As the new Congress convenes, budget cutters are eyeing Medicare, citing predictions the program for seniors is running out of money. But federal bean counters have erroneously predicted Medicare’s bankruptcy for decades. One mistake is they don’t consider medical breakthroughs.
Another problem is medical ethicists like Dr. Ezekiel Emanuel, who insist the elderly are a burden and resources would be better spent on the young.
Don’t believe it. New medical findings show how misguided this thinking is. Medicare spending on end-of-life care is dropping rapidly, down from 19% to 13% of the Medicare budget since 2000. Living to a ripe old age isn’t a problem. It’s a bargain. Someone who lives to 97 needs only about half as much end-of-life care as someone who dies at 68.
Surprised? Myth has it that the older people get, the sicker they are and the more costly their care. But in truth, disability and chronic illness are declining among the elderly.
Octogenarians, and even centenarians, are staying active instead of languishing crippled in wheelchairs. How? Medical advances such as carotid artery stenting and thrombolysis prevent stroke damage, something seniors fear worse than death.
Scientists call this overall improvement in aging “compression of morbidity.” The elderly live longer, stay healthier, and have shorter illnesses at the end of life.
All the more reason for seniors to resist making politically correct end-of-life medical plans or advance directives that forgo medical interventions, long before they’re actually facing a terminal illness. They shouldn’t rule out the use of tools like respirators and feeding tubes that could keep them going during a bout of flu or an accident, allowing them to recover and resume active lives.
Patients mistakenly assume ventilators and feeding tubes are permanent. But most patients recover after these interventions. Few ever remember being on a ventilator after it’s removed, because they’re sedated while on it.
Why would we emulate Zeke Emanuel, age 59, who swears that at 75, he will forego all medical care and let death come quickly? “Our older years are not of high quality,” he insists. He’ll skip them. In the Atlantic magazine, he dismisses compression of morbidity as “quintessentially American” wishful thinking, and mocks seniors for trying to “cheat death.”
Sorry, Doc. It’s not a pipe dream. Science proves old age is getting better. It’s worth living.
Like Emanuel, the federal government ignores this fact and writes off seniors. Take cancer screenings. Currently the U.S. Preventive Services Task Force recommends against routine colon cancer screenings after age 75. Even though patients over 75 have the highest risk.
The Task Force also recommends routine mammograms only until age 74. But Dr. Judith Malmgren of the University of Washington explains, “a 75 year old woman today has a 13 year life expectancy” and should get screened.
The Task Force’s guidelines alarmingly resemble those of Britain, where patients over 75 are routinely denied knee replacements, mastectomies, and other surgeries. It’s a slippery slope.
Too often, Congress treats Medicare as a piggy bank — raiding it when money is needed elsewhere. In 2010, Democrats in Congress paid for over half of Obamacare’s spending by cutting Medicare. This year, Republican lawmakers eager to control federal health spending should avoid that error and instead focus on fixing Medicaid, the money pit program for the poor, where spending per capita is growing twice as fast as for Medicare.
Medicaid spending now tops $8,000 per recipient. That’s thousands more than is spent on people in private plans. For all that money, Medicaid is not improving health.
By contrast, Medicare is a success story. It has transformed aging, enabling older Americans to lead longer, more independent lives than our grandparents did. The average man turning 65 today will live five years longer than in 1970. Not just more years. Quality years. What a gift.
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