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What to do with/for/about the elderly

What I write here I could just as well post as a comment to this entry:

http://ozarque.livejournal.com/200315.html

But I come back to this topic again and again, so I'd rather record my thougts on the matter here where I can find them more easily.

I work with the elderly every day. I don't bathe them or feed them or change their diapers. All I do is talk to them (and/or to their children) and advise them on how best to offload the financial cost of their prescription medicines onto the taxpayers.

I talk to people every day who remain alive only so long as they can take $500-$1,000 "worth" of prescription medication per month. I put "worth" in quotes because the cost of the drugs does not correspond to the value of the drugs. I equate "worth" more closely with "value" than with "cost" or "price."

Suppose someone requires a particular medicine to continue living and that medicine costs $120 a month. Then the patent on the drug expires and suddenly a generic equivalent becomes available. One month the person requires $120 "worth" of medicine and the next month they require $30 "worth" of medicine to stay alive. The chemical construction of the medicine hasn't changed, and I would judge it absurd to say that they very same medicine "is worth less" to the patient at $30 dollars than at $120.

That last paragraph looks like it could serve as the beginning of an "evil pharmacuetical industry" rant, but I don't plan to go there.

My concern centers more on what we as a society (or as individuals) can do about the fact that the Baby Boomers have just started to turn 60. We've got twenty years in which to figure something out, because I see no way in which we can tax the young to support the Baby Boomers in the same (admittadly pathetic) manner in which we currently support the so-called Greatest Generation.

Ideally, I'd like to see bio-tech advance to the point where advanced age does not correspond to decreased independence and capability. Still, that could happen in a way that proves financially ruinous for the majority of people. I certainly don't want to see 90 year-olds living as wage-slaves, sinking ever deeper into debt, working obscene hours at unrewarding tasks in order to afford the biotechnology that keeps them mobile and lucid.

The free-marketeer might answer, "Those who can afford the life-saving/extending/enhancing products and services will purchase them and continue to contribute to society, and those who can't afford them will die and spare everyone else the guilt and expense of maintaining them." One might object to this strategy on moral/philosophical grounds, but I object on practical grounds. We, as a society, do not presently tolerate a free-market approach to much of anything, and I see us continuing to move away from free-market principles. The strategy proposed by hypothetical free-marketeer would not fly today. Imagine a politician of either faction standing in front of a tv camera and saying, "Yes, drug companies give me and my kind millions in campain contributions every year, and yes, they charge $100 for something that costs them pennies to manufacture. People who have exercised fiscal responsibility over the course of their working lives can, barring unfortunate random events, afford to pay. Those who failed to plan for a future nobody predicted 50 years ago will get what they deserve."

Run that up the flag pole and see who salutes.

Techno-utopians will spin fantasy scenarios of nanotechnology making all material goods easily affordable to even the poorest seniors. Nonsense. The process by which nanotech will turn mundane matter into the stuff of life will constitute someone's intellectual property, just as the recipe to Plavix constitutes somebody's intellectual property today. Plavix costs pennies to manufacture, yet taxpayers will shell out (using conservative estimates) $400,000,000,000 over the next 8 years to provide seniors with discounted medications. How much will Generations X & Y have to pay to provide Baby Boomers with the whiz bang technologies that will allow them to retire at 65 and live another 100 years?

Obviously, some scenario will come to pass that will allow us to "manage." But will "managing" mean?

I'm going to leave off here for now. Normally, I would post something this rough as "friends only," but I will make this a public entry. Please post something to break my state. Show me the box opening.

Comments

( 6 comments — Leave a comment )
uminthecoil
Jan. 23rd, 2006 02:39 am (UTC)
wow...you know, i'm sorry to say that i've really not given this very idea any real thought before now, but you bring up some compelling and sobering facts with this post...sorry that i have nothing to 'break your state'...still, i'm sure i'll be pondering on it for a while to come.
mungojelly
Jan. 23rd, 2006 04:41 am (UTC)
I believe that intellectual property is going to lose. I believe that things will be truly free during the nanotech era. I don't know how many problems that will solve in the short term.

Another factor to consider: The development of new drugs is aided by computer automation, so it is plummeting in price. Within a decade or two the average cost to develop a drug will surely fall to less than a hundred million dollars, perhaps much less. This trend is already resulting in a mountain of new chemicals, many of which have not yet been fully integrated with society-- we're still grappling with Prozac and Viagra, for instance. The next generation, already in the pipeline, is going to be even more intense. They've developed a true aphrodisiac!! They'll probably have some successful weight control drugs soon too (they've been obsessed with that). It's going to get crazy.

