Longer Lives Mean More Health Policy Questions
December 23, 1999
New statistics show that Americans are getting better at delaying dying - - as long as they have money. And that is creating a crisis over the cost of health care, the rise of managed care and a larger number of uninsured. Comparing the death statistics of 1900 with those of 1998, not only do we die from different things, we avoid them longer. According to a report from the U.S. Centers for Disease Control:
- The leading killers in 1900, in order, were pneumonia and influenza, tuberculosis, diarrhea, enteritis and ulceration of the intestines, heart disease and stroke.
- In 1998 the leading killers were heart disease, cancer, stroke, lung diseases and accidents.
- In 1900, men's life expectancy was 43.6 years, while women's was 48.3 years.
- In 1996, men could expect to live 73 years, and women 79 years.
The most dramatic improvements came in life expectancy for children. In 1900, an infant had only an 80 percent chance of surviving to age 15. Today, it's 99 percent.
It's also become more difficult for doctors to predict imminent death than it was in 1900. There were fewer treatments, so if someone became acutely ill, he probably died. Now, we can fight illness so effectively we're faced with new challenges, such as how long to preserve life and how to pay for the miracles medicine can perform. Some analysts pose three health policy questions we must face in the year 2000:
- Should every U.S. citizen be guaranteed access to unlimited medical goods and services?
- Should life be prolonged with heroic measures even when there is no reasonable chance of success, or if the extension of life is only for a short duration?
- Is it acceptable to have different levels of health care -- with the lower levels guaranteed for all, but others available only to those who can afford them?
Those questions will become more critical as the over-65 population doubles to 73,434,000 by the year 2035.
Source: Editorial, "Death in America," Fort Worth Star-Telegram, December 22, 1999.
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