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Living longer

August 23rd, 2016

I’ve been invited to give a talk on the topic of challenges posed by an ageing population. This issue has been around ever since I can remember and, in a literal sense, it’s one I am pretty concerned about. Throughout my life I have, like the rest of the population, been aging at a rate of one year per year, and this poses plenty of challenges. On the other hand, as someone said recently, getting older may have its unpleasant aspects but it’s a lot better than the alternative.

Of course, when pundits talk about an ageing population, they do not mean that we are individually getting older but that we are not dying as soon as we used to. The result of this (and subject to demographic fluctuations) is that the average age of the population is increasing.

While I was a little snarky in my opening para, this is, in fact the correct way to think about things. We are, mostly, living longer and this creates a bunch of individual and social opportunities, choices and challenges. The two big ones are:

* How should the extra years of life be allocated between additional education, additional years of work (including household work most notably childraising) and additional years of retirement?

* What are the implications for our personal health and for the health care system.

I’ve looked at the first of these questions on quite a few occasions and concluded that the problems, if any, relate to the way the labour market works (or rather fails to work) for older worker

On the second, the operating assumption in much of the discussion seems to be that people will live longer, but that their health, at any given age, will be much the same as that of previous cohorts. This is obviously nonsensical. The reason the previous cohorts died earlier (on average) is that their health was worse. If people live longer, this will mostly mean more years of healthy life.

One possible exception I’ve been concerned about is dementia caused by Alzheimer’s and related diseases. Perhaps that’s inevitable deterioration rather than a product of ill health. But the news here is good. Age-specific rates of Alzheimers have been declining for the past 25 years as general health improves.

One remaining issue is that people with severe dementia are surviving longer than they used to, as a result of improved care, and this is socially costly. However, this is a once-off shift that has already happened, so the extra cost has been incurred already. Increases in lifespans associated with improvements in general health, including reductions in the age-specific frequency of dementia should not have any additional cost.

This is, in fact, an illustration of a more general point. The increase in health care expenditure we observe is the result of the development of new, and costly treatments. Unsurprisingly people want these treatments and are willing to pay for them, either privately or through the public health system. To regard this as a problem is like complaining about the availability of flat-screen TVs on the basis that buying them will increase our entertainment costs.

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  1. August 23rd, 2016 at 14:01 | #1

    Here is a summary of MediSave that will reduce the cost of Health Care by at least 50% by removing the cost of capital and inflation.

    MEDISAVE

    Instead of medical insurance people buy Health Rewards instead of insurance. Health Rewards entitle the buyer to a discount on future health invoices. Individuals receive Health Rewards if they are involved in accidents or events beyond their control such as contracting cancer from environmental pollution or having a congenital disease or …. Health Rewards are transferable to an immediate family member.

  2. derrida derider
    August 23rd, 2016 at 14:37 | #2

    Nothing actually controversial in this post to people familiar with the issues, but a couple of quibbles (no more than that):

    – “how labour markets operate” with respect to older workers may be largely endogenous to the proportion of older workers in the workforce. Roughly, more older workers means older workers may be more employable but worse paid than in the past.

    – sure the number of healthy years has been increasing, but that’s not the question for policy – the question is will it increase as fast as overall life expectancy. The median years before death that people get frail has not changed much, and the answer to both your questions above are quite critically dependent on whether it will change in future. You can think of a number of reasons (of which you have posted one, and in one direction) why it might change in either direction, but the honest answer is that no-one knows – its unforecastable.

    But your point about the rising cost of health being not mainly due to population aging is both correct and important. We will spend more on health mostly because we will have it to spend (because what’s the point of being rich if you’re not healthy?).

  3. John Quiggin
    August 23rd, 2016 at 15:38 | #3

    how labour markets operate

    I agree, though it’s a bit more complex than supply and demand. If you combine fairly rigid hierarchical structures with a willingness to sack people, you end up with lots of older workers who have lost jobs and can’t easily fit back in to the hierarchy. That’s part of what happened in the 1990s, I think.

    The median years before death that people get frail has not changed much

    That’s my understanding, which is consistent with the argument of the post. Each of us who dies a (roughly) natural death will impose on average much the same cost in terms of frail elderly care as we did in the past.It’s only if we get a lot better at keeping frail people alive than at preventing frailty that there is a problem.

