MATURE MARKET HEADLINES POSTED 05/01/98
Medicare's Future Busted By Boomers
"By any economic or political measure, Medicare as we know it is unsustainable", says the New England Journal of Medicine (April 30, 1998: "Medicare Policy for Future Generations"). No, this isn't another rhetorical scare. There's no subjective, "Chicken Little" behind this projection. The numbers tell the story.
Medicare is projected to be a $1.1 trillion drain on the U.S. Treasury over the next decade even though the number of beneficiaries is growing at a modest rate of 300,000 persons per year. Thirteen years from now the number of Americans who are 65 or older will increase by 1,600,000 a year and will continue to grow at that rate for the next 20 years.
At the current rate of growth in Medicare costs and the current rate of decline in the ratio of workers to retirees, the 1995 Report of the Bipartisan Commission on Entitlement Reform estimates that the payroll tax will have to quadruple over the next 25 years to fund the existing Medicare program. The combination of escalating health costs per retiree and the pending retirement of the baby-boom generation makes the preservation of Medicare benefits problematic at best and impossible under current policy.
The basic problem is that Medicare, like Social Security, relies on the concept of a "trust fund" strategy. The trust fund concept simply means that future generations rely on the previous generation's financial contributions. The problem with that concept is that the payments made by the current generation of workers are going to pay for benefits paid to current retirees.
There is no real investment for the future, which is the foundation of the trust fund concept. There are fewer and fewer workers paying for more and more retirees. The major problem is the baby boom generation. Currently, the working boomers represent an asset on the trust fund ledger because they contribute to the system. However, when the boomer generation retires, they will represent a huge liability on the trust fund ledger as they begin to draw down their retirement benefits.
So where do we go from here? Making Medicare sustainable over the long term requires two policy changes, says the New England Journal of Medicine (NEJM). First, we must stop the explosion of per capita costs by giving beneficiaries a choice among competing health care delivery systems. Emerging price competition in the private market for health care has helped push the growth of medical insurance costs below the growth of the Consumer Price Index.
On the other hand, lack of price competition has proven to be disastrous, as evidenced in the case of Maryland's experiment with centralized price controls (see AgeVenture article below: "Govt Medical Reform Prescription for Failure"). Second, we must move from a transfer-payment system of financing Medicare to an investment-based system, in which people build up assets during their working years to fund their medical costs in retirement.
Although restructuring Medicare will cost money in the short term, it will save more money in the long run and avert a Medicare catastrophe. A delay in taking action will guarantee a wholesale loss of retirement health care. The good news is that with decisive action now, the cost of preserving retirement health benefits can be contained and benefits can be guaranteed permanently. This long term strategy now being proposed for Medicare is already paralleled in the health care system.
Historically, the focus of American health care has been crisis management. Today, the trend is toward preventive medicine or wellness, a strategy resulting in a healthier population. Such a policy is a bit more expensive in the short term, but it's also a cost-effective policy because it will pay big dividends in the long term.
Let's hope the Congress and the White House can get beyond today's short-sighted, crisis management approach to Medicare in favor of a long term solution that embodies the two-fold strategy outlined by the NEJM.
See AgeVenture archives for related article:
Social Security Takes Stock of Wall Street
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Cigar Trend Has Oral Health Pros Fuming
There I was, driving down the highway on my way to the office when something caught my eye, a huge billboard with a picture of a young woman smoking a cigar. Hey, I'm all for gender equity. But you have to admit, the sight of a lady puffing on a stogie is ... well ... not a frequent occurrence. Anyway, this rather compelling image caused me to reflect on just how popular cigars have become among today's boomer generation.
Sure, cigar commercials have been around for a long time. It's been decades since the first cigar-maker suggested that women light-up. Maybe you remember that old TV commercial ... "Should a gentlemen offer a Tipperillo (a small cigar) to a lady?" Well, nothing much happened between women and cigars. Not, until very recently. Any how, somewhere between twenty years ago and today, cigars have caught on with boomers. And because there are so many boomers, whatever they do catches on "big time". So America is right in the middle of a cigar smoking boom, despite the fact that cigars smell bad, cause bad breath, and stain teeth and dental restorations.
