One of the greatest achievements in human history is increasing life expectancy. With every passing day, we gain roughly six hours of life, making time one of the few resources that grow as we spend it. But like everything else in life, longer lives come with a price tag.
Despite scientists’ efforts to boost healthy aging, healthcare costs seem set to rise. “Most of the progress now being made is in reducing death rates, but the prevalence of diseases associated with old age is not going down,” Christopher Murray,
director of the Institute for Health Metrics and Evaluation at the University of Washington, told PROJECT M.
A physician and health economist by training, Murray is uniquely positioned to assess the world’s state of health. He cofounded the
Global Burden of Disease (GBD) approach, an international scientific project which, since 1990, has generated more than 10 billion data points from 188 countries to capture death and disability from more than 300 diseases and injuries. “Mental health, musculoskeletal and neurological disorders account for the lion’s share of disability,” he says.
“Their prevalence is stagnating at best and increasing in some countries. Consequently, the lifetime cost, the total health spending for someone who is insured, will undoubtedly go up.” Where dramatic improvements in global health are occurring, they are primarily due to a decrease in infectious diseases as a cause of death.
GLOBAL BURDEN OF DISEASE METHODOLOGY
The largest and most detailed analysis to quantify levels, patterns and trends in death and ill health around the world between 1990 and today, the Global Burden of Disease (GBD) study quantifies health loss from a vast variety of diseases to inform health policymakers worldwide. The GBD regularly updates estimates for premature death and disability from more than 300 diseases and injuries, in 188 countries, by age and sex and makes it comparable.
FOUR STEPS FORWARD, ONE BACK
Murray sees aging as a blessing with drawbacks. “Aging is great news,” he says, but what concerns him is that there is no indication of compression of morbidity, the idea that sick years could become condensed into a short period at the end of longer lives. “The fact that more people are living into their 80s and 90s, an age where most have five or 10 different health conditions, has significant ramifications for individuals in terms of their quality of life and in terms of healthcare cost,” he concludes.
Take Japan, where life expectancy for men has increased four years since 1990, according to the
GBD study. But only three of them will be spent in good health; one quarter of the time gained is spent in poor health. Healthcare costs for those years spent in poor health arrive on top of the need to increase private retirement savings.
“An additional year in retirement requires approximately 2.5-3.5% additional savings,” says Richard Wolf, an economist with the Allianz International Pensions unit. In other words: a retirement pot of €100,000 needs to be topped up to €103,000 to provide the same income over the extended period of lifetime. Murray’s advice to policymakers is to invest more in prevention, “especially obesity, which has enormous cost repercussions. If policymakers could change obesity trends – which are rising nearly everywhere – they could have a big impact on future costs.”
Governments also have to change their mindset: “Historically, they have been focused on preventing death – rightly so. But to make longer lives more affordable, we have to look more at diseases that largely don’t kill, but cause a tremendous amount of disability and cost.”