WSJ: How Long Do We Really Want to Live?

Wall Street Journal ^ | June 22, 2005 | MILES D. WHITE

[OESY]

...In short, what do we want from our health-care system? As Americans, we expect it all. We expect: (1) The highest standard of care; (2) continued innovation, and (3) broader access to new technologies at a lower cost. It's possible to achieve two of these three goals. Which, then, can we do without? Will we accept less than optimal care? Will we accept a significant slowdown in medical progress? Will we say, implicitly or explicitly, "80 is long enough for a person to live?"....

Some critics contend that the largely private system in the U.S. is more costly and less effective than its government-run counterparts. What goes unremarked is those countries' reliance on rationing care. They implicitly accept that a life expectancy of about 80 is enough, and that certain people with certain needs are simply on their own. They're slower to adopt new medical innovations, and more sparing in their use.

But while we may disagree with some of their conclusions, at least they have asked the tough questions and made the hard choices that a society must. We have shown little or no willingness to even ask ourselves the real questions, let alone do the work to reach a consensus on potential answers that will work for our society. This includes those of us in the business of medical innovation: We must acknowledge that our innovations and their success in treating people pose a dilemma -- the more medical innovation extends, improves, and saves lives, the more health-care and other social costs rise.

As a result, we must start to analyze the value to society of innovations. This kind of evaluation is new for us. It also will add time, complexity and cost to our clinical trials. But it will help us make the right decisions....

[OESY]

Mr. White, chairman and CEO of Abbott, is former chairman of the Pharmaceutical Research and Manufacturers of America.

[Criminal Number 18F]

If you're going to post subscribers-only, pay-per-view stuff here, please identify it as such so those of us that don't want to shell out don't waste our time on it.

Thanks

d.o.l.

Criminal Number 18F

[EdHallick]

WSJ: How Long Do We Really Want to Live? Well for me it depends if Hitlery becomes Presdient. I don`t think I want to be around when Armageddon hits.

[Mr. Jeeves]

I want to live as long as I want...while not aging much beyond where I am now. It isn't going to do the health care system any good if people live to be 150 but spend the last 75 years of their lives in an advanced state of geriatric decay. If people can grow older without suffering the effects of aging until they are 150, for example, then society could adapt to the change.

[CrazyIvan]

"If you can't get old by a comfortable road, don't go." Mark Twain

[Dreagon]

I want to live for a very, very, very long time.

[Woodworker]

In life, you're always "on your own", on your own genes, that is; lifespan is determined by heredity. So, whether you enjoy good beyond "80" (or any other arbitrary number, is already programmed in.

[kabar]

Mr. White just turned 50. Let's see what his views are 20 years from now.

[TheForceOfOne]

"Welcome, humans! I am ready for you! Fish, plankton, sea greens and protein from the sea. Fresh as harvest day. Overwhelming, am I not?

[staytrue]

We should have a public finance health care system that is low cost and rations care especially to the elderly, and a private market system which is high quality, market rates, and where you pay from your own pocket.

[steve8714]

This is what happens when Americans accept that not all of our dreams can be made to come true by hard work, good decisions and a little bit of good fortune. Is this guy a lawyer or accountant by trade?

[The Great RJ]

We are rapidly reaching a point where insurance companies and HMOs will dictate who gets treated for what and when. Certainly if we have a national health insurance plan there will be rationing of care.

My insurance plan already dictates what medications I can use, how long I can stay in a hospital and even if certain conditions will be treated at all. True I am not denied obtaining and paying for this care myself, but the price of some treatments in effect rations the care I am able to get.

[Eva]

The WSJ had an article on Monday, that said that the maximum life expectancy of a human body was 122, so you don't have to worry about living to 150.

[OESY]

WSJ = Wall Street Journal (it's easy to memorize)

[Capriole]

We should have a public finance health care system that is low cost and rations care especially to the elderly, and a private market system which is high quality, market rates, and where you pay from your own pocket.

We already have that. The "public[ly] financed health care system that is low cost and rations health care especially to the elderly" is called Medicare/Medicaid. Then there's a private market system of insurance carriers whose coverage you can purchase, which is less expensive than paying a million dollars out of your own pocket if you need a transplant or have a premature baby.

[Steve_Seattle]

"Mr. White just turned 50. Let's see what his views are 20 years from now."

Well, the problem is that if we all want to live as long as possible, and commit ourselved morally and financially to routine expenditures of $200,000 or more to keep octegenarains alive for an extra few years, we will have to pay for it, and it will be very expensive. So what's your plan to pay for it?

[kabar]

Well, the problem is that if we all want to live as long as possible, and commit ourselved morally and financially to routine expenditures of $200,000 or more to keep octegenarains alive for an extra few years, we will have to pay for it, and it will be very expensive. So what's your plan to pay for it?

Preventative medicine to keep people healthier longer and living wills, which include no extraordinary medical treatment. In point of fact, doctors routinely "help" patients to die.

[Steve_Seattle]

I have nothing against "preventative" medicine, but I think it's a misnomer. It should be called - well, I can't come up with a name - but the point is that preventative medicine doesn't prevent disease, it just delays it. Whether people first get a serious illness at 58 or 85, they will eventually get a serious illness that requires hospitalization, unless they just drop dead from a heart attack, and the medical costs will eventually add up. As for "extraordinary" treatment, how do we define that? We think of someone like Terri Shiavo, but what about $100,000 surgeries for 85 year-olds that (maybe) extend their lives for 2-3 years? Is that a thumbs up or thumbs down? I think that's what the WSJ story is talking about; they are tough decisions.

[kabar]

I have nothing against "preventative" medicine, but I think it's a misnomer. It should be called - well, I can't come up with a name - but the point is that preventative medicine doesn't prevent disease, it just delays it.

I don't think it is a misnomer. Preventative medicine helps people living healthier lives longer. Healthier lifestyles can prevent diseases such as type II Diabetes. Exercise, eating well, and eliminating destructive habits such as smoking, overeating, and alcohol abuse can prevent certain illnesses associated with this behavior. Regular screening can also catch medical conditions before they progress to more advanced stages, which require a greater investment of medical resources.

The idea of preventative medicine is to place more money on the front end to eliminate the much higher costs on the back end. Most of the resources are now focused on the last few years of life.

As for "extraordinary" treatment, how do we define that? We think of someone like Terri Shiavo, but what about $100,000 surgeries for 85 year-olds that (maybe) extend their lives for 2-3 years? Is that a thumbs up or thumbs down? I think that's what the WSJ story is talking about; they are tough decisions.

There are legal definitions defining heroic or extraordinary measures to keep someone alive. Consumer’s Tool Kit for Health Care Advance Planning You should also have a living will to designate someone to make these decisions for you, if you are unable to do so.

Number of deaths for leading causes of death 2002

Heart Disease: 696,947

Cancer: 557,271

Stroke: 162,672

Chronic lower respiratory diseases: 124,816

Accidents (unintentional injuries): 106,742

Diabetes: 73,249

Influenza/Pneumonia: 65,681 Alzheimer's disease: 58,866

Nephritis, nephrotic syndrome, and nephrosis: 40,974

Septicemia: 33,865

[CzarChasm]

I plan to live forever or die trying.