  4. J-D
    August 23rd, 2016 at 15:41 | #4

    Decreases in fertility are at least as important in changing the age structure of the population as decreases in mortality.

  5. Matt
    August 23rd, 2016 at 16:02 | #5

    On the second, the operating assumption in much of the discussion seems to be that people will live longer, but that their health, at any given age, will be much the same as that of previous cohorts. This is obviously nonsensical. The reason the previous cohorts died earlier (on average) is that their health was worse. If people live longer, this will mostly mean more years of healthy life.

    Is this the case? Without taking the time to dive into the data, my understanding had been that at least some of the increase in life expectancy has been the reduction of accidents and workplace deaths that kill people at any age, childhood deaths from accidents and disease, and cancer treatments becoming more effective (either curing or prolonging post-diagnosis life).

    If that’s right, then we shouldn’t expect one additional year of disability-free life for each additional year of life.

  6. GrueBleen
    August 23rd, 2016 at 16:24 | #6

    @J-D

    Fertility or fecundity, J-D ?

    But yes, that’s why the ‘baby boom’ is a travelling wave phenomena which is currently pushing up the average age of the population, but which should lower it as the ‘wave’ dissipates.

    What it’s currently doing, apparently, is concentrating more a than ‘normal’ number of people into a comparatively short age range.

  7. Ivor
    August 23rd, 2016 at 16:35 | #7

    I would have thought a properly funded superannuation/pension scheme would resolve most issues and provide access to retirement medical, education and leisure facilities and so forth.

    If more was done to ensure everyone had 40 years of full-time work, economic issues of old age would be addressed.

    This issue is in the magazine “Money” in the newsagents. It complains about the cost of aged care but mentions “owners expect to make a return on their profits”. [p48]

    It can take up to $2 million deposit to get a aged care place (refundable deposit). And on top they want 85% of aged care pension minimum plus means test extra fees up to $244 per day.

    Aged care is a service industry and needs staffing at TAFE-qual level. I do not know what the staffing levels are, but I cannot see there to be much except in high-care (eg dementia) facilities.

    IN any case it would be less of a problem if funding was public and there was no attempt to sting the aged to provide a return on Capital.

  8. Ernestine Gross
    August 23rd, 2016 at 16:38 | #8

    Pleasure to read JQ’s post, particularly the first paragraph and the last sentence.

  9. Jim Birch
    August 23rd, 2016 at 17:03 | #9

    @Matt
    Childhood deaths have been low for a long time. For ages 0-4, deaths per 100,000 in Australia
    1907: 2,412
    1927: 1,543
    1947: 816
    1967: 438
    1987: 207
    2007: 107

    The rate like halves every twenty years over the data period. There’s continual improvement but we are now at a very low rate so the big changes have happened already. Continuing reductions in infant and earlier childhood mortality are not going to affect the population profile much. The action is now at the top end.

    source: http://www.aihw.gov.au/deaths/grim-books/

    I don’t have figures for accidents but I’d guess they are pretty low too. The predominant cause of death in Australia is age-related disease.

  10. Apocalypse
    August 23rd, 2016 at 17:59 | #10

    @Ivor

    It can take up to $2 million deposit to get a aged care place (refundable deposit). And on top they want 85% of aged care pension minimum plus means test extra fees up to $244 per day.

    That is misleading. It’s like saying a car can cost “up to” $3 million, the price of a Mercedes Maybach.

  11. hc
    August 23rd, 2016 at 18:06 | #11

    A bit off track.

    How much value can you attach to older workers? Are humans like machines that depreciate until they need to be scrapped? TOr does learning-by-doing and “experience” provide some more sustainable benefits? I think the latter is true – at least to a point – but find that many employers disagree.

    Of course, some older workers lose interest in work so that even if they could be productive they don’t want to be. I have got a foot in both camps and would prefer, myself, to do some part-time work as I age. Hard to get.

  12. Ikonoclast
    August 23rd, 2016 at 18:25 | #12

    I can speak as one who, along with my two siblings, had to undertake extra duties, organising of financial and medical affairs over several years and also extra care in many particulars (but not daily personal care) for two parents struck by dementia respectively in the early eighties for one and then late eighties for the other. These parents have both finally passed away in the last six months. I say “finally” because the last decade of their lives had no quality of life beyond good nursing home care and palliative measures for physical comfort. I have formed the opinion that living too long is to be as much feared (for both subject and close relatives) as dying too soon.

