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Why is old age so unhealthy in the US?

Jessica Hall asks a wonderful question: Why is Old Age so Unhealthy in the US?

More importantly, her article offers valuable insights into the grim realities of healthcare in your waning years. Hall offers us a new way to measure and evaluate the last stage of life - Healthy Life Expectancy. This metric attempts to distinguish between life expectancy and a healthy life expectancy. In other words, it compares your healthy length of life to your total life expectancy.

In short, living longer is not the real goal, rather living longer healthfully is the real goal. Take Japan vs. the US, for instance. In the US, our life expectancy is 78 (ranked 40th in the world). Yet our healthy life expectancy is only 66.1 (ranked 68th in the world). That's a significant drop. By contrast, Japan has the longest life expectancy at 84.3 years, and the longest healthy life expectancy at 74.1.

So, why does the US rank so poorly throughout the world? After all, the U.S. spends virtually double what these other advanced countries spend on healthcare. The obvious conclusion is that the US is spending its healthcare dollars on the wrong care.

Hall's article sheds light on this situation: “In recent decades, we have successfully extended our lifespans - [but] the years of dependable good health - have not kept up, remaining at an average age of 66 years. Americans will spend 12 years living with a disability or serious disease - and people do not want to spend the last 12 years with the wheels coming off…”

These facts should be of tremendous concern to health policy experts. Given the rapidly aging population and the burden of healthcare in the US, these realities call for a dramatic change in our healthcare policy.

Two reform opportunities standout above all the others: 1. Recenter the importance of primary care. 2. Implement well documented care models for end-of-life care. These two areas of focus should be how we shift US healthcare policy and investment.

If these topics pique your interest, you may wish to read my book The Journey’s End.

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