The Elderly May Not Be As Taxing As Generally Thought
by Linda Beale
The Elderly May Not Be As Taxing As Generally Thought
One of the common assumptions about health care costs (and the costs of benefit programs like Medicare) has been that the increasing life spans of Americans will result in significantly greater health care expenses. It is common knowledge that much of the highest cost medical care occurs near the end of life, as the elderly need more medicines and assistance in daily living. So speculation has suggested that as Americans live longer, health costs will increase correspondingly.
A recent study provides a glimmer of good news–apparently, most of the highest medical care costs occur in the last year of life, even for those that are living longer. That means that the longer lifespans aren’t translating into more time in intense medical care, but rather more years of generally healthy and active lifestyle followed by a similar duration of end-of-life care. See Michael Fitzgerald, Old Age May Not Ruin Medicare Budgets After All, Salon.com (Aug. 22, 2013).
What should that information mean for policy makers? It seems to support the progressive, social justice goal of ensuring that we have a system for universal health care coverage like “Medicare for all”. Under democratic egalitarianism, a combination of general revenue support and additional premium payments from those who have the ability to pay provides a means for decent protection of all of our citizens and the creation of a just society. By asking those with the ability to pay to carry more of the burden, such a system ensures adequacy for all even in times such as ours when there is extraordinary inequality of wealth or income. Our forebears handled that kind of situation through one-on-one charities, back when communities were much smaller and people knew that they depended on their neighbors for help in tough times, so were willing to help out when they were able. The modern version of that neighborly compassion is a government that creates safety net programs for all of its people, with public programs in those areas where a profit motive interferes with the creation of adequate, sustainable, just programs for everyone. Education and health services are clearly two key areas where people acting together through government create fairer and more adequate systems that serve all of the people.
cross posted with http://ataxingmatter.blogs.com/
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Linda:
I never got a round to addressing this issue so I am happy to see you do it. The aging of the population was never the problem it was made out to be by those who would attract attention by casting aspersions. Please take some time and read the references I have included in my comment to your article. A chart and a few words from Will Boomers Bankrupt Our Health Care System? Myths and Facts
“It turns out that when you look at estimates of growth in health care spending from 1990 to 2030, a senescent citizenry plays only a minor role in the projected jump from $585 billion (what we laid out for health care in 1990) to $14,026 billion (what analysts say we’ll ante up in 2030, assuming we continue in our profligate ways).
What will be the biggest factor pushing the tab so much higher? Innovation. ‘The health care industry will continue developing new stuff for every age group,” Reinhardt explains. Will that ‘new stuff’ — in the form of new drugs, devices, tests and procedures—be worth it?
Some of it will be. Some won’t. Indeed as an article from Health Affairs reveals, over the past twelve years, rising spending on new medical technologies designed to address heart disease has not meant that more patients survived. In many areas, we seem to have reached a point of diminishing returns. This also is true in the drug industry, where most new entries are “me too drugs”—little different from products already on the market.”
References:
Will Boomers Bankrupt Our Health Care System? Myths and Facts Maggie Mahar Health Beat Blog
Is Technological Change In Medicine Always Worth It? The Case Of Acute Myocardial Infarction Joseph Skinner Health Affairs
Of course the greatest thing about this isn’t so much that healthcare will cost less than projected*, it is that those expenditures are resulting in greater returns….More years of a decent quality of life rather than more years stuck in a nursing home bed.
*still a higher per patient rate than today.