Americans consumed 4.4 billion cigars in 1996, according to the Cigar Association of America. Since 1993, the number of Americans who smoke cigars has risen to 10 million. Magazines dedicated to cigar smoking and "cigar bars" have sprung up all over the country, while advertising for cigars is increasing at a phenomenal rate. Vending humidors will soon appear in golf shops, bowling alleys, restaurants, and country clubs.
The largest manufacturer and marketer of cigars in the United States, Consolidated Cigar Corporation, posted a net income for the first nine months of 1997 that is 85 percent higher than what it was for the same period just one year before. Many cigar smokers mistakenly assume they are not at risk for diseases caused by cigarette smoking because they don't inhale or only smoke occasionally. Even though cigars do not carry a health warning like cigarettes, cigars do carry health risks. That's why all the Baby Boomers who are lighting-up cigars need to know the following facts.
- Cancers of the mouth, larynx, and esophagus are more common among cigar smokers than among non-smokers.
- Cigar constituents enter the bloodstream directly through the mucosal lining of the mouth, so you don't need to inhale to be at risk.
- Cigar ingredients can include as many as 23 poisons and 43 carcinogens.
- Regular cigars can generate 7 times as much tar, 11 times as much carbon monoxide, and 4 times as much nicotine as a cigarette.
- Abrasive particles in the cigar's outer wrapping can erode teeth.
- Cigar smoke promotes periodontal disease.
As a result of these cigar statistics, the National Oral Health Information Clearinghouse (NOHIC) is urging health professionals to help their patients understand the risks of smoking cigars. The American Dental Association launched its own anti-cigar campaign in April of 1997.
That effort didn't slow down the cigar trend. That's why NOHIC, a service of the National Institute of Dental Research at the National Institutes of Health, is attacking the problem from a different angle, symbolism. NOHIC is working to combat the glamour associated with cigars that lures many young people to take up this dangerous habit. NOHIC invites visitors to its website at:
www.aerie.com/nohicweb/ so they can learn more about the dangers of this new trend.
AgeVenture News Service, www.demko.com
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Strengthening Doctor-Patient Relationships
While conducting a survey on the doctor-patient relationship for the newly founded Pfizer Medical Humanities Initiative (PMHI), researchers uncovered surprising information. Contrary to recent reports, patients were much more satisfied with their doctors than doctors expected.
Seniors (median age of 63 years) were the most satisfied age segment of the population. 87% of patients reported being satisfied with physician communication, accessibility, and follow-up office visits. In addition, despite the mobile nature of our society and dramatic changes in the health care system, 90% of seniors report having a regular doctor.
Overall, more than 95 percent of both patients and physicians report that they want a mutual partnership rather than the traditional, "authoritative" physician. Seniors, however, are more likely to view doctors as authority figures. Here's a brief summary of how patients and doctors propose to strengthen the doctor-patient partnership.
- Both groups agreed that doctors need to have the ability
to diagnose disease quickly and accurately, and
to demonstrate compassion for the patient's needs.
- Both groups agreed that patients need to
be open, honest, and thorough in their disclosures to physicians,
take a proactive role in their health care, and
always keep track of names of medications currently taken.
The survey findings, generated by Yankelovich Partners Inc, will be used by PMHI in a variety of ways in order to strengthen the doctor-patient relationship. The first step in this process is a series of "Patient-Physician Relationship Town Meetings", beginning April 30, 1998. The two-hour meetings will be hosted by Pfizer's PMHI Director, Dr. Mike Magee, M.D. The discussion and recommendations from these town meetings will be video-taped and disseminated for educational purposes. That effort is supplemented by a new website,
www.positiveprofiles.com that allows aspiring medical students to explore profiles of doctors who are exemplars in their dealings with patients.
This website also provides information about applying to medical schools and includes links to all 143 American medical schools. The entire effort (research, town meetings, educational materials, and website) is intended to improve the quality of healthcare by improving the quality of the doctor-patient relationship.
See AgeVenture archives for related articles:
Embarrassment Is Major Medical Problem
Demographics Demonstrate Doctor Debacle
AgeVenture News Service, www.demko.com
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Game Helps Boomers Re-spark Romance
Contrary to popular myth, romance does not end at age 50. In fact, for many couples, 50 represents a turning point toward a more relaxed and fulfilling lifestyle. The pressures of raising the children are gone, and professional careers are usually on track. But at least one burning question faces them. How do you keep the relationship exciting, fulfilling and interesting?
