Yet again, the U.S. has come in last in a survey measuring the state of health in developed countries. This latest piece of disheartening news put the spotlight on people over 65 — the age when Americans become eligible for Medicare. The survey, produced by the Commonwealth Fund, included more than 23,000 people from 11 developed countries, and revealed that American seniors were sicker than their counterparts in other countries and are more likely to go without needed health care because of costs.
Why should this be? For one thing, Americans are more likely to enter the 65-and-up age group with chronic diseases — heart disease, diabetes, hypertension — which aren’t curable but could have been headed off had people gotten better care earlier.
“New beneficiaries are coming into [Medicare] with a whole health trajectory set by the care they got earlier in life,” said physician Steven Woolf, director of the Virginia Commonwealth University Center for Society and Health. While he and other health care experts I spoke to favored the common-sense approach of creating a system more like those in the healthiest countries, they conceded that Americans aren’t likely to switch to anything that smells of socialized medicine.
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And yet, surveys show Americans like Medicare. So at the very least, perhaps Medicare could be adjusted to fit better with the realities of our biology. That would mean pushing the age of eligibility to somewhere around 50.
Just being over 50 is a major risk factor for everything from diabetes to colon cancer to detached retinas. It’s as if the warranty on your body expires. This is not just a casual observation. S. Jay Olshansky, a researcher who studies aging at the University of Chicago School of Public Health, said that our worst chronic diseases can be seen as an inevitable result of operating the human body beyond its warranty period.
He pointed out that all animals that engage in sexual reproduction have finite lifespans which are connected to the age of sexual maturity. Mice hit puberty at 30 days and live a mouse-sized lifespan of about 1,000 days. Humans hit puberty at 13 and live around 75 years, and Greenland sharks reach puberty at 150 and can live to be 400. “What I’m talking about is a set of genetically fixed programs for growth, development and reproduction,” he said.
Someday perhaps we can engineer ourselves to be more like Greenland sharks, but for now, humans reach the end of our reproductive lives around 50. While men don’t technically go through menopause when they reach that age, they are on the same trajectory as women, actually sliding toward death a little faster in most mammals. Evolution has equipped many of us with the ability to coast for a few years after 50 — thus allowing humans to care for any late-arriving offspring. But for the most part, Olshansky said, “You’re living on your reserves.”