Mr. Burnett: Maybe what is key is the expectation of an "independent" seniority. The costs of living alone could buy a lot of health care.

Buttercup:

Yes, and if reports we see with increasing frequency on the state of both private and public pension plans are at all accurate, the idea that work stops at 65 for most may soon be a nostalgic dream. Time to get out those videos of "The Waltons".

Back in the days of Walton, age 65 meant you had another 18 months to live, tops. Peculiarly, living longer means you will now live long enough to see further advances in medicine, advances to which you will feel entitled.

These things are self-limiting. If the marginal cost of extending your life by another year (or increasing the quality of life but not extending it) is high enough, it will not be done. There comes a point where you can't further tax the incomes of every young person to pay for every old person's care.

I beg your pardon, older Americans are able and willing to work longer than 65 if you young ones will let us work. My Mother worked and paid taxes and social security until she was 78 years old. She is now 84. She deserves every dime she gets from Social Security and Medicare. I am 60 and am working and hope to work for a long time to come if the companies will continue to let me work. Older people are healthier than ever before and most do not look forward to sitting at home and twiddling our thumbs. We work, do volunteer work and we buy a lot of the products so that the rest of the population can have jobs.

As the article points out, the cost of supplying quality care at, say, a 1990 standard hasn't increased all that much.
It's supplying cutting edge treatments and drugs that's crushing health care budgets, treatments that are desirable but not strictly necessary, as Bruce Cleaver alludes to.

Also, people can "save" in non-monetary terms, when speaking of health care.
If the entire population quit smoking, fastened their seat belts, exercised regularly in moderation, and ate sparingly, our society-wide health care costs might be halved.

Even though no population, (except perhaps the Okinawans), will do the above, it's still possible to do it at an individual level, with the added bonus that most of us know what our genetic risks are, and can tailor our behavior accordingly.
Living a low-risk, healthy lifestyle, one can afford to buy a health policy with an enormous deductible, which'll put the premium within most people's comfort zone. That should hold true even as premiums rise, and services fall, for everybody else.

I think the comments about working past 65 hit the nail exactly on the head. Increased life expectancy will necitate an increase in the retirement age. And why is that a bad thing? It strikes me as unseemly, if not european , to expect or want 20-plus years of leisure.

As they say, if something cannot continue forever, it necessaryily will stop. I don't agree that this will be some big ethical/existential crisis. You'll have to work longer, boo hoo, so make sure you like what you do.

Besides, they are running into this fact much quicker in low birthrate societies. Watch the fireworks in Japan and China to see how this is going to play out.

JR:

I'm sure no one begrudges your mother anything. But if people keep living longer, birthrates don't increase and technology keeps exploding in medecine and pharmaceuticals, those now in their thirties and forties simply won't have the same benefits, or rather the same expectation of keeping up with the cutting edge. If that happens, expectations of both the elderly and their families are going to have to change. The danger is that the issue is so sensitive that the issue isn't faced squarely and the government is forced by populist pressure into ineffective but expensive bandaid programs.

Michael:

That sounds as much like a declaration of faith as factual analysis. Have you considered:

A)Apart from a general enjoinder to be moderate in all things, notions of what constitutes a healthy lifestyle fluctuate constantly. A lot of what looked good in the fifties isn't so good now and what looks good today won't in twenty years;

B)The political problem is how society funds medical and other care, the growth in which is weighted heavily towards caring for seniors who are living longer. Why are you so sure genetics and simple aging trump lifestyle as the major factor? The fact is that older people have more afflictions and surely it is a pious hope that a vice-free life of exercise and vegetables will see them through to their nineties and then carry them off in perfect health. It's called life.

Have you even considered that older people do not want to give up their jobs and still want to be a part of the working and producing society. Many who have retired have gone back to work, therefore, they are still contributing to society. Therefore, retirement is being pushed to a much later date naturally and these individuals are healthy and not a drain on resources. Many of my friends have no intention of retiring unless we are forced to because we are not given jobs.

>It strikes me as unseemly, if not european, to
>expect or want 20-plus years of leisure.

I've seen what idle retirement can do to people.

My father was a workaholic who couldn't wait to retire. Once he did, he had nothing to do, ran out of money doing all the things he'd put off, and after the money ran out his health just failed completely. (As in dead within the year.)

Another retiree I know of has been just sitting around the house for 10-20 years "waiting to die".

I have less than 20 years until "retirement age". While I plan to cut back my working from full- to part-time (and probably change careers a bit), I intend to keep working in some way until my health fails. If nothing else, the responsibility of a regular job will give structure to the day.

>Those of us who believe it is important to
>increase the average birthrate must face the
>fact we are calling for a trend that will
>reduce the capacity of most to salt away the
>huge sums necessary to support a healthy,
>lengthy and independent seniority. But that
>raises difficult existential issues few want to
>face or even talk about.

i.e. it's a trade-off, and both alternatives have some pretty heavy side effects.

You are overlooking the fact that most people in their 60s are not only helping to take care of their parents, but also are boosting the income of their children and grandchildren. It takes less money for us now, so we spread it around to help others. The people I have known who have just decided to completely retire in their 60s seem to die pretty quickly. I think I will just keep working.

Peter B:

We have many examples of what a healthy lifestyle looks like, and we know this because people who live it die older with fewer problems.
You may wish to investigate the health and longevity of the Okinawans and Seventh-Day Adventists.

Your points about changing medical advice are well taken, but your continued insistence that fat smokers suffer no more problems in old age than Senior Olympians is puzzling, as well as being contradicted by every medical study performed in the 20th century.

People with good genes and healthy lifestyles suffer far fewer problems throughout their lives, have an easier time in old age, live independently for longer, and die at older ages.

Thus, they consume fewer medical services over their entire lives, and especially when seniors.

How is this controversial ?