The Past, Present and Future of Aging
Conrad F. Meier
In response to one of my columns on health care, a reader wrote and called me an "old geezer" ranting in opposition to universal health care. I confess to having a healthy discontent for the way things are, but I have to draw the line at being called an "old geezer." Having just turned the corner on 66 got me to thinking about ageism --- an ignorant practice of judging people on the basis of age rather than the ability to perform.
Putting This in Perspective
Those of us with birth dates before 1940 were born before long-term care, guaranteed-issue, gatekeepers, managed care, PPOs, IPAs, MCOs, ERISA, COBRA, CHIPs, MSAs and HIPAA. Medicare was an unheard of public policy initiative we are living long enough to see bankrupt the nation's health care system. Social Security legislation, passed in the year I was born, was meant to be a supplement, not the sole means of financial support.
We did not have CAT scans, heart transplants, bypass surgery, contact lenses, the pill, split genes, group therapy, pacemakers, proctoscopic exams and WebMD. We were before Viagra, Prozac, Ritalin, Zoloft, Tylenol, Celebrex, Ibuprofen and generic drugs.
We were not before weekly life insurance premiums, but we did precede employee benefits, group health insurance, pension plans, annuities, IRAs, SEPs, 401(k)s, viatical settlements, patients rights issues and multi-million dollar medical malpractice settlements.
That, of course, was not the whole fabric of our lives: As enumerated in an old and anonymous essay, We Are Survivors, we were also born before television, videos, cell phones, pagers, fax machines, credit cards, panty hose, dishwashers, clothes dryers, air conditioners, frozen food and ball point pens. In an update to the essay, I submit we were before the computer, the computer economy, the computer virus, and the dreaded computer crash. Software wasn't even a word and Yahoo! was an expression I used when Cindy said she would be my date to the prom.
We got married first, then lived together. Rock music was a Mother's lullaby and wisdom was bestowed by a Father's firm hand.
Been There, Done That!
Over many years we said goodbye to our relatives and friends who died in world-wide hell-holes defending freedom of speech, liberty, individual responsibility, the right to privately contract for goods and services and the right to own property.
In spite of all we did not know and everything we did not have, we managed to invent penicillin, cure polio, advance medical technology, put a man on the Moon and write music with lyrics people understood; we managed to produce large families and grow up to become a powerful social influence.
As such we can make or break a company profit line, we can repeal laws that don't serve us well, we can vote politicians in and out of office and we can influence the passage or failure of legislation.
From this perspective, if one views the aged as a homogenous group of old geezers on a mindless rant, there is a fault here leading to development of one social policy designed to fit all. Economic and societal distortions arise when grouping all the aged together and generalizing about our financial, physical and mental well being.
As politicians and activists try to develop one statist health care policy, we learned such attempts always create havoc and eventually fail when dealing with diverse groups. There is no such thing as the collective aged.
Health Care Dysfunction
Because many aspects of government-controlled health care are based on collective logic, it is out of step with reality and the emerging problems attending the aging. This dysfunction is, for the most part, the result of political pandering and a liberal desire to treat everyone the same in a single-payer health care system.
For example, we know from research by the National Center for Health Statistics that Medicare funding has ballooned to over $7,000 per senior adult per annum. But the true cost of age-related health care goes way beyond what government pays. Medicare covers less than half of a typical senior's health care costs and does not reimburse many expenses related to disease prevention. Medicare will pay for a quadruple bypass, but it will not pay for preventive services like smoking cessation.
To further expand this government dysfunction, Rep. John Tierney (D-MA) introduced State's Rights to Innovate in Health Care 2000 (H.R. 4412). Never mind for now, passage or failure. My point is in how this represents the statist mindset of legislators who would provide $3.75 million to each of ten states to fund planning for state-run health plans. Of the ten states, five would be granted $10 million plus $3.00 per capita to fund a demonstration project. Incredibly, the bill allows use of taxpayer dollars currently directed to the financially shaky Medicare program. Never mind also all those states trying to clone the Clinton Care plan, which are now repealing earlier legislation in an effort to restore a free-market approach.
Not only is the source of funding suspect, but so is the real intent: the creation of a fast track to single-payer health care.
From Age-ing to Sage-ing
While I confessed to discontent with the ways things are I also hold out hope for the future, a future where tens of millions outspoken, wise and healthy long-lived men and women will redefine government in general and health care in particular.
We are witnessing market-based alternatives in long-term care insurance, in the repeal of earning caps for working seniors, in the collapse of Medicare-MC Plus, in the failure of centralized health care wherever tried, in the growth of MSAs and in the almost invisible trend back to fee-for-service health care and private ownership of health care policies.
Contrary to what my critic may believe, there is significant evidence from aging experts like Ken Dychtwald, PhD, and others indicating seniors continue to grow, at least intellectually, and bloom late in their years. The best measure of this is in the way aging people process and express complex ideas in argument or discussion and how they courageously exercise the right to speak out.
Given this point-of-view, the elderly now and the age wave of baby-boomers right behind me must be seen not as a collective age group of old geezers, but as living historians who have been to yesterday, are here today and who are headed towards tomorrow with their eyes wide open. I just hope my optimism is not misplaced.
Conrad F. Meier is senior fellow in health policy at The Heartland Institute, Chicago, and Managing Editor of Health Care News. E-mail: email@example.com.
Originally published in the Medical Sentinel 2001;6(3):100-101. Copyright ©2001 Association of American Physicians and Surgeons (AAPS).