Why Medicare is so Expensive: The cost of expanding life expectancy:
At 65 years of age, costs rose more rapidly than did life expectancy: the cost per year of life gained was $121,000 between 1980 and 1990 and $145,000 between 1990 and 2000.
That's to be expected. Presumably that's why it's so hard to get life and disability insurance when you're over 65. The authors conclude that all in all, the money's worth it.
The research used a lot of fine statistical methods. I'll leave its dissection to those with better mathematical minds than mine. But the causes of increased life expectancy were interesting. Reduced rates of cardiovascular disease gave us almost 5 extra years of life from 1960 to 2000. We can thank better drugs for blood pressure control and successful interventions for coronary artery disease for those extra years. Next in importance was the reduction in the rate of death in infancy which gave us almost one and a half extra years. (Say thank you to childhood immunizations and neonatal intensive care technology.) Smaller contributions were made by reducing "death from external causes" - presumably murder and accidents and wars and the like (1/4 of a year gained); reduced deaths from pneumonia and influenza (1/3 of a year - so much for pneumonia and influenza vaccines), and reduction in cancer death rates (only 1/5 of a year). Maybe those cardiologists deserve their high salaries.
I bet the drop in smoking had as much to do with the decline in CV disease than the cardiologists, and that was free.
ReplyDeleteIn a way, I found these results discouraging, because each new medical advance is going to be less and less cost-effective for the population as a whole. One would think the cheap and easy interventions have already been done. Except for helmet laws, which don't affect enough people to really change these statistics all that much.