    As a rough rule of thumb, I would say life is worth living until about age 80 or just a little older for most people with current longevity and average health outcomes. After that, it rapidly worsens for many people, although there are those exceptional people who remain fully cognisant and sprightly until 90 or a little older.

    Dementia indeed is the scourge to be feared in all this. Although, if the mind goes completely as my mother’s did there is the “consolation”, for those forced to watch the long deterioration, that the elderly, dementia-struck person finally has no grasp or insight into his or her own condition and situation.

    Ultimately, we as modern, civilized humans, are finding that the suspension or stretching of “wild” biological laws is a double-edged sword. It confers many benefits and prevents many kinds of suffering and indignity. Yet it opens new forms of suffering and indignity too.

    I certainly support Andrew Denton’s campaign with respect to the right to die. I won’t make the case here. Andrew Denton makes the case well. It’s worth looking at his speeches and writings on this issue.

    Again, using the wisdom I hope I have gleaned from experience, I would advocate that compos mentis adult persons get not only their wills and powers of attorney documents in order but also sign legal health care directives for themselves. Whilst the right to die does not exist yet in Australia, the right to not be kept alive artificially and too long certainly does exist. “Artificially” does not mean just artificial respiration it means things like feeding tubes too. Advanced dementia patients, for example, often lose the ability to swallow properly. Palliative care can be given if necessary at such junctures (morphine below fatal dosages for example) and such measures do not medically or legally constitute assisted dying.

    After that cheery heads-up, have as nice a day as possible folks! Every healthy day is a bonus. Be thankful and put it to good use.

  13. Ikonoclast
    August 23rd, 2016 at 18:29 | #13

    Sorry, above I should have the term “assisted dying” rather than “right to die”.

  14. Ivor
    August 23rd, 2016 at 18:57 | #14

    @Apocalypse

    What’s wrong with saying that the cost of a car can cost up to 3 million if some cars cost $3 million?

  15. James Wimberley
    August 23rd, 2016 at 19:15 | #15

    The rise in health costs we observe is the result if new, costly and ineffective treatments – a point elegantly made by Lewis Thomas years ago. Do you really think that in 2030 cancer therapy will still consist of cocktails of dangerous drugs, hugely expensive because each one will be replaced in a couple of years by a marginally less ineffective one? True high-tech medicine, like polio vaccine, is cheap. The cure for syphilis – a week of antibiotics – costs $50 or so.

  16. BilB
    August 23rd, 2016 at 20:05 | #16

    I thought I had a solution.

    For a long time now I’ve been having non birthday years. But as it turns out that just made me more frail for my numerical age, though I am still working and paying taxes. The other strategy I had was to sleep less. That gave me more work time for my numerical age, an increase near 30%, still working and paying taxes but at an increased rate. The sum effect though is that I have paid more tax for my numerical age than I otherwise would have so my marginally increased need for medical servicing should be covered by my increased contributions. The real bonus for some future government is that I will probably drop dead on the job, if I have timed it right.

  17. J-D
    August 23rd, 2016 at 20:13 | #17

    GrueBleen :
    Fertility or fecundity, J-D ?

    Or natality?

  18. Tom Davies
    August 23rd, 2016 at 20:54 | #18

    Ivor :
    @Apocalypse
    What’s wrong with saying that the cost of a car can cost up to 3 million if some cars cost $3 million?

    The information is completely correct and entirely useless for the median car buyer.

  19. Graeme
    August 23rd, 2016 at 21:06 | #19

    @J-D Perhaps professors tend to be beyond fertility and closer to mortality. In my experience, child rearing speeds up physical ageing whilst retarding mental ageing.

  20. John Goss
    August 23rd, 2016 at 21:56 | #20

    You are correct James Wimberley that much of the increase in health expenditure has gone on ineffective treatments, but the example of cancer you use is an example of the opposite. Cancer is a disease where most of the increase in treatment costs has been to good purpose. There are exceptions eg prostate cancer treatment, but most of the waste is with other diseases. We have so misallocated our increase in health service resources in the last 15 years, that we could cut resources by 25% and still have the same health outcomes.

