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Investing in Research Will Rescue Medicare

Health care: Alzheimer's could go the way of polio and tuberculosis if we altered our spending priorities.

June 07, 1996|EDWARD L. SCHNEIDER | Edward L. Schneider is the dean and executive director of the Ethel Percy Andrus Gerontology Center at USC. He is a professor of gerontology and medicine at the USC School of Medicine, with a joint appointment in biological sciences and molecular biology

Medicare's hospital trust fund, we learned this week, will run out of money by 2001. No longer can we blame "the usual suspects"--lavish salaries for physicians, inefficiencies of hospitals or avarice of lawyers. The system is being bankrupted by the growing number of older Americans.

The population now 65 or older, currently 33.6 million, will more than double by 2030, reaching 70.2 million. The number of people 85 and older is the fastest growing segment of the population: Now totaling 3.3 million, by 2050 the number could be as high as 48 million. This age group has disproportionate medical costs and will account for a large proportion of future health care costs.

Trimming Medicare expenditures will only further threaten the quality of health care provided to older Americans. Anyone hospitalized in the last few years has witnessed a decline in the quality of care as medical institutions have worked to cut their costs. Further cuts in Medicare are likely to cause the care of all patients to deteriorate, with older ones suffering the most because of the ageist attitudes that permeate many providers.

While legislators have focused on cutting hospital and physician costs, they have lost sight of the real cause of the current dilemma: the growing number of seniors and their impact on Medicare and Medicaid costs.

The only positive and real long-term solution to the crisis is to improve the health of aging Americans. For example, if we could delay the risk of hip fracture in women by five years, reducing the number of such cases by 140,000 a year, the U.S. health care system could save $5 billion a year. This would represent real savings, not a cut in service. Similarly, if we could delay by five years the onset of Alzheimer's disease--which affects almost half of all nursing home patients--we could save at least $50 billion a year.

The only way to make such substantial savings is through research--to find effective ways to prevent or cure the conditions of older people that have such great impact on health care costs. The medical bill for those 65 and older now accounts for a third of a trillion dollars a year; our investment in the National Institute of Aging, part of the National Institutes of Health, is about $450 million--a ratio of about one cent in research for every $10 spent on services.

In the 1940s and 1950s, America pursued a vigorous program of biomedical research on chronic diseases. Among the results were vaccines for polio and antibiotics for tuberculosis, which meant better citizen health and lower costs for care because these diseases were practically eradicated. Today we myopically focus on Band-Aid cuts to our medical programs, an approach that could turn the United States into a Third World society in terms of health care.

We need to invest in long-term research rather than a quick fix. We need the vision that will allow us, through biomedical research, to eliminate those diseases and disorders that will affect all of us who are lucky enough to reach old age. If we can eliminate or delay the onset of age-related debilitating diseases, we will not be facing ruinous Medicare and Medicaid costs in the decades ahead.

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