Is Old all Gold?

As public health practitioners, the health care system of the United States has constantly been under scrutiny in our eyes from the minute we stepped into that classroom. And it is from this that I now believe that it is one of the most complex systems of its kind and it is precisely for this reason why it has become increasingly difficult for it to navigate in the current climate of the United States.

Some of the issues arise with the health care industry being unique in the sense that its consumers, the patients, will interact so frequently with the providers and yet but gain much less in return. The technology is welcomed, but it is expensive to maintain and provide. Furthermore, the support structure is not sufficient to advance the technology; more qualified staffs, more machines, and better therapies are needed. As the health industry becomes more and more revolutionized, there are more major stakeholders in Health Care: the Public--collective and individual interest; Employers--constitute an influential group because they take on much more pro-active roles in determining cost of health care (large coalitions); and providers--professionals themselves; at the core--these are the people have the actual process of outcomes (they want to change it, but they cannot.) All of these facets have not yet addressed one of the most complex areas in health care: the aging population. By 2050, 30% of US population will be over age 65. Americans are living longer but are they living longer healthily?

An aging population results from the decline in fertility and increase in life expectancy. An increase in longevity raises the average age of the population by raising the number of years that each person is old relative to the number of years in which he is young. These two forces have in turn resulted in a large geriatric population. In fact, there are several reasons why health care providers are worried - First, sustaining their age and then prolonging it has become a huge economic strain. Second, although the quantity has increased, the quality of life decreases; more and more elderly are incapacitated or plagued by incurable diseases. Third, more Americans are waiting for a medical catastrophe by extending the natural lives of the elderly.

The economy has become increasingly strained when it comes to providing healthcare, in this case, long-term healthcare, for the elderly. According to the federal Agency for Healthcare Research and Quality, “5% of Americans averaged $11,500/year and accounted for 49 percent of all health care spending in 2002… One in four of these people was between ages 65 and 79 and one in six was 80 or older.” Government organizations like Medicare established payment plans for home health facilities and visiting nurses associations. These systems are still in place, yet they changed this long-term care financing by diverting payments to and from providers. Since then, the financing system has been in turmoil, with federal and state legislative and regulating bodies hunting for solutions to a system that is fundamentally flawed. In focus group studies, elderly adults say that they consider health care an entitlement. Medicare can fund at levels the federal and state governments cannot afford, but the quality of care and quality of life that these programs provide do not suffice for the elderly. The system needs to allow for a shift in resources from the young to the old, yet due to the increase in longevity, this shift has not yet been possible. This redistribution needs to analyze what areas in medicine require the most funds and which can survive with lesser funds. Essentially, it is a stable economy that can insure a more financially stable health care system that caters to the elderly.
The aging population has been fortunate to receive better medical treatment than previous generations. Advancements in technology, medical awareness, and a sense of healthy living have increased the length of their lives. In fact, there are better facilities like rehab, better surgical procedures, and better treatments are adapting to their needs. However, as time goes on, the elderly lose function of basic activities and become frail. Management of their health over time becomes difficult as they endure strokes, diabetes, and multiple chronic illnesses. The system is not set up to treat long-term illnesses for so many people and can work successfully in fewer situations. The system is set up to merely diagnose, treat, and cure and unfortunately, the elderly need more long-term care around the clock.

The US health care system must learn quickly how to adapt itself to the aging population. Geriatric care is not easy, but if more and more elderly are living longer and more and more Americans would rather prolong their lives, it makes it essential that the system know accommodate for them. The US government must pay more attention to this national crisis and lobby for more funding into hospitals, clinics, home health services, nursing homes, rehab centers, and any other geriatric facilities. There need to be more programs put in place to hire CNAs, Physician Assistants, technicians, physical therapists, and nurses in order to support this essential expansion. Geriatric departments across the US must bring in the best doctors and find the best technologies to provide a comfortable setting.

To better adapt to the aging population, the health care industry must continue to provide the traditional excellent care and treatment, and expand it to focus more on the geriatric population. There should be an emphasis on healthy living in the elderly, prevention of disabilities, maintenance of current health state, encouragement to be independent, and above all amelioration of the quality of life. Additionally, I strongly believe that community organizations headed by public health departments should encourage programs that monitor the state of the elderly as well as the young in the community by shifting the focus to preventative medicine. Although it is a difficult task, this transition is one of the most essential phenomena in Medicine and affects all areas of society.