  21. Ernestine Gross
    August 23rd, 2016 at 22:59 | #21

    @BilB
    Good one.

  22. Geoff Edwards
    August 23rd, 2016 at 23:00 | #22

    In any discussion of longevity and chronic disease, two contemporary trends should be factored into the models. One is the reported upward trend in numbers of people who have fried their brains with ice, cannabis or other psychotropic drugs and turned themselves into schizophrenics. Many users will require medical support for decades, often including hospitalisation.

    The other is the reported upward trend in obesity amongst children. Giving children sugary drinks (in particular) programs their bodies for a lifetime of chronic disease. Even a small percentage rise in obesity will lead to a large percentage rise in costs of medical treatment over their lifetimes.

    Medical costs can be pulled down substantially not only by squeezing inefficiency and rorting out of the current system, as one or two posters above have noted, but by increasing expenditure on preventative health, teaching children life skills and offering free breakfasts in schools. This is where a progressive government could find easy cost savings, although with a time lag.

  23. GrueBleen
    August 24th, 2016 at 02:13 | #23

    @Ikonoclast

    Your #12 of 23 Aug.

    My partner’s parents (born in Europe, came here as WWII refugees) both made it to 90 still of mostly sound mind (as sound as in their earlier time anyway), though her mother lasted a few more years than her father and was getting fairly vague towards the end. Maybe it’s just individual variability, but up to about 90 seems fairly common now.

    For myself, making 90 would be another 17 years, and I’m not at all sanguine about that prospect. Of course, I think I’m still totally compos mentis, but YMMV.

    There is one thing I’m getting though: about 10 years ago I watched a doco on SBS about aging in which an older actress (nearly 60) talked of her 85yo mother: apparently as she got older, to her mother days seemed to get shorter and shorter until, at her age “There seems to be only 15 minutes between breakfasts”.

    Well, I haven’t got to that stage yet, for me there’s still at least a couple of hours between breakfasts. (And I’m still only sleeping about 7 1/2 hours out of 24 – but in two shifts.)

  24. GrueBleen
    August 24th, 2016 at 09:08 | #24

    @J-D

    Or nativity ?

    Ooops, no – that was someone else entirely.

    Ok, now we’ve agreed that the ‘baby boom’ (of which I am not a part) was a short term surge of natality, so what effect does that have as the population ‘bulge’ ages ? Will there be much increased demands for all of the ‘aged services’ over the next 15 or so years – as the boomers age through their 70s and 80s – and will that then significantly decrease in about 20 years as they then have all more or less died off ?

  25. August 24th, 2016 at 09:55 | #25

    Geoff, I don’t favour adjusting estimates for increasing obesity and more drugtaking unless and until someone can point out an effect in the existing data. The graph of Australian life expectancy has been going up by a couple of months a year since 1980, straight as a broomstick (bar a peculiar and unexplained kink in the sixties). Yes, we’re getting fatter; no, you can’t point at the graph and say ‘that’s where it started’. Either we would have been living longer by, say, six months a year if we hadn’t been pigging out, or fat doesn’t matter nearly as much as everybody says. It’s much more the roller towel effect – we all go up or down together, carried along by the society around us.
    [Sometimes that’s countered with ‘the fat young people aren’t old enough to die and register on the stats yet’, but if it was really a simple effect you’d expect it to increase the deathrate at all ages, and we don’t see increasing deathrates (or slowed life expectancy increases) among younger people either.]
    It’s also worth pointing out that medicine isn’t everything. Older American white female life expectancy has been dropping, and that can’t really be because medical progress has been going backward. It’s a lack of societal meaning, the same effect that totalled the Russian stats after the breakup of the USSR. Here in Aus, for all our faults, we still (on the basis of the stats) seem to have it. Remembering, too, the Whitehall study – what you do about your own health matters much less in calculating your life expectancy than where you stand in the hierarchy.

