Arnold Kling  

Medical Paradigm

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From an article by Ron Bailey.

Olshansky argues that the old paradigm of directly targeting diseases is about to run out of steam. Even if all cancer, all heart disease and all diabetes were eliminated, it would add only 3 more years to average life expectancy in the United States. So if researchers want to achieve big gains in lifespan and healthspan they have to go after the aging process itself. For adults the doubling time for risk of death is seven years. If you slow aging by seven years, you cut the risk of death at any age in half, and cut the risk everything else that goes wrong with the body in half too. The idea is not to make people older longer, but to make them younger longer. Not being libertarians, Olshansky and other advocates for the longevity dividend want to reprogram $3 billion in federal biomedical research to target aging itself.

Being a libertarian, I want the same thing.

Our medical paradigm is to throw lots of resources at people when they are old and desperately ill, or at research on treatments for such people. This is very kind-hearted, but it is not cost-effective. The best people to throw medical resources at are pregnant mothers and very young children. The best medical researchers to throw money at are those doing fundamental research on making cells more robust and/or regenerative.

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COMMENTS (5 to date)
Biomed Tim writes:

"This is very kind-hearted, but it is not cost-effective"

It's not cost-effective in terms of longevity. But just as Bailey himself reports, David Meltzer warns that the "quality of life must be included in the calculations of net benefits and costs stemming from medical interventions."

I think targeting heart diseases and cancer still has tremendous benefits at the margin in terms of quality of life improvements.

Was Olshansky referring to mere life expectancy or QALY?

Horatio writes:

Give the money back to the people. There is no market failure to fix here. People value their lives and their health. Drug companies know this and are pouring billions upon billions of dollars into research trying to meet those demands.

Bruce G Charlton writes:

Hmm - not sure about this.

It is the standard spiel in public health and community medicine and has led to vast amounts of nothing much research.

The known effective preventive things are simple and everyone already knows them (don't smoke, don't drink too much alcohol, don't be sedentary, stay slim, treat high blood pressure etc).

Search for further preventive ideas has been pretty fruitless - a lot of commonly given current advice is very speculative indeed (it takes decades to be sure that preventive ideas really are effective).

So - I would say the cost effectiveness argument of prevention as a general strategy is unproven.

Also, much of medicine is and ought to be alleviating suffering and improving function. That's very important - probably more important than marginal life extension using nasty treatments like chemotherapy and radiotherapy.

Marr writes:

We say the socialized health insurance is involuntary. I choose to say it has a very long update cycle.

However we thnk of it, any large progam affecting the entire population with a long update cycle will cause harm. In this case, if we saddle the young with huge payments for mom and pop's helath care, then we drop fertility rates. Regression analysis of socialized health care across industrial nations shows the connecion.

I pose the problem this way: Does granddad want three grandchildren and live to 71, or does granddad want two grandchildren and live to 75?

Nenad Ilincic writes:

"Even if all cancer, all heart disease and all diabetes were eliminated, it would add only 3 more years to average life expectancy in the United States." How did Olshansky come up with this number? It really looks suspicious to me. Is this simply an average age at death from some causes vs. others? In that case it is obiously wrong... (if childhood deseases would kill many, it would follow that eliminating the big three above would actually *shorten* the average life span!) How else could he have come up with '3 years' estimate?

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