A prominent retirement investment planning firm cites two lifespan statistics in its advertising campaign that, if true, will stun to death any efforts to rein in the aggregate growth of what we spend as a nation on health care.  “One in three people born today will live to be 100 years old,” says one billboard.  “The first person who will live to be 150 years old is alive today,” says another.  Thought-provoking ads, both, and the health care cost implications of such a trend are breathtaking.

Medicare will cost our nation over $1 trillion dollars in 2020, almost twice what it cost us in 2010, says the non-partisan Congressional Budget Office (CBO).  Curious about how that number was calculated, I dove deeper into the agency’s published reports.  Basically, this near-double increase in spending was calculated using three factors:  the projected increase in the number of Americans reaching age 65, projected utilization, and the projected increase in payment rates over a 10-year period.  I could not find where an increase in the average lifespan beyond 78 years was included in the calculation.  This does not mean that the CBO is wrong.  It simply means that the cost demands on Medicare will explode as we move out a few decades beyond 2020 if the investment company is right and structural changes, like extending the qualifying age of eligibility for the program, are not made.

If aging is a proxy for the onset of chronic disease, and if every one percent increase in the incidence of chronic disease produces a six percent increase in the consumption of medical resources, then today’s Medicare program will not be financially sustainable as the average lifespan of Americans extends.  Reducing utilization as discussed in my last blog won’t do much to stop that crash because this silver tsunami of ever-aging Medicare beneficiaries will overwhelm any benefits derived from current cost containment efforts, and it will drown any tolerance for increasing federal budget outlays.

So what’s the answer to this Sisyphus-like dilemma dogging Medicare?  Nothing as radical as the “Soylent Green” plan, but the rational delivery of end-of-life care must be considered.  For more on this, watch The Cost of Dying: End-of-Life Care, a 15-minute, “60 Minutes” segment on the issue, and write back to me with your thoughts.