  26. Ikonoclast
    August 24th, 2016 at 10:02 | #26

    @Geoff Edwards

    I think there are plenty of people who might have fried their brains with medications like anti-inflammatories and blood pressure medicines. The link between these and dementia appears to be there but the issue is determining the precise nature of the link. Do these medications simply allow people to live long enough to get dementia? Or do the medications do damage of some kind? In turn, the question must be asked: What causes more damage, a stroke or blood pressure medication? The trade-offs are tricky. I have come down on the side of avoiding all medications. But my numbers and aches and pains are still in the passable zone where that is an option. I happen to believe that the multiple interactions of anti-inflammatories, blood pressure medications and other medications are linked to some development of dementia and alzheimers but I guess it’s only my belief at this stage.

    Too many old people are pharmacological disaster zones of multiple drugs and multiple interactions. An initiative in the USA now involves hospitalising confused elderly patients, reviewing their whole drug regimen, weaning them off most of the pills and getting back to a medication approach as minimalist as possible to deal with only priority medical conditions. Many patients respond well and get back a good deal of intellectual and social function.

  27. sunshine
    August 24th, 2016 at 10:22 | #27

    My friend with muscular dystrophy in her neck and arms/hands says she is happier now than she ever has been. She can still live independently (tho she gets a cleaner in once a week) and use her computer. There is some research showing that happiness levels are mostly or all-together unaffected by illness as long as the sufferer expects that the condition will not worsen. Also older people are usually found to be happier than younger when this is investigated. It is reasonable to expect that life will get better as you get older .

    Our society would fall over without the army of cheap imported labour and the gigantic unpaid contribution made by older or ‘retired’ people .Dont believe the hype – youth is over rated ,they aren’t half as good as they think they are .What JQ is saying is good. Older people are being put into the budget category of items (along with the unemployed ,disabled ,indigenous etc) where spending needs to be cut so it can go on elsewhere, and wealth can continue to accumulate as per usual.

  28. rog
    August 24th, 2016 at 10:41 | #28

    The second most common form of dementia is vascular and that can be, in large part, attributed to lifestyle choices.

    Recently Jack the Insider was diagnosed with a virulent form of bladder cancer, which is almost wholly attributed to smoking. He writes that this will not deter him is satisfying his habit, which is one based on the principle of free personal choice.

  29. Troy Prideaux
    August 24th, 2016 at 10:44 | #29

    @Ikonoclast
    Yeah, it’s pretty scary how much prescription medication your avg >60yo takes daily. You only have to play golf with a group of them when the conversation turns to how many meds they’ll all taking which can almost turn into a one-upmanship thing with some scary numbers thrown around.

  30. Ikonoclast
    August 24th, 2016 at 10:46 | #30

    @sunshine

    From “East Coker” – T. S. Eliot

    “What was to be the value of the long looked forward to,
    Long hope for calm, the autumnal serenity
    And the wisdom of age? Had they deceived us
    Or deceived themselves, the quiet-voiced elders,
    bequeathing us merely a receipt for deceit?
    The serenity only a deliberate hebitude,
    The wisdom only the knowledge of dead secrets
    Useless in the darkness into which they peered
    Or from which they turned their eyes.

    Do not let me hear
    Of the wisdom of old men, but rather of their folly,
    …”

    As someone getting on himself (62) I am aghast at the numbers of people my age and older who won’t entertain any new thoughts, who have settled into the most sclerotic of prejudices and smug self-satisfaction. There really is not much wisdom in most of that cohort. The only hope for the revolutionary improvements we need are the young. Most geniuses do their best work before thirty in the sciences and before forty in the humanities. Most ordinary, competent people do their best work before fifty. There are some exceptions. This longevity business can become a long, useless coda and a trap. It doesn’t have to be but it takes a fight to prevent that.

    “He not busy being born is busy dying.” – Bob Dylan.

    As the selfish elderly aggrandize everything for themselves, this political economy is failing the young and it will pay the price.

  31. derrida derider
    August 24th, 2016 at 10:56 | #31

    What ChrisB said about obesity – the only sign of it in the data so far is higher rates of type II diabetes, but a lot of people think that is at least partly driven by better diagnosis of it (evidence for which is the declining rate of strokes and heart attacks – long-term sequelae of diabetes – in late middle/early old age). Now that may change in the future, but if you do the figures it’s still fairly unlikely to change aggregate life expectancy or morbidity rates a great deal.