That's exactly the question that Barbara and Michael Jonas asked before they created "An Enchanting Evening", a romantic game they used to re-spark their love-life. The collection of romantic entertainments energize any relationship and provide a way for couples to stay close, have fun and keep the enchantment alive. The game is accompanied by their "Book of Love, Laughter & Romance" which is full of romantic ideas suggested by thousands of couples who shared their romantic secrets with Barbara and Michael.
The Game begins with each player writing down a "secret wish" that can be granted that evening. Players then move around the game board by rolling a die and drawing a card that matches the spaces on which they land. The subtle game cards, which offer light and playful suggestions, elicit compliments from each partner in the relationship.
The Game has become so popular that hotels and resorts use it to offer "Romantic Getaway Weekends". Participating hotels include the Abbey Resort in Lake Geneva, the Renaissance hotels in Atlanta and Nashville, and the Pacific Terrace Inn in San Diego. The romantic weekends often include a champagne dinner for two, a bouquet of flowers, strolling violinists, and breakfast in bed. Although the packages differ at each hotel, all use the Game as the centerpiece of the weekend. The Game, "An Enchanting Evening", is manufactured by Games Partnership, Ltd Inc of San Francisco, California. Gift shops, lingerie stores, and major department stores sell the game for $25. Specific store locations may be obtained by calling: 1-800-776-7662.
See AgeVenture archives for related articles:
Mature Couples Find Spouses Demanding
Husband Says Home Chores Lead to Sex
AgeVenture News Service, www.demko.com
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Fewer Heart Surgery Risks for Elderly
These days, when it comes to heart surgery, the times they are a'chang'in. The average age of patients who seek, survive and live healthy, productive lives after elective heart surgery has shifted dramatically upward in the past two decades due to sophisticated medical technology and new miracle drugs. In the 1970's, most patients who required coronary artery surgery were in their mid-fifties.
Today, the average age for heart patients is 67; and, it is not uncommon for coronary artery patients to be in their eighties or for valvular heart patients to be in their nineties. Researchers have found that elders, age 75-plus, experience little increased risk associated with elective heart surgery, and that they derive the same benefits in "quality of life" as their younger counterparts after these cardiac procedures. "...the elderly heart patient has a very full recovery, and gets more out of life after surgery," says Jeffrey Gold, M.D., chairman of Montefiore Medical Center's Cardiothoracic Surgery Department.
Dr. Gold has found that the risk of complications from heart surgery is 3.3 percent for those over age 75 versus 2.1 percent for those under 75 years of age. "These minimal differences in surgical risk apply only to elective surgery, not to emergent or urgent heart surgery, for which there is a far greater risk among older patients. This underscores the need for older patients to seek medical and surgical care before their condition becomes an emergency."
AgeVenture News Service, www.demko.com
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Govt Medical Reform Prescription for Failure
The state of Maryland has created a socialized medical system that some medical experts are calling a disaster. No other state imposes more mandates on the health insurance market. Maryland's General Assembly has already introduced 85 new healthcare and companion bills and 18 mental-health bills.
The result? Healthcare in Maryland is a $15 billion industry in which doctors and patients are losing control and the number of uninsured persons is rising. "The cost of a hospital stay increased almost twice as fast as the national average, and the number of uninsured has climbed from approximately 570,000 in 1992 to more than 700,000 today," says Dale Snyder, a Maryland healthcare consultant.
The Maryland system now features five regulatory bureaucracies costing $30 million annually, a government-run health care database that violates a patient's right to privacy, and a central agency that sets all rates hospitals may charge for medical services. During the second half of last year, under the state's complicated price-fixing system, Maryland's hospitals saw their profits cut in half; 15 of the state's 52 hospitals lost money.
One free-enterprise remedy that has been proposed to counter the state's socialized medicine calls for the promotion of personal ownership and portability of health insurance by giving tax credits to middle-income workers and vouchers to low-income workers. Details of this and other measures appear in "Building Bureaucracy and Invading Patient Privacy: Maryland's Health Care Regulations", report #1168, prepared by the Heritage Foundation, Washington, D.C. Sources: Dale Snyder, medical consultant, and Robert E. Moffit, Director of the Domestic Policy Studies at the Heritage Foundation.
See AgeVenture archives for related articles:
Fascist Healthcare in the West
We Don't Want This Healthcare .... Bill
AgeVenture News Service, www.demko.com
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