21st-century age demographics and based on a financial and economic analysis that will not leave our grandchildren bankrupt.