    The drugs stuff (Geoff [email protected]) is a complete furphy. For a start, drug-related morbidity (including mental health morbidity) has fallen, and is continuing to fall, sharply. Apart from falling nicotine intake, alcoholism is rarer now – and alcohol definitely causes major depression, and aggravates schizophrenia. Plus Foetal Alcohol Syndrome is thankfully rarer now. Ice addicts are too few to affect chronic psychosis numbers (caffeine induced psychosis might have comparable numbers – the individual risk is far lower but the population exposure is far higher), and despite the propaganda marijuana is only weakly linked to schizophrenia.

  32. Ikonoclast
    August 24th, 2016 at 11:00 | #32

    @Troy Prideaux

    I currently take none at 62 but part of that is good luck. Another part of that is good management except of my weight which is still a bit high (current BMI 25 but slowly on the way down). I am even reluctant to take any over the counter medication. For example, I would estimate my annual intake of panadol at about 6 to 12 tablets max. No cigs, no booze but two brewed coffees a day, my one indulgence.

  33. Tim Macknay
    August 24th, 2016 at 11:21 | #33

    @Geoff Edwards

    In any discussion of longevity and chronic disease, two contemporary trends should be factored into the models. One is the reported upward trend in numbers of people who have fried their brains with ice, cannabis or other psychotropic drugs and turned themselves into schizophrenics. Many users will require medical support for decades, often including hospitalisation.

    Do you have any evidence for this alleged trend?

  34. derrida derider
    August 24th, 2016 at 12:11 | #34

    Ikonoclast, I’m 63 and I share your horror at the rigidity of mind and resistance to change so many people our age have. But looking back at the people I knew in my parent’s cohort I think this is actually, like other morbidities, occurring later than it used to. We have turned into stubborn narrowminded and resentful old coots – but not quite as stubborn, narrowminded and resentful as our parents were. But then there’s more of us than there were of them.

    Putting the economist’s hat on, I have always thought the real threat to economic growth from population aging is precisely greater resistance to innovation – the old are not at all fond of creative destruction. Small-c conservative governments, deeply unwilling to disturb established rents (including property ones), will become the norm once the median voter gets to late middle age.

    When I were a young ‘un Jim Morrison sang of generational conflict:

    They got the guns but we’ve got the numbers
    Gonna win, yeah we’re taking over

    Well we’ve taken over, and the difference is we’ve got both the guns and the numbers. Today’s young aint got no chance.

  35. Apocalypse
    August 24th, 2016 at 12:35 | #35

    @derrida derider

    once the median voter gets to late middle age

    Just about a mathematical-demographic impossibility, unless governments adopt Hayek’s suggestion and make the 40 the minimum voting age. The oldest country in the world, right now, Japan has a median age of only 46.5 years. That’s where we will be in the middle of the century.

  36. Ikonoclast
    August 24th, 2016 at 13:00 | #36

    @derrida derider

    Yes, you make some good points there. I am certainly resistant to some innovations. My stubborn refusal to own and then to use a mobile phone when it was finally gifted to me one birthday, is notorious within my family. But overall, mobile phones are a good innovation.

    I hold that resistance to bad innovations is a good thing. Judgements vary on what is a bad innovation. Events can give us enough data after some time. Need one mention all the bad financial innovations which played such a significant role in the GFC?

    The “established rents” you refer to are a good point. The pendulum has swung too far in favour of the older cohorts. They (we) ought to voluntarily give some up. For example, special tax treatment for self-funded retirees is unjustifiable. Student loan debt for young people is unjustifiable. If conditions get really tough (say a long grinding economic emergency which is a slow motion collapse over decades), the young will easily out-compete the old. The game can always change again.

  37. Ivor
    August 24th, 2016 at 13:36 | #37

    @Tom Davies

    This just means that the median car buyer is a different topic.

    If you want to address median buyers – then different data is required. Whatever this is, it is still the case that:

    If cars cost 3 million then they will also cost up to 3 million.

    You should not read anything more into this.

  38. sunshine
    August 24th, 2016 at 14:04 | #38

    There are lots of old coots stuck in their ways ,but there are also lots of open minded older folk .The greater portion of hope for the future seems to me on balance to lie with the young at present. I havent seen the research ,but it is easy to imagine that the young are on average more open minded than those older. Growing up in the post truth era probably helps in a way .I’d like to think I remain open minded at 52 years of age, its something I value and work on. Maybe being deliberately barren has helped. Apparently people tend to become more conservative after having children . A friend of mine said ‘you just stop caring about other people’ (he vehemently denies having said that !).

