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Do The Elderly Benefit From The “Fury Of American Medicine?”

I don’t consider myself a right-wing healthcare fear monger, but if I were this study would be worthy of amplification. As reported concisely in the New York Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, older Americans live longer once they make it to 70. Why would this be?

Is it because Americans who reach 70 are “heartier” than Britons, as Columbia University PhD (but now on leave and working at HHS) Sherry Giled says. Or is better survival of the American elderly one of the benefits of the “fury of American medicine?”

Masters of the obvious, as well as American voters, seem to have sided with the lead author, Dr James P. Smith, who says:

…higher spending in the United States was a stronger explanation. For example, the Netherlands, he said, had a philosophy of “Let nature take its course.”

“There was a backlash,” Mr. Smith said, “and the state began spending a lot more money on health care at older ages. Survival rates went up in the last five years or so. They spent the money and they did extend life spans.”

Others may argue that an extra few years in the late innings of life might not be worth the expensive and often invasive therapy required. Surely this is true in obvious cases of hopeless runs of cancer chemotherapy or defibrillator implantation in end-stage heart disease, but the decision to treat an elderly patient is rarely this discrete, and the value of added years would surely be answered differently at age 75 than 35.

So far, the American electorate fancies the idea that patients and doctors, not government, choose the best course of medical therapy.

JMM

*This blog post was originally published at Dr John M*


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