Sunday, July 20, 2008

Baby Boomers and Health Care Reform

I read always interesting Nicholas Kristof's New York Times op-ed on "Geezers Doing Good" over coffee this morning. The sentence "If we boomers decide to use our retirement to change the world, rather than our golf game, our dodderdom will have consequences for society every bit as profound as our youth did" caught my eye.

I've thought a lot about how we in the U.S. can shift our dominant values about health care from the current high technology/costs-be-damned/me-me-me configuration to a more communitarian perspective that thinks of individual and population health in a more holistic way.

After telling the story of Rob Mather, a British management consultant who now devotes himself to eradicating malaria, Kristof concludes:
If more people take on encore careers like that, the boomers who arrived on the scene by igniting a sexual revolution could leave by staging a give-back revolution. Boomers just may be remembered more for what they did in their 60s than for what they did in the Sixties.
In my clinical practice I've been struck by how often my older patients think about the implications of health care costs and utilization patterns for others. Sometimes they're thinking about their children - "I want to be able to help them, so I don't want to spend all my money, and theirs, on every little thing for me." Sometimes they're thinking about future generations - "I don't want us to keep piling up more debt for our grandchildren, and not investing in their education and a healthy environment."

The common wisdom is that boomers are infinitely selfish, and will demand ever more use of costly technologies - paid for by others - to make them more beautiful and athletic. But Kristof's column suggests an alternative vision. At least some may use their experience, brainpower, and leadership abilities to bring more sanity into our public discourse abou health and health care.

That's an idea to work on. Eradicating malaria is an ennobling goal. So is helping the U.S. steer itself away from the ultimately health-stifling way of governing health care that we are mired in today.