Map of life expectancy at birth from Global Education Project.

Monday, April 23, 2007

The dark horizon

Watching the hairhatted elocutionists blathering on the TV last night got me to thinking. One of the problems with the news is that most of it consists of, well, news. It has to be about distinct events that happened in the past 24 hours, and even more recently if possible, so that, for example, if some soldiers were killed in Iraq yesterday, but too late to make last night's broadcast, they won't mention it today.

The exceptions, of course, are events that based on some mystical alchemy they all decide need to be talked about incessantly for anywhere from 4 days to a week, even though there isn't actually any new information and their import is largely local and temporal. The Virginia Tech shooting is obviously in this category, as have been other events of even less importance such as the missing young white woman phenomenon.

But the biggest part of what we need to be thinking about, and worrying about, and doing something about, as a nation and as a society, does not turn on immediate events. Most of our important problems are chronic, not acute. So, hardly anybody is talking about what will be the ruin of this country, and I don't mean global climate change or World War III or the death of the constitutional order. I mean ruin as in broke, busted, going through the trash for deposit bottles.

In accounting terms, the United States is bankrupt. And it's not because of the $2 trillion liability for the war in Iraq, and it's not because of Social Security. Even though the Deceiver in Chief threatened us with Social Security bankruptcy in his attempt to eliminate the program, Social Security has only a modest deficit which could easily be fixed -- in fact, just eliminating the cap on earnings subject to the payroll tax would just about do the trick, and make the tax structure more progressive at the same time. Nope, the problemn is Medicare. You think $2 trillion is a lot of money? Try $27.8 trillion, which was the projected 75 year Medicare deficit two years ago. (I believe it is more now, but I didn't have time to find a more recent projection.) And Bush was yelling about Social Security with a $3.7 trillion projected shortfall.

Many people have held out hope that this won't actually be such a big problem because the retiring baby boomers are going to be healthier than their parents and so will consume less in Medicare spending. Sadly, very sadly, no. Or at least the proposition is in grave doubt. They -- we, well hopefully not me personally but us not-quite-yet-fogeys -- are less healthy than our parents, according to self-reports. Now, maybe we're just a bunch of whiners, and maybe we're just getting diagnosed more, and we aren't actually sicker, but either way, we're still going to consume more health care.

But, there's a good chance that in some important ways we are less healthy. Yes, we smoke less, but we are -- and you know what's coming -- fatter. Physical inactivity and obesity mean heart disease, diabetes, and osteoarthritis. That would save Medicare money if it would just go ahead and kill us, but what's actually going to happen is that we'll soldier on with drugs, surgery, and ultimately nursing care.

And, once our kids hit later life, they'll be doomed because they're going to be even fatter than we are. For that we can thank the TV and the "food" industry, which are conspiring to keep them zombified on the sofa and guzzling the sucrose.

So who is going to pay for all these bypass grafts and lower extremity amputations and bedpan changes? Where is that $27.8 trillion going to come from? It's not a fit topic for the nightly news, because it didn't happen yesterday. But somebody needs to talk about it.

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