Some time tonight, Australia’s population will click over the 23 million mark. Some squalling newborn, or migrant, will hit that milestone. The ABS estimates there may be as many as 62 million of us around the time that baby dies.

Australia’s steadily increasing — and ageing — population is a major issue which is arguably not adequately considered and planned for by our politicians. It means higher greenhouse emissions, more traffic and roads, greater difficulties in sourcing enough fresh water. And it means a budget disaster as we provide healthcare for all these people — especially all these old people. Right?

Not necessarily. Bernard Keane does some digging today and argues the significant increase in health spending and in the size of the health workforce — now Australia’s largest employment sector — is, in fact, not inevitable. And Keane’s international comparison shows it’s not necessarily caused by the ageing population:

“The lesson from Canada — both from the 1990s and now — is that an ageing population doesn’t necessarily drive rising healthcare expenses: increased spending is a choice of governments, until they are faced with having no choice but to cut back, as Canadian governments were in the mid-1990s.

This dovetails with the conclusion reached by the Grattan Institute, that it is more use of the health system, not an ageing population, that has driven the bulk of the rise in Australia’s healthcare expenditure, even though we’re getting much better value out of our health system than the Americans are.”

So you may be delighted or alarmed as Australia crosses the 23 million mark tonight, depending on how you see the world (and whether it’s your baby). Either way, it’s pause for thought on population and demographic issues — not least, healthcare spending.