Eight hours is a critical window for hospitals.
For every 72 people who wait in emergency departments longer than that, one will die.
Not long ago, more than 95 per cent of patients were discharged from emergency in fewer than eight hours. Now, that's dropping.
"It's like we need 700 things done three per cent better," Australasian College of Emergency Medicine president Peter Allely told AAP.
More older Australians are arriving in emergency rooms and they were sicker, Dr Allely said.
In the six years to 2024, a fresh report from the college shows over-65s' hospital visits spiked 16 per cent, compared to just four per cent for those younger.
It's a problem everyone saw coming.
"This has been the most predictable public demographic for the last few decades," Dr Allely said before the release of the report on Tuesday.
The Australian Bureau of Statistics in 2010 predicted the number of over-85s presenting to EDs would grow more than fivefold by 2050.
Dr Allely said the forecasts were spot on.
"They plotted a curve, which unfortunately, right about now, is starting to go exponential," he said.
Most older patients arrive by ambulance, the vast majority need care within 30 minutes and about half are admitted to hospital, according to the report.
Regional Australia is also ageing at about double the speed of capital cities, meaning overstretched services have grappled with almost twice the increase in older ED presentations than elsewhere.
"This is not the fault of older people, it is a success story, it's testament to modern science, medical advances and good public policy," Dr Allely said.
"The system has not planned or prepared for the inevitable needs of people as they get older and more frail and more complicated."
The college's report recommends bolstering non-hospital treatment pathways for older people, unclogging emergency departments, expanding prevention and funding research to keep more geriatrics out of waiting rooms.
"There aren't many efficiencies to be gained in the healthcare system, but there will be some," Dr Allely said.
It comes as it's revealed about 80,000 older Australians are expected to ditch private health insurance cover by 2030 if Labor succeeds in winding back generous rebates, to be spent elsewhere in the system.
Australia needs to be building an aged care facility every three days for the next 20 years to keep up with demand, according to Health Minister Mark Butler, with older Australians tipped to comprise up to a quarter of the population by 2066.
But Labor, the coalition and One Nation have also announced plans to cut migration on which the sector heavily depends, slugging it with more pressure.
Of the aged care workforce alone, about 40 per cent are thought to be migrants.
Opposition Leader Angus Taylor, whose migration policy was last off the rank, has admitted cutting population growth due to migration to 100,000 for three years and 160,000 thereafter would affect the visas of some aged care workers.