The life expectancy of Americans has grown over the last few decades and is expected to continue to grow. Uncertainty abounds about whether this extended aging results in more or less health spending. Two articles in Health Affairs explore the subject. (HA Article) (HA Article) The first article focuses on research being done to delay the effects of aging–in essence keeping people healthier for a longer period of time. Obviously if this can be done, health spending at a particular age might drop, but would only be delayed until a later year, on average. The authors find that it is possible that this research could extend life expectancy by over two years, which would significantly raise entitlement spending. While people might be healthier longer, already bankrupt entitlement programs would be further stressed. The obvious solution, long-overdue, is to raise the social security and Medicare eligibility ages as life expectancy rises. If both programs had an eligibility age that had risen along with life expectancy, we wouldn’t have an entitlement crisis now. The second article more realistically recognizes that as medicine allows people to live longer and longer with disease, not only does spending rise, but quality of life declines. The authors focus on cardiovascular disease and find that some factors have contributed to lessening incidence and morbidity of the disease, such as lower smoking rates and more use of drugs, but other factors, particularly obesity, are increasing its incidence. Overall they conclude that there will be more cardiovascular disease and that patients will live with it for a longer period of time, leading to greater health spending and more life-years spend in relative disability.
