Aging and Health Care Costs: Narrative Versus Reality

Abstract

This study documents the widespread belief among the public, “pundits,“ and policymakers that health care inflation in the United States is heavily influenced by longevity. It demonstrates the error of that belief. It points out that health care experts recognize that, although health care costs for the elderly are high, the aging of the population is an insignificant factor in health care cost inflation. Nevertheless, existing literature tends to ignore important influences on cost, such as poverty, lack of access, lifestyle issues, and matters of social justice. It also ignores the differences among numerous subgroups of patients. Ignoring these factors and concentrating on an aging society as a major cause of health care inflation distracts policymakers' attention from the true causes and leads to unjustified calls for benefit reductions in Medicare. As part of this study, the author includes analyses of hospital discharge data that have not been published previously.

Profile of disability retirement among civil servants at Oswaldo Cruz Foundation, 2012–2016

“…Embora a idade avançada seja geralmente associada a aumento nas necessidades relacionadas à saúde, a associação com a utilização de cuidados de saúde e das despesas é variável (14)(15)(16)(17). De fato, em alguns países de alta renda, as despesas de saúde por pessoa caem significativamente após aproximadamente 75 anos de idade (enquanto as despesas com cuidados de longo prazo aumentam) (18)(19)(20). Uma vez que mais e mais pessoas estão chegando a idades mais avançadas, permitir que elas levem uma vida longa e saudável pode, portanto, realmente aliviar as pressões sobre a inflação nos gastos com saúde.…”

“…Isso é reforçado por análises históricas que sugerem que o envelhecimento tem muito menos influência sobre os gastos com saúde do que diversos outros fatores. Por exemplo, entre 1940 e 1990 nos Estados Unidos (um período de envelhecimento significativamente mais rápido da população já ocorrido), o envelhecimento parece ter contribuído apenas cerca de 2% dos gastos com saúde, enquanto as mudanças relacionadas à tecnologia foram responsáveis entre 38% e 65% de crescimento (19).…”

Valuing older people: time for a global campaign to combat ageism

“…Although most older people will eventually experience multiple health problems, older age is not the most significant driver of health care costs and does not imply dependence. For example, in a period of unprecedented population ageing in the United States of America (1940–1990) ageing contributed to around 2% of the increase in health expenditures, compared to 51% related to technology innovation in medical practice 6 . Older adults make significant social and economic contributions to their societies.…”

Quantification and Scientism in Political Science: Domination of Discourse by Experts Presenting Mathematical Models of Reality

“…The other half is budgetary and requires a transfer from the U.S. Treasury. 31 Practically all discussions of the budget lump total expenditures on Social Security and Medicare into one sum and claim that it accounts for the highest budgetary expenditure (approximately $1.5 trillion of the approximately $3.8 trillion budget in 2016). This false narrative has entered public discourse and has led to ageism and scapegoating of the elderly.…”