  39. Tim Macknay
    August 24th, 2016 at 14:21 | #39

    @sunshine

    Maybe being deliberately barren has helped.

    If hope for the future lies with the young, maybe not… 😉

  40. GrueBleen
    August 24th, 2016 at 16:06 | #40

    @derrida derider

    Come mothers and fathers
    Throughout the land
    And don’t criticize
    What you can’t understand
    Your sons and your daughters
    Are beyond your command
    Your old road is
    Rapidly agin’
    Please get out of the new one
    If you can’t lend your hand
    For the times they are a-changin’.

  41. GrueBleen
    August 24th, 2016 at 16:13 | #41

    @sunshine

    Speak for yourself, sunshine: this old coot isn’t stuck in anybody’s ways.

    But do, please, remember: striving to better, of we mar what’s well.

    The line it is drawn
    The curse it is cast
    The slow one now
    Will later be fast
    As the present now
    Will later be past
    The order is
    Rapidly fadin’
    And the first one now
    Will later be last
    For the times they are a-changin’.

  42. James Wimberley
    August 25th, 2016 at 07:02 | #42

    @John Goss
    The new cancer treatments are ineffective by comparison to cures. As I noted, each new drug is marginally better, or less bad, than the one before. So there is progress, as at the Somme.

  43. John Goss
    August 25th, 2016 at 09:32 | #43

    James, the interesting thing about cancer is that progress is being made on all fronts. Risk factors like smoking are being reduced so cancer is prevented, Hep B and Hep C are being treated by very effective drugs so liver cancer is prevented, and, because of much better understanding of cancers due to genetic techniques, some of the newer treatments for cancer are so effective that cancer is effectively being eliminated. We still have some way to go to get totally effective interventions based on a full understanding of the cancer a la Lewis Thomas, but we are on the right path.

  44. Ikonoclast
    August 25th, 2016 at 09:35 | #44

    @James Wimberley

    Well, that’s the nature of cancer. It’s a complex of complex diseases. It seems unlikely there will ever be a single, silver bullet. Longevity obtained from many advances then permits us to live long enough to get more cancers and more dementia. For every benefit there is a cost. Speaking of costs, medication price rises seem to be out of control in the US. “Prescription drug prices jumped more than 10 percent in 2015”. “EpiPen cost soars, but it’s not the only drug.” The headlines keep coming.

    Among other things, we need to remain philosophical and even fatalistic about the fact that we are mortals. Living too long is not a worthwhile goal. I would think that every person from about age 60 needs to think about “what expense is worthwhile for saving me and what expense is not worthwhile for saving me”. A true philosopher with the requisite courage and still of sound mind would say “Beyond this point, it is not worth the cost to my family nor to society to save me. I have no right to inflict further costs, financial and emotional, on other people.” I attempt to be a philosopher. I am not sure about my courage though. Time will tell.

  45. August 25th, 2016 at 11:14 | #45

    Bearing in mind that the complete abolition of cancer would increase overall life expectancy by only about three years. Most of the people who die are old enough to be close to dying of something else anyway. The one final rule is that you have to die of something, and if it isn’t cancer it almost has to be heart disease.

  46. Tim Macknay
    August 25th, 2016 at 11:51 | #46

    @ChrisB

    Among other things, we need to remain philosophical and even fatalistic about the fact that we are mortals.

    Indeed. As far as I am aware, the only “alternative” (if you could call it that) to being philosophical is cryonics, i.e. freezing your corpse in the hope that future high tech will bring you back to life (!). Lots of “Libertarians” seem to be into it for some reason. Oh, and the “Libertarian” billionaire Peter Theil wants to stay young by, well, feeding off the blood of the young. That’s where “Libertarian” thinking gets you, apparently.

  47. Tim Macknay
    August 25th, 2016 at 11:52 | #47

    Oops, sorry – that was a reply to Ikon.

  48. derrida derider
    August 25th, 2016 at 13:44 | #48

    @Apocalypse
    Err, Apocalypse, note the term “median voter“, not “median person”. I don’t have time to calculate projected median age of 18 and overs in Oz, but ABS 3222.0 is what you need if you care to do some spreadsheeting.

