Age & Reason
The Health Cost that Can Ruin the Economy
Wednesday, April 11, 2012 - 1:05pm
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Now that Santorum has suspended his campaign, Romney and Obama are setting their sights on one another. For both candidates, the growing “senior” demographic is becoming an ever-more coveted prize. As they market themselves to the AARP and other voting blocs, Medicare is proving to be the decisive issue.

Obama claims that a Romney presidency will end Medicare as we know it. And Romney contends that the reforms within the “marvelous” Ryan budget are exactly what is needed to save Medicare. Who makes the better sell of his Medicare vision may prove victorious come November. 

This debate is not limited to the U.S. In fact, if the Medicare debate has taken a brash rhetorical turn here in the States, then in Britain it’s downright ugly. Last month, former British Health Minister Stephen Dorrell claimed that debates over the future of the NHS have “lost touch with reality,” because they are built on “an increasing perception that care for the elderly does not work”.

In Japan, where the politics are less sensational, the healthcare equation remains more daunting. With the “oldest” population in the world, Japan’s “demographic tsunami” is “driving up the costs of universal healthcare...to unprecedented levels.” A full seven years ago now, health scholars Colby and Ziolkowski noted that the world was “nervously watching Japan as it attempts to balance social needs with economic viability.” Today, all eyes remain on Japan.

Thus, while Romney and Obama  jockey for favor with the senior crowd, they’re operating in a landscape of global health reform. And it’s time they recognize as much. How, for example, can the U.S. reign in its world-leading health expenditure while still pushing the frontiers of innovation? And how can the U.S. create paths for healthy and active aging without spending superfluously?  In 2010, the U.S. spent almost 18 percent of its GDP on health, a proportion that is more than double that of Japan, the UK, and the OECD average.

At first glance, this seems wasteful. But the question we need to be asking is this: does this expenditure provide incentives for research and development that will lead to prevention strategies and innovative cures for the 21st century’s aging population?  Most innovation, after all, comes about incrementally, which needs a receptive marketplace to flourish.

While the presidential candidates exchange jabs over Medicare reforms, we should press them to answer these questions. This is where the future success of the U.S. and other nations begins, especially in an era where we are living so much longer.    

There is no disease that needs health innovations more than Alzheimer’s, a disease that is directly correlated with aging and it is already consuming one percent of global GDP.  Not only is the Alzheimer’s trajectory fiscally unsustainable, but it’s also immoral for us to only address the tragic human suffering it creates. As much as any other health crisis,  Alzheimer’s reach spreads throughout families and communities. And the future of Alzheimer’s is crystal clear. Without innovations to treat, prevent, and ultimately cure it, Alzheimer’s is, according to Dr. Peter Piot, former head of UNAIDS, a global “time bomb”.

No wonder the WHO has officially now set Alzheimer’s as a priority with the launch today of its historic Report "Dementia: A Global Health Priority."  According to the report, jointly prepared with Alzheimer’s Disease International,  Alzheimer’s is “overwhelming for the families of affected people and for their caregivers,” and it requires support from “the health, social, financial, and legal systems”.  Indeed, without significant changes in our treatment paradigms, Alzheimer’s will become a nightmare of the 21st century

So what’s the first step forward? According to Alzheimer’s Disease International, it’s earlier detection and diagnosis. Due to social stigmas and ineffectual diagnosis processes, Alzheimer’s advances without early medical intervention. And the loss here is twofold: one, medical researchers lose out on data they could use to work towards cures; two, the patients, families, and caregivers aren’t given the opportunity to ease into the new realities that come along with the disease.

Today, we focus on managing illness through care models. Looking ahead, this is less and less adequate – as populations age globally and the risks of non-communicable disease steadily mounts. Twenty-first century demographic realities require a new approach to care. Now that the World Health Organization has stepped up and declared both Alzheimer’s and aging populations as defining  challenges of our era, it is time for our presidential candidates to also get serious and honest  about health policy fit for this century’s demographics truths.  

Executive director of the Global Coalition on Aging, Michael W. Hodin, Ph.D., is also managing partner at High Lantern Group and a fellow at Oxford University's Harris Manchester College.