Americans are living longer—which means we’re all going to be stuck with ever-increasing medical bills for the growing ranks of the elderly, right? Though many analysts think so, a new study says that may not be the case. A new working paper from the National Bureau of Economic Research concludes that disease rates are being “compressed” into the last year or two before death. That means we’re living longer, but also living healthier in our advanced years up until the last year of life. If that’s true, then the aging of the baby boomers may not be the Medicare budget-buster that many fear.
Non-fatal conditions like arthritis and diabetes have increased, while major disease prevalence has held relatively steady.
As the authors point out, medical spending for relatively healthy seniors is modest, while spending on seniors disabled by chronic illness can be stratospheric. So it was cause for concern when earlier studies by groups like the American Hospital Association and the United Health Foundation found seniors were increasingly sick.
There have been a few issues with prior studies of morbidity in the elderly,which this study tried to avoid. For example, some surveys that those studies are based on only ask seniors about their chronic conditions; others look at how functional the elderly are in their day-to-day lives—measuring the practical effect of those chronic conditions, as well as more isolated maladies. For this paper, however, the authors used the Medicare Current Beneficiary Survey, by the federal government’s Medicare and Medicaid administrative department. The MCBS annually surveyed over 10,000 senior citizens from 1991 to 2009, across a wider range of health metrics and with nationally representative respondent demographics. More importantly, the NBER paper links those results to death records through 2008, matching all deaths to the ailments that appeared prior to death—regardless of whether they ended up causing the fatality. So the study offers a unique measure of morbidity by time until death for a large, representative elderly population.
And what does the data show? Non-fatal conditions like arthritis and diabetes have increased, while major disease prevalence has held relatively steady. Meanwhile, the rate of all cancers has held constant among the elderly. Digging deeper into the MCBS numbers, the authors found that major diseases are also doing less to actually physically and mentally impair the elderly. They aren’t having as hard a time taking care of themselves of going about their daily business. More surprisingly, these findings were consistent regardless of race, gender, or education levels. Turns out the golden years might be just as golden, and longer, than ever.