Wednesday, January 16, 2013

The future belongs to the young...

But the present belongs to us geezers. Thanks to a system sharply slanted toward the elderly we have developed an odd actuarial situation.
But a funny thing happens to Americans’ life expectancy when they age. The U.S. mortality rate is the highest of the 17 nations until Americans hit 50 and the second-highest until they hit 70. Then our mortality ranking precipitously shifts: By the time American seniors hit 80, they have some of the longest life expectancies in the world.
What gives? Have seniors discovered the Fountain of Youth? Do U.S. geriatricians outpace all our other physicians?
Part of the answer is Darwinian: Those Americans who have been less able to access reliable medical care, maintain good diets and live in neighborhoods that are not prey to gun violence have disproportionately died off before age 80. That isn’t natural selection but social selection — the survival of the economically fittest in a nation that rations longevity by wealth.
But the larger part of the answer is that at age 65, Americans enter a health-care system that ceases to be exceptional when compared with the systems in the other 16 nations studied. They leave behind the private provision of medical coverage, forsake the genius of the market and avail themselves of universal medical insurance. For the first time, they are beneficiaries of the same kind of social policy that their counterparts in other lands enjoy. And presto, change-o: Their life expectancy catches up with and eventually surpasses those of the French, Germans, Britons and Canadians. [More]
The absolute conviction that the US medical system is the envy of the world is a conceit supportable for only a few of us. It is also inconsistent with almost every measure of health outcomes. It needs to be changed. Period.

As Jan and other colleagues begin to enroll in Medicare, I can tell you for a fact, that not one - even the most rabid free-market, anti-government evangelists - is less than thrilled. I think we had doped out the above trend long ago. "We got ours" is the motto of my generation.

3 comments:

Anonymous said...

does inner city violence skew these numbers?

Dave said...

gun Violence??? Have you been drinking the kool-aid? While the rest of the article may very well be true that one statement puts a question mark on the whole thing.

Anonymous said...

Dave,

What do you mean? Are you saying that because gun violence is mentioned as a factor, that implies there were mathematical errors made in the analysis? Do you think the calculations of mortality rates were flawed in some way? Why does mentioning gun violence render everything in the article as questionable?

This tendency to dismiss everything because even one little part of it doesn't sit well with us is a perfect example of how nation has gotten so politically polarized. Your approach to this article - discounting the whole thing because you don't like one part, is exactly the same strategy being employed by political parties. "I don't like the Democrats position on spending, therefore everything they do is questionable." Or "I don't like the GOP position on women's rights, therefore all their ideas are bad." That lack of intellectual diligence is exactly what each party wants to instill in you in regards to the opposition. It's bad for the country, and leads to ridiculous situations like the debt ceiling fiascos we have (and apparently will continue) to experience. Buying into that way of thinking is truly "drinking the kool-aid". Don't do it, Dave. Don't shut down your brain just to save your ego.