Fight Aging!

Having a plan to save Medicare is somewhat like wearing a tie or cufflinks, in that it is somewhat de reigueur in some parts of society - but ultimately a cultural signal of belonging, of little value otherwise. The economic future of the US is somewhat grim; the decline of an empire is inevitable as its increasingly unaccountable elite class debauch the currency, centralize power, and regulate all aspects of a citizen's life. They tax and waste ever more of the flow of resources whilst destroying the freedom and competition needed for the creation of those resources - in much the same way as a cancer is parasitic to its host but ultimately destroys both host and itself. This is an inexorable progression of society, built upon the foundation of human nature and the individual actions and interactions of millions of people. It has happened over and again and is just about as likely as the tide to be turned aside.

So having a plan to save Medicare is rather like having a plan to save a part of your cancer. That portion in the lower left, perhaps. Medicare is but one part of the network of regulation, perverse incentives, and regulatory capture that causes medicine in the US to be ever more expensive, wasteful, and poor in quality. It's large enough to be considered in the context of the more general economic decline across the board, which occurs for roughly the same set of reasons, and is just as hard to turn back. Medicine is in a more advanced state of socialist decrepitude than most other US industries, but the same process operates throughout society.

From there let me segue into a discussion of responses to shortage. Regulation inevitably creates shortage and rationing: we see this in the provision of medicine in countries like Canada and the UK, where regulators set up waiting systems or simply forbid treatment, especially to the old. Much of the public discussion that results from this state of affairs looks at what to do about the shortages - though of course without a great deal of reflection on how they came to exist in the first place, sad to say. There are two broad lines of thinking here: firstly, use less of whatever is rationed; secondly try to create more of whatever is in short supply.

One of the defining and frankly rather sorry aspects of our age is that public debates veer towards cutting back on use far more often than towards creating abundance. See the bulk of the environmentalist or other Malthusian movements for example - they have little to say about building more of whatever it is they think is in short supply.

When it comes to Medicare, and given that very few people are calling to get rid of the whole system and let freedom and free markets rule the day, the two sides of the coin look much like (a) a call for increased rationing of services to ensure that people use less in the way of medicine, and (b) a call for ways to create greater health such that people use less in the way of medicine. There are of course many different approaches to either of these paths, but both ultimately sidestep the real issue, the real cause of the problem - and this again is absolutely characteristic of debate over societal organization and politics in our age.

That all said, here is one researcher's call for using progress in longevity-enhancing medical technology to save Medicare - an example of the "create greater health" approach to patching over the problem whilst ignoring its root causes.

How to save Medicare: the anti-aging remedy:

One solution is to cut Medicare and other health care benefits, to narrow treatment options, to slow the growth in benefits somewhat for wealthier recipients. Another solution is to increase taxes (in whatever form) and/or to increase the federal budget deficit. These solutions are political. Here I will discuss a biomedical solution, which can be easily incorporated into their political program by both Democrats and Republicans.

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There is a misconception that an anti-aging medicine would increase the number of chronically ill people because they are old. On the contrary, it would decrease the ratio of unhealthy to healthy population because an anti-aging medicine will delay the onset of aging, diseases and their complications at older age. Fast-aging animals (mice) develop diseases of aging fast, whereas slowly aging organisms such as humans acquire these diseases at 40 times older age than mice. Centenarians, people who live more than 100 years, age slowly and generally experience good health until very old ages, when diseases that kill them finally develop. ... Slowing down aging both increases lifespan and postpones diseases. One may even say that anti-aging interventions increase lifespan by postponing diseases.

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Unfortunately, the only way to stop the rising costs of Medicare completely [without the use of anti-aging medicine] is to prevent the use of more effective (and expensive) medical options and to stop further biomedical research. This draconian option would accelerate the mortality of the sickest elderly, further decreasing Medicare costs. Of course this is unacceptable. So costs must continue to rise. But this wouldn't necessarily lead to a fiscal crisis, given that anti-aging medicine could increase health span and therefore the ratio of healthy to unhealthy individuals in the elderly population. In conjunction with the increase in health span, the age of retirement could be increased. This would increase federal revenues and provide a means to cover increasing costs of Medicare.