Desry Hyacinth

Week 10; Initial post.

Today, 45 million adults living in the United States—14% of the population—are 65 or older. By 2050, that number is expected to climb to about 80 million, or 20% of the population. This growth in the number and proportion of older adults is unprecedented. Americans are living longer than ever before. Chronic diseases—such as heart disease, cancer, and diabetes—account for most deaths in the United States, and Americans are at higher risk of these conditions as they age. In 2012, 63% of Medicare beneficiaries aged 65 to 74, 78% of those aged 75 to 84, and 83% of those aged 85 or older had multiple chronic conditions (Centers for Disease Control and Prevention 2015).

Chronic diseases have significant health and economic costs in the United States. Preventing chronic diseases, or managing symptoms when prevention is not possible, can reduce these costs. Nothing kills more Americans than heart disease and stroke. More than 810,000 Americans die of heart disease or stroke every year—that’s one-third of all deaths. These diseases take an economic toll, as well, costing our health care system $190 billion per year and causing $126 billion in lost productivity on the job (Centers for Disease Control and Prevention 2018).

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The aging of the U.S. population will have broad economic consequences for the country, particularly for federal programs that support the elderly, and its long-term effects on all generations will be mediated by how — and how quickly — the nation responds, says a new congressionally mandated report from the National Research Council. “The bottom line is that the nation has many good options for responding to population aging,” said Roger Ferguson, CEO of TIAA-CREF and co-chair of the committee that wrote the report. “Nonetheless, there is little doubt that there will need to be major changes in the structure of federal programs, particularly those for health. The transition to sustainable policies will be smoother and less costly if steps are taken sooner rather than later.” Social Security, Medicare, and Medicaid are on unsustainable paths, and the failure to remedy the situation raises a number of economic risks, the report says. Together, the cost of the three programs currently amounts to roughly 40 percent of all federal spending and 10 percent of the nation’s gross domestic product. Because of overall longer life expectancy and lower birth rates, these programs will have more beneficiaries with relatively fewer workers contributing to support them in the coming decades. Combined with soaring health care costs, population aging will drive up public health care expenditures and demand an ever-larger fraction of national resources.

“The nation needs to rethink its outlook and policies on working and retirement,” said Ronald Lee, professor of demography and economics at the University of California, Berkeley, and committee co-chair. “Although 65 has conventionally been considered a normal retirement age, it is an increasingly obsolete threshold for defining old age and for setting benefits for the elderly.” The committee found that there is substantial potential for increased labor force participation at older ages, which would boost national output, slow the draw-down on retirement savings, and allow workers to save longer. The report adds that longer working lives would have little effect on employment opportunities for younger workers, productivity, or innovation. In addition, workers can better prepare for retirement by planning ahead and adapting their saving and spending habits, the report suggests. Improved financial literacy will be critical, since between one-fifth and two-thirds of today’s older population have not saved enough for retirement and therefore rely heavily on Social Security and Medicare (National Academy of Sciences 2015).

End-of-life care decision making carries paramount importance due to the advancements in medical sciences. Since medical science has evolved over the time and now has a potentiality to reshape the circumstances during death and in turn prolong lives, various ethical issues surround end-of-life care. All human-beings are mortals and hence death is an inevitable occurrence. Advancements in medical technology are changing the norms of natural death. These technologically advanced treatments have a capability to intervene at the time of death and prolong the lives of people. Even though we are discussing about patients right to autonomy we are talking about its limitations. To elaborate further, autonomy gives patients’ a right to control their treatment according to their preferences, though many a times their autonomy is not respected. They receive end-of-life care which is in-consistent with their end-of-life care preferences. This gives importance to the ethical issue of autonomy surrounding end-of-life care preferences (Karnik and Kanekar 2016).

References:

Helping Older Americans Achieve Healthy and High-Quality Lives At A Glance. (2015). Retrieved from https://www.cdc.gov/chronicdisease/resources/publications/aag/healthy-aging.htm

Health and Economic Costs of Chronic Diseases. (2018). Retrieved from https://www.cdc.gov/chronicdisease/about/costs/index.htm

Population aging will have long-term implications for economy. (2012). Retrieved from https://www.sciencedaily.com/releases/2012/09/120925143920.htm

Ethical Issues Surrounding End-of-Life Care: A Narrative Review. (2016). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934577/

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