If it ain’t one thing, it’s another.
For the last several years, healthcare reformers have been arguing that preventive care can save us big bucks by keeping people healthier and cutting down on doctor visits and hospital stays. And oh yes, we’d live longer too.
And I suppose that’s all true. But no one seems to be talking about the social costs that society will incur if this aspect of healthcare reform works really well and more and more Americans do live healthier and longer lives.
As it is, demographers project that by 2050, 1 in 4 Americans will be 65 or older. Twenty million people will be 85 or older, and
1 million will be over 100. If we get even healthier, those numbers are certain to grow, and we’d see what some wags call the Floridization of America.
You hear critics grousing all the time about the social consequences of having large cohorts of restless young people -- particularly men -- around. They are generally blamed for rises in crime and even social and political unrest in places like the Middle East. But what kind of social consequences can we expect from large cohorts of the elderly, retired and healthy Floridizing all 50 states?
I’m not just talking about the burden of bloated pensions or paying for Medicare, though these are real problems. I’m thinking about the cultural shifts an aging society is likely to endure. Off the top of my head, I’d say a senior-heavy population pyramid might see more cranky “tea partyers” and a less optimistic and forward-thinking culture. If the baby boomers live longer, we’re bracing for a couple more decades of those nostalgic television shows that tell us how great the 1960s were.
If that isn’t scary enough, take a look at Japan, which has the world’s fastest-aging population. Its experience points to much more profound consequences: If too many of us live too long, however physically healthy we may be, it could lead to an epidemic of loneliness and ennui.
The Japanese, with their healthy diet, good healthcare and advanced medicine, have the highest life expectancy in the world. In 2008, nearly a quarter of the population, or 28.2 million people, was over 65. By 2030, 1 in 3 Japanese will be senior citizens. If civilization is the struggle against death, then surely Japan’s high life expectancy is a triumph of human culture.
But according to Florian Coulmas of the German Institute for Japanese Studies in Tokyo, the Japanese are “exhausted” and the mood in the country is “depressed.” They are burdened by the lengths of their lives.
And in fact, Japan, a place where suicide isn’t utterly taboo, has seen a dramatic rise in senior citizens taking their own lives.
Coulmas points to a much less extreme sign of the problem: sales of self-help books with advice to give meaning to the lives of the elderly. Titles such as “Courage
to Live,” “91: Happy and No Regrets” and “Conversations About Happy Old Age” are on bestseller lists.
Others are targeting the emotional needs of the elderly. Government and industry have teamed to develop a new generation of robots designed to serve the incapacitated or simply to amuse a lonely senior. Honda has a prototype that can dance and serve tea, while Toyota has showcased one that plays “Pomp and Circumstance” on the violin. Not to be outdone, two weeks ago researchers at Fujitsu announced a cuddly teddy bear robot designed to comfort the elderly by reading and responding to facial expressions.
But coping with loneliness isn’t the only senior problem. Between 1998 and 2008, the number of people 65 or older convicted of crimes in Japan tripled. The government is spending tens of millions of dollars building special prison wards for the elderly.
Is Japan a bellwether? Is it possible that we can be too healthy and live too long? Are we calibrating our social programs just to find out we’ll outlive not just usefulness but any sort of happiness?
No one wants to die young. No one wants to face the last years of life infirm and fragile. But if Japan, where ancestors are revered, is plagued with unhappy seniors, what does it bode for us?
“Live strong,” sure, but also remember to be careful what you wish for. You could make it to 100, with consequences as onerous as the ones you ate right and exercised to avoid.