As Kathleen Sebelius was under fire for the monumental screw-up of the Obamacare website, Senator Bill Nelson held a smaller, less sensational conversation on the future of America. In a Member's Roundtable, Senator Nelson called together a group of experts to discuss how medical and scientific research on aging can slow the skyrocketing rate of non-communicable diseases and lead to a healthier, more active aging process.
While the events may seem associated, they are looking in exact opposite directions.
President Obama's health insurance reform gazes into the past, building from last century's European model of public control and responsibility for a nation's health care. The model worked well for a while, but in the late 1970s it began to fall apart, as demographics started shifting. With more "old" and fewer "young," the system has been growing increasingly difficult to sustain. And it requires "structural reforms," as noted by Congressman Paul Ryan.
Structural reforms, indeed. The U.S. is undergoing a profound demographic transformation that should be the defining force for health reform. This is hardly news. In 2010, Standard and Poor's got it exactly right in "Global Population Aging: An Irreversible Truth," writing that "No other force is likely to shape the future of national public health, national finances, and national policies at the irreversible rate at which the world's population is aging." The masterminds behind the Affordable Care Act, apparently, never got the memo.
As we witness the awkward, unfortunate early implementation of the ACA, it is agreed by critics and admirers alike that the system will only work if enough young people enroll to balance out the older enrollees. And with demographics ever-tilting, this magic balance is more dream than reality. A dream that requires last century's demographics.
Senator Nelson's Roundtable, on the other hand, is focused directly on the future. The Roundtable opened a two-day confab of scientists and researchers from across America -- including the National Institute of Health -- to debate how and to what extent the U.S. ought to invest in "aging research." Given the rate at which non-communicable diseases like Alzheimer's, diabetes, hypertension, and a handful of others are increasing in prevalence, this discussion is far more important than the dog-and-pony show over Obamacare.
More importantly, it is the answer to Obamacare itself. Namely, if we can stay healthier as we age, we will bend the curve on the health benefits that 21st century demographics will cost. And investment into aging research will unlock solutions for age-related conditions -- such as vision loss, skin health, and muscular skeletal deterioration -- that will yield huge paybacks.
It's welcome news that investments in healthy aging are catching on in Washington. Beltway insiders were risking falling behind the pack.
Indeed, the gee-whiz digital giants of Silicon Valley have already begun throwing huge investments into healthy aging. Google's latest "moon-shot" is to solve death. And Google is joined by a cadre of buttoned-up, Excel-sheet economists calling for investment to "delay aging." In a rare moment, political leaders such as Senator Nelson, Collins, Warren and Donnelly -- all Committee members who joined the scientists at their Roundtable -- are seeing eye-to-eye with business and intellectuals.
The "delayed aging" scenario, as it is discussed in the peer-reviewed journal Health Affairs, is worth considering.
What they propose is a case for investing in the research and development to "slow the aging process." Such an innovation, they contend, might be better than "disease specific" research age-related diseases like cancer, heart disease and Alzheimer's. A "slowed aging," they contend, would "delay the onset of progression of all fatal and disabling diseases simultaneously."
Through a micro-simulation of future health and spending the authors of Health Affairs "Delayed Aging" argue that "investing in research to delay aging should become a priority." Such a scenario would reduce health costs and save, they estimate, around $7 trillion over the next 50 years.
Seven trillion is a gargantuan figure, even to this spend-happy administration. And, as they show, smart, forward-looking medical science policy is great economic policy. For as tone-deaf as Washington may seem these days, some arguments are too poignant to ignore. And the marriage of economics, science, demography and health may be just what is needed to steer U.S. health care in the right direction. One of the authors and early thinkers on this otherwise science fiction platform of "delaying aging", Dr. Jay Oshansky reminds us the same was thought not too long ago about life after 40.
In the course of this "national project," we would certainly uncover much we hadn't even anticipated. Think of the Space Program, for example. Senator Nelson himself has flown into space, and perhaps it's no coincidence that this visionary risk-taker would be leading the charge.
While Sebelius takes shot after shot, and while Google takes its moon-shot at a paradigm shift to our longevity, perhaps Senator Nelson and Health Affairs got it right: health policy and economic policy are no longer distinct, and investing in disease prevention, treatment and cures is the key to fiscal sustainability in this "old" 21st century.