As recently noted “Republicans and Democrats are noisily blaming each other for the problems of the popular programs, which provide benefits to more than 55 million people. [1
]” Yet, the health care crisis is not the fault of either Republicans or Democrats. The crisis is a “side-effect” of the ever-increasing effectiveness of medicine. That is, the crisis is indirectly due to the marvelous achievements of the modern medicine such as organ transplantation, coronary stents, intensive and emergency care, antibiotics against resistant bacteria, MRI and sophisticated tests, all of which decrease human suffering and allow patients with deadly conditions to live for many years. But this life-saving medicine is also responsible, in part, for increasing health care costs.
First, obviously but not most importantly, these medical options are expensive. For example, organ transplantation may cost hundreds of thousands of dollars. The development of a new antibiotic against drug resistant bacteria requires substantial spending for research. Second, and most importantly, precisely because medicine is becoming so effective in saving lives, this increases a number of elderly patients with chronic and multiple diseases (Figure ), which necessitates multiple treatments all of which cost money. No one dies from aging itself, all humans die from age-related diseases such as cancer, atherosclerosis, hypertension, diabetes, osteoporosis or actually from their complications. So every old person becomes a patient at some point. Medical interventions delay death from age-related diseases, often without curing them. For example, saved by defibrillation from sudden death due to coronary atherosclerosis, a patient can live for many decades (with treatment) and may even die from another age-related disease. With treatment and nursing, patients with macular degeneration, Alzheimer and Parkinson diseases, type II diabetes, hypertension, coronary atherosclerosis, sarcopenia and osteoporosis can live for decades. Cancer is also becoming a chronic disease. Of course this is a great medical and social success. As “a side effect,” however, this increases a number of elderly people with chronic age-related diseases in constant need of health care (who would otherwise have died). Since diseases of aging tend to gradually develop with age, such a patient suffers from several and sometimes many diseases. A combination of obesity, diabetes, atherosclerosis, hypertension, retinopathy, osteoporosis is very common. So there is simultaneously an increase of the number of diseases afflicting each elderly person and an increase in the number of such patients.
From longer life span to longer health span (and life span)
In summary, current medicine is effective in preventingdeath from age-related diseases without delaying their onset, thus increasing the number of people with age-related diseases and the number of diseases afflicting each elderly person. In addition, each disease of aging is now treated separately, which is costly and can lead to unavaoidable adverse effects. For example, chemotherapy, used for cancer treatment, has a negative impact on normal tissues and organs. And vice versa, insulin, which is used for treatment of diabetes, is a pro-aging factor [2
] and may accelerate some pathologies such as cancer [3
]. (Note: In contrast, due to some anti-aging activities, the anti-diabetic drug metformin prevents cancer [5
]). One solution is to delay age-related diseases, thus extending healthy life span. But is it possible?