In the last module, we discussed the future possibility of an “anti-aging” pill.
Even if it is not developed, our lifespan as human beings (especially within
the United States) is increasing dramatically. In the 1700s, life expectancy in
the United States was approximately 30 years of age. We did not know that
much about communicable diseases, and our health care system was fairly
nonexistent. We soon discovered antibiotics, and through a series of major
medical advancements, our life expectancy doubled to age 60 by the year
1930. In America today, when we take the average of males and females (as
women live longer), our expected time on this planet is roughly 78 years. As
a side note, the World Health Organization anticipates that by the year
2040, individuals in the United States will live to be 100 years of age; it
would mean everything mentioned in this lecture multiplied several times!
The fastest growing age group in the United States is those over the age of
85. We are watching as America inches closer and closer to a term known
as zero population growth (ZPG). ZPG is quite simply when the number of
newborns is equal to the number of deaths. This website will take you to
Population Pyramids of the World. In agrarian-based societies, where
individuals do not live that long and there is high infant mortality, we would
expect to see a very well-defined pyramid. In a ZPG society, such as Japan,
the pyramid more closely resembles a square. This has huge implications for
health care delivery.
In 1935, the United States Government enacted the Social Security (SS)
program. At the time, America was still reeling from the Great Depression,
and the elderly were among the hardest hit by the economic downturn. The
SS program was designed to provide assistance to the aged and allow them
to secure their basic housing and necessities; quite frankly, it was never
designed to pay for health care. However, today’s elderly use the vast
majority (if not all) of their Social Security monies on paying for prescription
medications or to cover costly copayments. An individual over the age of 65
utilizes four times the amount of health care as those in their 30s. As the
cost of health care continues to increase, the percentage of monies spent
by the elderly for medical care will increase beyond their means.
In the year 1965, President Johnson was moving toward universal health
care. Opponents gained strength, and instead of insuring everyone, a
compromise was reached—insure the elderly and the impoverished. This
resulted in the birth of Medicare and Medicaid, respectively. Someone born
at this time would expect to live to the ripe old age of 70. As such, Medicare
was designed to cover the aged individual for a total of 5 years. As
mentioned earlier, the lifespan today is 78 years of age. A program that was
only designed to cover an individual for 5 years is now expected to cover
them for 13.
Today, over 49 million Americans are enrolled in Medicare, making it one of
the largest insurance entities in the world. Annual expenditures are over
$500 billion and are increasing rapidly. With such large numbers, it should
be no surprise that fraud within the system is at an all-time high.
What does the future of the elderly look like in the United States? Some
individuals worry that we are increasing our gerontophobia (fear of the
elderly). They point out the increase in nursing homes, senior citizen-only
complexes, and other means through which we are slowly moving our
elderly out of mainstream America. Others have a counterargument that the
elderly are more active and are actually increasing their presence. No matter
which side of the debate you find yourself, the point is clear: Our population
is growing older, and the elderly consume more health services. Can our
current health care system support this growth? Will Medicare be viable for
the next generation?
Reference
Henry J. Kaiser Family Foundation (2011). Medicare at a glance. Retrieved
from http://www.kff.org/medicare/upload/1066-14.pdf
