By 1995 population aging will decrease the size of the high-injury-risk age cohort (14–34 years) by 7.0 million (-8.2%). The reduction in the high-injury-risk age cohort should reduce the overall volume of penetrating and blunt injury nationally despite a population increase of 21 million. However, the number of, and the proportion of, elderly victims of injury will increase as there will be an additional 5.3 million (+18.5%) people age 65 years or older. Yet payments based on Medicare diagnosis-related groups (DRG's) do not provide adequate reimbursement for any, let alone the elderly, victims of injury. Moreover, Medicare and Medicaid reimbursements for the long-term care so frequently needed by the elderly victims of injury is inadequate. As our population ages, the adverse financial impact of these circumstances resultant from population aging will increasingly strain the financial resources of our trauma centers.