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Shackling our future to our elderly
By GEORGE F. WILL
Thursday, Feb. 4, 2010 Share on Facebook
On Day One of his vow to take "meaningful steps to rein in our debt," Barack Obama asked Congress to freeze portions of discretionary domestic spending. This would follow an astonishing permanent expansion: Republicans on the House Budget Committee say appropriations bills Obama has signed, along with his stimulus spending, have increased discretionary domestic spending 84 percent. He almost certainly will not keep his promise to veto spending bills when Congress, as it almost certainly will, largely disregards his request.
Or to require that middle-class tax cuts enacted under The Great Alibi (George W. Bush) be allowed to expire. Or even to scrub from the budget such filigrees from olden days as $430 million for the Corporation for Public Broadcasting, which perhaps made some sense 42 years and 500 channels ago, when public television meant for some Americans a 33 percent increase in channels, from three to four.
The depressing minutiae of the moment pale next to two large possibilities anticipated by Robert Fogel, a Nobel Prize-winning economist. They concern the rise of American health spending and the even more dramatic rise of China's economy.
Writing last September for the online journal The American, published by the American Enterprise Institute, Fogel warned that spending on health care is going to surge, for two reasons: By living longer, Americans will become susceptible to more health problems. By becoming richer, they will be able to purchase more biotechnologies that make health interventions more effective.
"The financial per capita (health care) burden at age 85 and older," Fogel wrote, "is nearly six times as high as the burden at ages 50-54" and "the financial burden of health care for ages 85 and older is over 75 percent higher per capita than at ages 75-79." A century ago, "the burden of chronic diseases among elderly Americans was not only of greater severity but began more than 10 years earlier in the life cycle than it does today."
But the severity of afflictions increases and the cost of preventing further deterioration increases with age: "Five years before the year of death, annual health cost is virtually the same as all annual Medicare costs per capita. By the second year before death, the cost has risen by about 60 percent, and in the year of death the annual cost exceeds the average by more than four times. Indeed, expenditures on persons during their last two years of life account for 40 percent of all Medicare expenditures."
The 20th century radically reduced deaths due to acute infectious diseases, which were concentrated in infancy and early childhood. In 1900, more than 33 percent of all deaths were of children under 5; today they are less than 2 percent. In 1900, deaths of persons 65 and older were only 18 percent of all deaths; today they are 75 percent.
This demographic destiny might entail starving every other sector of society -- including national defense, at great cost to America's international standing. It had better not, given what Fogel argues in another essay, this one in the current issue of Foreign Policy. It is titled "$123,000,000,000,000." Fogel's subtitle is: "China's estimated economy by the year 2040. Be warned."
He expects that by 2040 China's gross domestic product will be $123 trillion, or three times the entire world's economic output in 2000. He says China's per capita income will be more than double what is forecast for the European Union. China's 40 percent share of global GDP will be almost triple that of the United States' 14 percent.
Fogel finds many reasons for this, including the increased productivity of the 700 million (55 percent) rural Chinese. But he especially stresses "the enormous investment China is making in education."
While China increasingly invests in its future, America increasingly invests in its past, the elderly. China's ascent to global economic hegemony could be slowed or derailed by unforeseen scarcities or social fissures. America's destiny is demographic, and therefore is inexorable and predictable, which makes the nation's fiscal mismanagement, by both parties, especially shocking.
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George Will's e-mail address is georgewill@washpost.com.
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Deb, Derry
Thanks for writing. I greatly appreciate the question.
Article 2, Section 4 of the United States Constitution
"The President, Vice President and all civil Officers of the United States, shall be removed from Office on Impeachment for, and Conviction of, Treason, Bribery, or other high Crimes and Misdemeanors"
Article 3, Section 3 has
"Treason against the United States, shall consist only in levying War against them, or in adhering to their Enemies, giving them Aid and Comfort. No person shall be convicted of Treason unless on the Testimony of two Witnesses to the same overt Act, or on Confession in open Court.
The Congress shall have Power to declare the Punishment of Treason, but no Attainder of Treason shall work Corruption of Blood, or Forfeiture except during the Life of the Person attainted."
Do I think a Treaty is the supreme Law of the Land if it is treasonous? NO
What does it take for a Treaty to be treasonous? I hope people will think about this. I have. I decided to support allowing State Legislatures to choose some United States Senators again because of the harm a Treaty could do to the Bill of Rights. The Bill of Rights are very important to me. Read John Locke if you want to know why the Bill of Rights is so important to me.
I think state governments have the right to ignore Treaties that are treasonous. I think people have the right to ignore Treaties that are treasonous. How do you protect people from the harm of the federal government when the federal government enforces a Treaty that is treasonous?
An interesting situation may develop if state governments say a Treaty is treasonous.
If Congress decides a Treaty is treasonous, it would no longer be the supreme Law of the Land.
If the United States Supreme Court decides a Treaty is treasonous, it would no longer be the supreme Law of the Land.
Our government has the power to abrogate a Treaty.
One of the reasons I want State Legislatures to again be able to choose some United States Senators is Treason.
I would like many Treaties to be abrogated.
I recommend people read
"Criminals Bilk Medicare of Billions Each Year" by Jay Weaver AARP Bulletin
November 1, 2009 which is on the net
The following is a quote from the article
"Medicare loses billions of dollars to fraud each year. "Those billions of dollars," said Eric Holder, U.S. attorney general, "represent health care dollars" that could be spent on medicine or care or hospital visits, "but instead are wasted on greed."
