As I noted a little while ago, the SAGE Crossroads website rose from the dead this year to restart its series of podcasts on aging research and longevity science, with a focus on policy matters and publicly funded research. That slant isn't quite my cup of tea, but each to their own. The most recent four podcasts are themed on economics:
KYLE JENSEN: The audience of the SAGE Crossroads website is made up of scientists, policy makers, and curious consumers. If there is one last statement you would like to make to them regarding the economics and longevity science in the future, what would it be?
ROBERT FOGEL: Don’t be afraid of it; it’s actually the leading industry. The demands of healthcare are going to pull all other industries forward. Of course they require new technologies in steel and heavy industry and as well as delivery systems. I think they should be looked at positively. Again I say if this were a privatized system, we would all say “gee it’s wonderful. All these people want more health care, this industry is thriving”. Let me put one other analogy. Suppose we made cars a government entitlement. Instead of cheering when auto production went up, we’d say, “Oh my God, we can’t afford this!”. How you finance it may greatly affect the psychology and actually the freedom of the economy to take advantage of these new opportunities.
Which is interesting, as this fellow spends the rest of his talk telling us that government entitlements are great and can always be fixed if they're not. "Fixed" is a word that springs to mind, yes, but not in the sense of "repaired."
KYLE JENSEN: Mr. Perry, how have developments in aging research, longevity science, and public health affected the ways that Americans live the 65 plus years of their life?
DANIEL PERRY: Well, we are probably too close to the changes to appreciate them and to understand them, but we’ve really succeeded in scrambling the images of life’s mileposts of aging. We’ve added 50% to average life expectancy in the last 100 years, and all of the studies suggest that people are not only living longer, but they are living with less disability and they are healthier than any other time we have known in the past. The short hand for this is to say that 50 is the new 30 or that 65 and 70 are still the prime years of life, and I wouldn’t be a bit surprised if we were going to be saying that 85 is the new 60 before very long. In fact, at age 65, which at one point most Americans considered the beginning of the end if you will, most Americans can count on living another 18 years of life, and half of them will live past 90. All of this has had huge positive economic impact. The vast majority of people at middle age are now saying in surveys that they expect to work well past retirement age, traditional retirement age, half expect to work into their 70s, either because they need to or because they want to stay working and engaged.
KYLE JENSEN: Your work also seems to argue that longer, healthier life is very valuable yet historically undervalued and conservative. Why do you believe this is true?
DAVID MELTZER: Well, so the way I like to think of it is in terms of length of life and quality of life. So a lot of work in medical cost effective analysis and in other areas have tried to determine the gains to health in terms of both length of life and quality of life. You then weigh those gains versus the costs of the interventions that produce them. What my work is focused on, or at least an aspect of my work, is understanding how extensions of life create costs in ways that may not be obvious. So, for example, when you live longer, you have more years in which you have to support the cost of being alive, medical expenditures. Conversely, if you're living longer and working, you take earnings away from that. It's traditionally been the case that fields of medical cost effective analysis haven't included costs of living longer. As a result, cost effectiveness has also systematically underestimated the costs of life extending interventions. In contrasts, interventions that improve the quality of life don't have these costs due to length of life. As a result, there has tended to be a bias in traditional methods of cost effective analyses. You spend too much money on things that make you live longer relative to things that improve the quality of life. And that's been one of the major focuses in the work that I've done on cost effectiveness.
This way of looking at things is very much a function of the limited medical technology of today. When you can ensure increased longevity with accompanying extension of health - which is very much not the focus of mainstream aging and late-life disease research today - economic problems go away. Daniel Perry has it right: a healthy, working person at any age is a net producer of wealth. The more healthy people that exist, and the longer they live, the more wealth is produced.
Trying to find any economic benefit or trade-off in loss of function and aging to death is a form of the broken window fallacy. Destruction is always, exactly, and only destruction - there is no gain that comes from it.
KYLE JENSEN: Do you feel that Americans that are living longer would impact social security, Medicare, and various other entitlement fields negatively?
GREGORY STOCK: Well, they certainly should impact those programs. The question is that these kinds of programs which always come up in these kinds of discussions are set up so that people when they are no longer functional and vital are able to be supported in some way by society, so if you have much, much older people chronologically that can be fully active and participate in society, then they should have to do that or should have to provide for themselves. And, you know, the other point of it is that something like social security is already going to be bankrupt, so of course if you have people living longer and you don’t make any adjustments and you try to support a large segment of the population that isn’t going to be a good solution.
KYLE JENSEN: Do you think we are on the right track to revamp those programs?
GREGORY STOCK: I don’t think we’re doing much at all, but those things will clearly occur and the political process will allow them to occur and will force them to occur when there is a real problem that is proximate rather than some real distant thing that can be passed off or left to the next generation or to later politicians.
Radical change is certainly ahead, as the present culture of entitlements and forced wealth transfer is barely sustainable even without the near future technologies of healthy life extension. Something has to give, and the longer the present political system lasts, the worse off we'll all be.