WHEN you talk to Chinese officials lately, it doesn’t take long before they express concern about America’s “rebalancing” of forces – the prospect that we’ll shift more troops from the Middle East, where they are containing instability, to Asia, where they would contain China. My standard reply is that China is worrying about the wrong thing. It is not that we’ll shift our Marines from the Middle East to Asia; it’s that we are going to shift them from the Middle East to San Diego – because we can’t afford to be the world’s policeman much longer, and China will have to fill some of the void. Good luck, world! It’s been fun hanging with you, but we can’t pay for it anymore – not with all of us baby boomers about to retire with no savings. We have a new strategic doctrine coming: “US foreign policy in the age of Alzheimer’s.” We’ll do what we can afford and forget the rest. Why do I say that? In part it’s because I spent time this week with the Washington staff of The Jewish Federations of North America, or JFNA, which represents the 155 Jewish community federations across America. They may seem like an unlikely interlocutor for a foreign affairs columnist, but they’re not. Like their counterparts, Catholic Charities and Lutheran Services, these Jewish federations operate nursing homes, hospitals, elder-care programs, meals on wheels, job-training, hospices and family social services in cities across America. And the financial challenges they’re all facing today are profound – as the baby boomers are aging – and so too are the tradeoffs we’ll have to make between nursing homes in America and nursery schools in Afghanistan. Unless we get some sustained economic growth, Afghanistan is going to lose. William Daroff, the director of JFNA’s Washington office, starts with this fact: Since the 2008 economic crisis, annual donations to Jewish federations have been flat, while there has been a sharp increase in demand for services and significant cuts in Medicaid and block grants that help pay for them. “We have people who were donors to our programs five years ago, now knocking on the door to use those same programs”, said Daroff. And we haven’t seen anything yet, explains Barbara Bedney, the director of public policy for JFNA. “We will see a doubling of the number of older adults by 2030, as the baby boomers age,” she explained, and one of the fastest growing groups will be the “old-old” – those who are 85 and older, who are living longer but requiring even more expensive care. And wait until the baby boomer cohort reaches their 80s. Alzheimer’s Disease Research reports that roughly 5.4 million Americans of all ages had Alzheimer’s disease in 2012, and, by 2050, more than 15 million Americans could be living with the disease. And many baby boomers, says Steven Woolf, the senior tax policy counsel for JFNA, “are nowhere near prepared in terms of retirement savings” for the kinds of costs they are going to incur after they stop working – in an age in which they will be living longer, the government will have less to offer, they each will have fewer kids to care for them and social service agencies will be swamped with demands. Indeed, a 2011 survey by the Employee Benefit Research Institute found that a “sizable percentage of workers report they have virtually no savings or investments.” Among those workers polled in its retirement confidence survey, “29 percent say they have less than $1,000. In total, more than half of workers (56 percent) report that the total value of their household’s savings and investments, excluding the value of their primary home and any defined benefit plans, is less than $25,000.” Fortunately, two-thirds of baby boomer households are expected to receive some kind of inheritance over their lifetime to cushion the blow. Also, baby boomers as a generation have been very volunteeroriented, and we’re going to need a lot of family volunteers to work with the elderly. Indeed, says Bedney, today “family informal caregivers provide about 80 percent of elder care,” delivering meals to parents or aunts or driving them from place to place and managing their doctor visits and medications. Up to now, though, family caregivers have been largely ignored by policymakers, which is a mistake we must remedy, because “when we support family caregivers, we enable older adults to ‘age in place’ instead of in a high-cost institution,” Bedney said. But, as any family caregiver can tell you, it is no picnic. Add up all these trend lines and you can see why, over the next decade, we must get more consistent economic growth as a society and, also, adds Daroff, come up with more policy and technology innovations that allow us to provide a lot more elder care, in particular aging at home, for a lot less money. Nursing homes, nursery schools or nursing Afghanistan – these are the trade-offs we’ll have to make in this decade, unless we have a real growth spurt. Mitt Romney gave a big foreign policy speech last week, waxing eloquent about how he would be more assertive of US interests abroad than President Barack Obama and ensure that this is an “American century.” Really? I like American centuries. But to paraphrase an old saying: A foreign policy vision without a real plan to pay for it – and manage all the trade-offs back home – is just a hallucination.