Consider this one. With an aging population, how can we address the rising costs and the burden on the health care system associated with chronic illnesses? That’s one of the burning issues facing system providers and policy makers these days. But I look at that question another way.
The gains we’ve made in the function and health of our seniors is one of the most phenomenal success stories in health care.
Think about it. Through modern medicine, years of health promotion and disease prevention campaigns, and gains in novel medical interventions, we’ve actually achieved what we’ve dreamed of for generations – more people living longer, and with a higher quality of life, than ever in human history.
Yes, some member of this aging population will develop certain conditions, and draw on more resources to maintain their health and well-being. That’s literally the price we pay for what, in societal terms, is a tremendous benefit – a group of citizens who are able to enjoy life, continue to contribute, and be treasured by their families and communities.
Now, if we formulate that as problem, we’re in trouble. If we formulate it as a byproduct of advances in a progressive and civil society, well, there are costs that come with that.
So why do we focus so much on the sustainability of the health care system as it specifically pertains to the aging population?
After all, think of how western nations responded to the economic downturn. Over the last two years, with little dissent, we’ve spent untold billions to keep the economy going and bail out, in some places, an unwieldy (some would say corrupted) financial system. Compared to that, what we spend on health care for the elderly is loose change.
However much we pay lip service to the value of the elderly, I think our society is ageist in many ways.
Perhaps it’s because once someone leaves the workforce they’re perceived to be “unproductive”. We can’t put a dollar value on them or their “productivity”, so they start to lose value. Their lives become “discounted’ in both senses, ignored and valued less. One regrettable outcome is we begin to question the spending on them.
Don’t get me wrong, I recognize that an aging population poses tremendous health care pressures. An inordinate portion of a person’s lifetime health care costs occur in the last year or two of life. Changing that would be a significant accomplishment. The only dilemma – we can never identify that last year or two for sure until after the fact.
But the costs are real. So what do we do about them?
Do we start to have conversations, as families and as a society, of whether the expense of an ICU or a nursing home bed for an extra week or two of life, or month or two or three or six, is worth it?
Do we create a new social contract – full health coverage until a certain age, say, and then you’re on your own?
Do we institute mandatory contributions for long-term care, along the CPP model?
Do we consider new funding options to regain some of the money spent on senior programs? As one possibility, we could recoup some of the special financial gains made by health care product manufacturers (quite separate from their general taxation contributions) to be directed back into the health care system. For example, pharmaceutical companies would make an extra contribution into the Ontario Drug Benefit Program as the cost of that program increases.
I’m not offering any solutions here, but I do know that it’s time to re-think the “problem” we have.
No doubt, there are enormous demands on the health care system. There are also many creative ways to re-distribute our collective resources for health care for all.
But remember this – our aging population is an asset, not a cost. Unless we’re prepared to say that they’re expendable, we simply have to come to terms with valuing and investing in them.
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