- The Washington Times - Wednesday, September 10, 2003


More “golden years” do not cost the health care system more: Whether people are healthy at age 70 and live independently for many more years or are sickly and die sooner, their medical costs are about the same, federal researchers say.

The findings have big implications for taxpayers, because they suggest the outlook for the Medicare program as America’s baby boomers grow old is not as dire as some policy-makers feared.

Given projections saying the baby-boom generation will bankrupt the Medicare trust fund in about 25 years, politicians and economists have wondered whether the increasing longevity of healthy senior citizens would increase or reduce Medicare spending.

The answer is neither, say researchers at the National Center for Health Statistics. They found medical expenses from age 70 until death averaged $140,700, with little difference between active, long-lived senior citizens and disabled ones — except for those already in a nursing home.

“The basic lesson of our study is that although healthy people live longer, they don’t cost more in the long run,” said Jim Lubitz, acting chief of the Aging Studies Branch in the statistics center’s Office of Analysis, Epidemiology and Health Promotion. “Improving health should be the overall goal of our health care policy, but it’s not going to save the Medicare system.”

Sandra Decker, a researcher at the International Longevity Center-USA, said Medicare costs will rise because of the sheer number of beneficiaries, not their longer life spans.

“It means, yes, we’ll spend more on Medicare, but maybe not as much more as we thought,” she said.

Mr. Lubitz said the study should give a boost to efforts by government and doctors to encourage middle-aged and elderly people to improve their health by getting more exercise, eating better and not smoking.

Uwe Reinhardt, a professor and health economist at Princeton University, said 70-year-olds today have far fewer disabilities than their counterparts a couple of decades ago, when economist Victor R. Fuchs first reported that longevity does not affect health care spending much. Mr. Reinhardt said the new study provides updated numbers on those costs. The study is available in today’s New England Journal of Medicine.

Mr. Lubitz and colleagues, using Medicare and other billing records and interviews about health status from 16,964 Medicare beneficiaries surveyed from 1992 through 1998, used complex statistical calculations to determine average longevity and end-of-life costs.

They found that someone healthy and mobile at age 70 could expect to live 14.3 more years and accumulate about $136,000 in medical costs, in 1998 dollars, over those years. Someone with at least one limitation in daily activities, such as not being able to bathe or use the toilet without assistance, could be expected to live 11.6 years more, with cumulative medical expenses of about $145,000.

Senior citizens with no limitations ran up an average of $4,600 a year in health care costs, compared with $8,500 a year for people with moderate disabilities, $14,100 for those with more severe disabilities and $45,400 for nursing-home patients.

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