<3
kmo
Jan. 23rd, 2006 05:53 am (UTC)
intellectual property rights
The development of new drugs is aided by computer automation, so it is plummeting in price. Within a decade or two the average cost to develop a drug will surely fall to less than a hundred million dollars, perhaps much less.

So long as intellectual property rights remain enforced/enforcable, it won't matter how cheap the development costs get. Pharamcuetical companies base drug prices on what they can get for the drugs, not on the amount spent on development. So long as the biggest spender gets elected to office and as long as the pharmacuetical industry remains the biggest source of lobbying dollars in DC, the federal government will continue to convert tax dollars into drug company profits and sheild drug prices from market forces which might drive prices down.

They'll probably have some successful weight control drugs soon too (they've been obsessed with that). It's going to get crazy.

I agree that things will get crazy.

A while back Lara and I were watching tv, and an ad came on for a diet product that promised that you could take it and loose weight without changing your diet or taking up physical exercise. I said to Lara something to the effect of, "Someday they'll make that exact claim about a product and it will be true. I wonder how we'll know when to believe it?"
mungojelly
Jan. 23rd, 2006 07:00 am (UTC)
Re: intellectual property rights
So long as intellectual property rights remain enforced/enforcable, it won't matter how cheap the development costs get. Pharamcuetical companies base drug prices on what they can get for the drugs, not on the amount spent on development.

Of course, one aspect of this is that drug patents do still expire. According to some random intarweb page, they have 20 years from the date of filing. So at most that can slow things by twenty years, unless their lobbying somehow becomes as obscenely successful as the copyright industry. A tragic and greedy delay, but not a showstopper.

Perhaps things will change as more drugs enter the picture. So far drugs have been bright lights in an empty room, picking off this disease here, that symptom there. Maybe there will start to be so many drugs that there will actually be competition between drugs. Mostly the human body is complicated enough that there's more than one pathway to solving any given problem.

A while back Lara and I were watching tv, and an ad came on for a diet product that promised that you could take it and loose weight without changing your diet or taking up physical exercise. I said to Lara something to the effect of, "Someday they'll make that exact claim about a product and it will be true. I wonder how we'll know when to believe it?"

You'll know to believe it because the culture will roar, & because the world will be overthrown. Those moments used to be rare. Soon they'll be daily. It's hard to see how we won't crumble.

On the other side of that, I think that our bodies become programmable. With nanotechnology, we start to stare into ourselves from the other side. One world becomes another. It really seems like we're ascending.

<3
mamalara
Jan. 23rd, 2006 03:12 pm (UTC)
Love will save us all?
Don't we all have parents, and don't most of us love them? Those of us who have children seem to love them quite a lot. What about our siblings? Best friends? Isn't (nearly) everyone connected, in some way, to a network of real, live human love?

Forgive me for being simplistic, but the old people are our parents and grandparents, and I'd like to think that none of us consciously wants to live at the expense of others, but rather in a viable community where love creates a positive feedback loop with tangible rewards.

At some point, I hope/think that enough people will get pissed off about the establishment ripping off their struggling grandparents (and even more, themselves), and their friends' grandparents, and the scales will tip from a culture that prizes independence to one that prizes cooperation. Our last two elections have demonstrated that the split factions of the populace are neck and neck in terms of membership numbers.

It strikes me time and time again that much of the us v. them mentality that spawns so much warfare and corporate crime culture is, at its base, utterly bogus. It is a false dilemma; we live in false dichotomy.

I think that our generation and the kids coming up behind us---media-savvy, born skeptics---will see this with clarity and simplicity, and as they are already so used to doing, will find a way to subvert and ultimately improve our cultural obsession with imbalance. After all, this crappy corporate/government shit IS a real drag.

Kids these days grow up watching The Daily Show, and seeing the administration unmasked---easily and handily---as an inept and frightfully destructive puppet show.

They grow up with the internet, which is a real and vibrant manifestation of many differing ideas and factions inhabiting the same space to the benefit at all, at the expense of none.

I mean, can't we all just get along? It seems we can in cyperspace. As the lines between reality and virtual reality blur, perhaps we will begin to model the real on the virtual instead of vice versa.
mamalara
Jan. 23rd, 2006 08:56 pm (UTC)
To wit (when lacking)
I failed to make the obvious point about open-source software code, like our own LJ, as a communally beneficial alternative to the intellectual property system of hierarchy. When everybody benefits, everybody benefits.

In my defense, there were two boys creating enormous diversion at great volume, which almost ended our fish's life.

Sigh. A helmet, earplugs, and a nanny would be nice sometimes.

And a gin and tonic.
( 6 comments — Leave a comment )

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