Greater Life Expectancy Calls for Revised Society Model

Humor and history took center stage as Nobel laureate Robert Fogel launched a panel discussion, “Changes in the Process of Aging During the 20th Century,” at the 56th Annual Management Conference on May 16 at Gleacher Center.

“If I had been born in the 19th century, I would have been dead 15 years ago,” said the octogenarian, Charles R. Walgreen Distinguished Service Professor of American Institutions. “Once you get chronic diseases (today), the care is marvelous compared to what it used to be. If I were willing to give up my Mercedes, I could get a new pair of knees. That choice didn’t exist half a century ago.”

Fogel and three panelists tackled issues linked to aging, including advances in life expectancy; how those added years impact government-sponsored health programs in rich countries; and the high cost of health care in the United States.

Louis Cain, professor of economics at Loyola University of Chicago, presented statistics showing that while infant mortality in the United States dropped dramatically between 1850 and 1900, life expectancy for older people increased most significantly in the second half of the 20th century. In 1935, 6.13 percent of the U.S. population was 65 and older. In 2006, that same percentage applied to people 75 and older, Cain said.

Paula Canavese, manager at Deloitte Tax LLP, said, “The onset of chronic diseases now takes place at much older ages.” Control of the environment and issues of sanitation factor into survival, she said.

Fogel illustrated Canavese’s remark. “In 1929, only 3 percent of the GDP went to health care and we were much sicker than we are today,” he said. “We still had horses, and horses defecated a lot, attracting hordes of [disease-spreading] flies. In New York City, where I grew up, everyone had sticky flypaper, black with flies and changed daily,” he said. “Today if there’s a fly in my house, it’s a national emergency.”

Panelists addressed other issues in addition to sanitation that increase longevity, including drugs and medical procedures. However, an aging population impacts the viability and sustainability of government entitlement programs, said Lorens Helmchen, assistant professor, division of health policy, at the University of Illinois at Chicago. The ratio of elderly eligible for government benefits such as Social Security and Medicare is increasing faster than the population that pays into the system, Helmchen said.

Fogel noted, “Entitlements are problems because the government has to find a way to finance them. These are not gifts from the gods.”

Responding to a Canadian audience member who extolled that country’s national health care system, Fogel said in some countries with single payer, people simply don’t get the care they need or have to wait — sometimes years — for treatment. Several audience members reflected that insurance companies in this country also control treatment.

Still, Fogel said, if a single payer system becomes a reality in the United States, not everyone will use it. “You have to know something about how to work the system,” he said. “The rich opt out and don’t wait, and the poor are knocked out because they don’t know how to get to the system.”

Cain agreed. “The closer you are to Alzheimer’s, the more paperwork they throw at you.”

—Myra Eder