Map of life expectancy at birth from Global Education Project.

Thursday, April 04, 2013


I read the New England Journal of Medicine every Wednesday morning when the new issue hits Your Intertubes. So today there were quite a few items worth discussing here, one of which, to my surprise, ended up in the upper-right-hand-corner place of honor on the front page of the New York Times. No need to link to the Times, which will eventually try to hit you up for money if you keep going there, since NEJM, bowing to the awesome power of Stayin' Alive which has berated it over the decades for its paywall, has made the piece available to you, the common rabble.

We have long known qualitatively that as more and more people live a long time, we're going to have a huge increase in the number of people living with dementia, and that this will cost unimaginable gobs of money as well as being a terrible personal strain on loved ones. (Believe me, I know. My father had a long, slow course of dementia which led from care at home which was very stressful to my mother, to an assisted living facility, to a nursing home, which wiped out my parents' savings, to a lingering death.) Basically the news here is that they did some fairly convincing quantitative calculations which find that right now, almost 15% of the population 70 and older is diagnosable with dementia, that it's already costing somewhere around $200 billion a year, and that it will increase 80% by 2040. This is mostly for custodial care rather than medical services. Medicare doesn't pay for that, which means you have to wipe out your savings, as my parents did, before Medicaid will pick up the tab. Since we're talking somewhere around $40,000 a year, vanishingly few old folks have the income to cover it, obviously.

That's bad news, to be sure. But in the same issue, A.J. McMichael makes the case that human civilization is not sustainable, unless we make some very radical changes in the way we all live. I guess that's not exactly news, so why should we read about it in the New York Times?  But, if there is a single point to all this, it is . . .

We're spending all our time talking about how we need to cut federal spending and balance the budget because otherwise we'll be placing a great burden on our children and grandchildren. That, my friends, is from opposite world. The catastrophe that awaits our descendants will happen because we don't spend the money now to avert it. We need a massive investment in renewable energy, energy conservation, population control (yep, Godless contraception), medical research, long-term care infrastructure, and I could go on and on but you get the idea. Rich people, who are hiding trillions of dollars from the tax collector in the British Virgin Islands and many other places, while whining about the taxes they don't manage to evade, have plenty of money to save humanity, but they don't want to. Because evidently they aren't examples.


robin andrea said...

I think the thing that surprises me the most is not the it's all falling apart, but that it's happening more quickly than I thought it would. The effects of the population explosion, climate change, planetary degradation... I once thought the mid 2050s might see the damage... not anymore. I'm not sure it can be undone.

Supermom said...

Working in a long term care facility, I can attest to the growing number of our elderly living with Dementia. The disease process leads to a number of complications, for example, falls, frequent UTI's, skin breakdown, difficulty eating and swallowing which leads to pneumonia. The result is repeated visits to the hospitals, polypharmacy (multiple medication use), and increasing cost to both insurance companies and the community.

Funding should be focused on two areas, which is health prevention and research. Prevention to decrease to comorbidities found in Dementia patient's, making treatments more complicated. Research is imperative in order to find effective medication to treat the symptoms and make them managable.

Finally, as stated by the originator of this subject, understand that voting is paramount in all elections national, state and local levels.