    Plus in all those benighted countries that have failed to make voting compulsory the median voter will be older again – sometimes much more so.

  49. derrida derider
    August 25th, 2016 at 13:45 | #49

    @GrueBleen
    I always preferred The Doors to Dylan – especially early Dylan

  50. Apocalypse
    August 25th, 2016 at 13:50 | #50

    @derrida derider

    In countries with ageing populations, there aren’t many median population age, but not by all that much.

  51. Apocalypse
    August 25th, 2016 at 13:52 | #51

    @Apocalypse

    In countries with ageing populations, there aren’t many under 18s, because oldies don’t breed. Median voter age will be more than median population age, but not by all that much.

  52. August 25th, 2016 at 16:07 | #52

    A first dash at ABS 3222 suggests that median voter age today is about 45 and in 2100 it’ll be about 51.

  53. GrueBleen
    August 26th, 2016 at 08:32 | #53

    @derrida derider

    Well of course. Who wouldn’t prefer ‘Light My Fire’ to ‘Don’t Think Twice, It’s All Right’ and, say, ‘Roadhouse Blues’ to maybe ‘All Along the Watchtower’.

    But perhaps it’s because you were a mere tyke of about 10 or so when ‘The Freewheelin’ Bob Dylan’ was released, but a freshly post-pubescent teen when ‘Light My Fire’ came out.

  54. GrueBleen
    August 26th, 2016 at 08:36 | #54

    @Tim Macknay

    Yes but Theil did catch that particular meme from the Simpsons, of course.

    And whatever happened to:

    Do not go gentle into that good night,
    Old age should burn and rave at close of day;
    Rage, rage against the dying of the light.

  55. Moz of Yarramulla
    August 26th, 2016 at 10:23 | #55

    GrueBleen :
    Old age should burn and rave at close of day;
    Rage, rage against the dying of the light.

    Raves typically peak just before the coming of the light, it’s only the oldies who struggle to stay up after sunset 🙂 And to quote the BBC’s number one Christmas song for 2009 by Rage Against The … Machine: “f** you I won’t do what you tell me

    Although my taste is more getting up before dawn to hear Salmonella Dub play their final set of the night just as the sun comes up over Canaan Downs. Hearing “Platetechtonics” echoing down the valley at dawn is a magical way to welcome the new year. I miss the old country sometimes, the bush here is just not the same.

  56. Ikonoclast
    August 27th, 2016 at 16:53 | #56

    @Moz of Yarramulla

    You mean the “young country” don’t you? The Shaky Isles where the next time Taupo caldera blows they slide under the sea and send OZ a mega-tsunami which rolls all the way to Uluru?! 😉

  57. GrueBleen
    August 27th, 2016 at 17:47 | #57

    @Moz of Yarramulla

    Heh, well I’ll leave Ikono to his interjections and just say that nostalgia is always with the dear departed.

    But surely Canaan Downs, like the rest of the Long White Cloud, is blessed with a vigorous possum population now ? And therefor the NZ bush is just like the Aussie bush ? Perhaps you should take on kangaroos and wallabies next.

  58. Ikonoclast
    August 28th, 2016 at 06:24 | #58

    @GrueBleen

    Nostalgia isn’t what it used to be.

  59. GrueBleen
    August 28th, 2016 at 09:18 | #59

    @Ikonoclast

    And never will be again.

  60. Greg McKenzie
    August 29th, 2016 at 09:35 | #60

    One solution to the issue of health costs during retirement is to have a Medicare Levy
    on superannuation yearly payments. Whilst electric fencing the aged pension payments from any levies is essential, the same is not true for all superannuation yearly pay outs.
    With millionaire superannuation recipients using tax dodgers to avoid income tax elsewhere, a specific health care levy would be appropriate. Of course, if such millionaires want to pay for top cover private health insurance that would be a bonus to an already overcrowded aged health care system.
    I certainly do no agree with a certain Liberal politician who seems to think that rich people, with over a million dollars in their superannuation fund, should get tax benefits. But fairness demands that anyone who can afford to pay the Medicare levy do so for as long as they are able to cope financially.

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