"Yet Congress has denied Medicare the money officials say it needs to truly police itself. Four years ago, as fraud began spinning out of control, lawmakers ignored Medicare's request for $300 million to fight these crimes - even though the agency's Office of Inspector General says that every dollar spent protecting the program returns $17."
- Ken Stremsky, Manchester, NH
Ken Stremsky
"Read Article 2, Section 2 and Article 6 dealing with Treaties. Treaties are "the supreme Law of the Land; and the Judges in every State shall be bound thereby"
I'm curious Ken does the constitution speak of treason? What if a treaty was treasonous to the constitution, our sovereignty and the people would it still be the supreme law of the land?
I ask because treason is another one of those things we no longer enforce or have left in the past.
- Deb, Derry
The amount we spend to keep people alive for 6 months or 2 years longer is absurd. Why should my 14-year old daughter be faced with a lifetime of paying for an elderly person's 6 additional months of breathing? Why are 85 year olds having heart valves replaced? So they can sit and read for another five years? We simply cannot afford this level of care.
However, we might have a bit more available if the George Will's of the world paid for their own healthcare and didn't take a dime from the government program. It's easy for him to say stop paying, since he can afford to pay his own way. Ironically, though, I agree with the point that we should stop paying out for the ederly, but think it funny that George didn't offer to pay his own way.
- John, Rumney
Spike
Read Article 1, Section 3 of the United States Constitution before it was amended by Amendment Seventeen.
Read Article 1, Section 8 dealing with currency, trade agreements, and the military.
Read Article 2, Section 2 and Article 6 dealing with Treaties. Treaties are "the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding" according to Article 6.
I hope you will come to the conclusion that I have that if the harm the federal government causes to state governments and the people is going to reduced that State Legislatures need to again be able to choose some United States Senators.
Since Reagan became President, most Republicans and most Democrats have not cared about the national debt and the value of our currency. Most Republicans and most Democrats have NOT cared about military spending and non military spending being spent wisely.
Before Amendment Seventeen of the United States Constitution was passed, State Legislatures got to choose United States Senators which gave State Legislatures a say on military spending, non military spending, federal laws, trade agreements, Treaties, United States Supreme Court Justices, the national debt, our currency, and other things.
If each State Legislature is able to choose at least 1 United States Senator, State Legislatures may be able to reduce military spending, reduce non military spending, reduce the national debt, and get better trade agreements and Treaties passed.
I would like each State to have at least 3 United States Senators. I would prefer to have 2 chosen by the people of the state.
If our country has 50 United States Senators chosen by State Legislatures, I think our Republic will have a lot better leadership than it has now. I think our Individual Liberty and freedoms are more likely to be protected.
Because of Amendment Seventeen, the federal government has the power to cause significant harm in a short period of time and State Legislatures have no way of reducing this harm.
- Ken Stremsky, Manchester, NH
Increased demand for health services is a demographic fact. What we do about it depends on our wisdom. I just heard Carol Shea-Porter in Epping chant that spending 16%, eventually 20%, of "our" money on health care is "unsustainable." To her, this is not a number that reflects our PREFERENCES but a national total that must be held down by gunpoint--necessarily, by denying treatment. She comes not to serve us but to manage us--to manage us by the numbers. And she may have Listening Tours but she will not hear. To do so would call decades of service in "social work" into question.
- Spike, Brentwood NH
Yes!let's panic and start screaming about Death Panels!!George will is pointing out what will happen if elderly care becomes a Govt.entitlement under universal health care.If you've lived to be elderly,it's probably because you've always taken care of yourself,so i would think being forced into healthcare regimens,govt.sanctioned,of course will be detrimental,anyway.If you're too old and tired to care for yourself,move to Arizona,man,and if you're too old and tired to be politically active,please shut up.
- David Winters, hooksett
Don't I recall someone being unjustly savaged when she warned us of death panels?
I'm seventy, healthy, and scared.
- Patriot Paul, Hampton
Yeah, "kick 'em [the elderly] to the curb" George. On second thought, for someone who's going to be 69 in 3 months, you might want to reconsider, your shameful conservative Republican view about the elderly. Who knows, maybe you'll find yourself standing before one of those so-called "death panels" one day, or maybe being baked into a "Soylet Green" cookie - and remember: 2022 is only 12 years away!
- Robert Thorn, New York
Bill, jolene--Don't make the mistake of thinking that ignoring the facts will make them go away. George Will hasn't proposed a thing here, but he has presented the reader with some uncomfortable truths. We can either think hard about these demographic trends and debate new approaches, or we can sit back and ignore them. It seems unwise, to me, to do the latter.
Here's a possible approach: Guarantee a certain basic level of medical care to everyone, but beyond that level you get what you pay for. If you're 90 and can afford a kidney transplant, go for it. If not, I can't see that it's society's responsibility to give it to you for free so you can survive another year or two. For one thing, the money has to come from somewhere, and that somewhere is someone else.
- Steve K., Grosse Ile, MI
I am in my mid thirties and see that America has become a nation of me.
Everyone wants someone else to pay for something, to cover somethin, to bail us out. I say get back to the heart of america - independence. Indepencence meanint I will take care and look out for my own problems and issues and family.
Don't look for handouts from anyone.
- CJ, Bedford
George Will's article gives new meaning to "Kick'em to the curb." So much for gratitude and respect for our older citizens who fought the good fights for this generation. Surely there must be a humane solution....How old is George?
- jolene, hollis
It sounds like George Will is coming around to the death squad ideas that conservatives rushed to judgement on in the health care bill.
- Bill, Moultonborough