The upward pressure on healthcare budgets is usually explained in demographic terms: Older people have more medical problems, therefore the ageing of the population drives up demand for healthcare.

Or does it? New research, while confirming that increased life expectancy is a relevant factor, suggests that it is not the only one, or even the main one:

“Since 1900, the average American lifespan has increased by 30 years, or by 62 percent. That nugget comes near the beginning of a new report taking stock of the U.S. healthcare system, published in the Journal of the American Medical Association this week, and it’s also pretty much the last piece of good news in it.

“The study authors… take a point-by-point look at why healthcare costs so much, why our outcomes are comparatively poor, and what accounts for the growth in medical expenditures.”

In a briefing for the Atlantic, Olga Khazan highlights some of the more unexpected findings:

“The aging population doesn’t account for most medical spending.

“…chronic diseases, such as heart disease and diabetes, among people younger than 65 drives two-thirds of medical spending. About 85 percent of medical costs are spent on people younger than 65, though people do spend more on healthcare as they age.

“‘Between 2000 and 2011, increase in price (particularly of drugs, medical devices, and hospital care), not intensity of service or demographic change, produced most of the increase in health’s share of GDP,’ the authors write.

“The biggest-spending disease with the fastest growth rate was hyperlipidemia—high cholesterol and triglycerides—for which spending grew by 14.4 percent annually between 2000 and 2010.”

It is sometimes said that people who live unhealthy lifestyles save their fellow citizens money by checking-out early (and therefore sparing the country the expense of caring for them in their dotage). But what the cynics overlook is that those who hope to die before they’re old (and who smoke, drink and eat accordingly) risk getting ill while they’re still young.

Furthermore, while an unhealthy lifestyle could mean an early death, it probably won’t be that early, allowing excess to rub shoulders with decrepitude. To put it another way, it’s not a case of being old or fat, but old and fat. Indeed, some of the medical conditions we associate with age alone – such as Alzheimer’s and Parkinson’s – may have a causal link to poor diet.

For instance, research featured in New Scientist suggests that the excessive consumption of sugary drinks is messing up our brains as well as our bodies:

“It is well established that drinking sugar-sweetened drinks is linked to obesity and diabetes, as well as increasing the risk of cardiovascular problems. A recent estimate put the number of deaths associated with soft drinks at 184,000 a year globally.

“But the effects of sugar-rich drinks on the brain have received much less attention. ‘For many people around the world, soft drinks are their sole source of liquid, or at least they provide a very high proportion of their daily calories’, says Jane Franklin [no relation] at the behavioural neuropharmacology lab at Macquarie University in Sydney, Australia, who carried out the study…

“‘The results are telling us that sugar exposure has the potential to alter a lot of diverse biological processes and play a role in neurological disorders – much more than we expected,’ says Franklin.”

It’s all very well moaning about the nanny state, but when our bad habits catch up with us, it is nanny – and therefore the taxpayer – who picks up the tab.

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