It's paradoxical that the idea of living a long life appeals to everyone,
but the idea of getting old doesn't appeal to anyone.
– Andy Rooney
In a recent issue of his regular financial newsletter, John Mauldin wrote about the Gray Wave, an insightful essay on the coming retirement crisis. This stimulated my thinking on the subject of human longevity. (1)
Population History & Projections
Global population reached 1 billion around the year 1800; the second billion took only 130 years (1930), the third billion in 30 years (1960), the fourth billion in 15 years (1975), and the fifth billion in only 13 years (1987). During the 20th century alone, the population in the world has grown from 1.65 billion to 6 billion. In 2016 it is about 7.5 billion, and future guesstimates vary. (2)
Late-20th century acceleration in population growth was a result of modern vaccinations and medications. Other future technologies will have similar impacts. Unpredictable future events could have negative effects: wars, famines, epidemics and the like.
The highest population growth rates are in sub-Saharan Africa and parts of the Middle East. The lowest growth rates (even decline) are in Eastern Europe, Russia, China, and Japan. Total growth masks the shrinking population in much of the developed world.
Globally, the combination of falling fertility and longer lifespan means that, in the next few years, the world will have more people over age 65 than it has children under 5. (3) This means that there will be fewer younger people supporting a larger number of older people. Recognizing that children also need care, the real problem will be shortages of young and middle-aged people to support children and the elderly.
For every 100 working age (20-64) people, there will be almost 80 children and retirees who will require support. Most children are going to be in Africa and Asia-Pacific, while most retirees will be in the developed world and China.
China’s one-child policy is creating an upside-down pyramid. Each worker in that generation in China will end up supporting two parents, four grandparents, and probably some of the worker’s own children, too. China does not have a Social Security program or the safety nets that have been created in the developed world.
If predicted fertility trends continue, within decades most of the world will be reproducing at below-replacement rate. Total population will have to peak at some point and then begin to fall.
Medical advancements are adding many years to human lifespan. The rich live longer because new technologies are expensive and won’t be available to everyone. But they will spread fairly quickly. Cures for obesity, heart disease and cancer are all foreseeable within the next 10 years, with more advances over future decades.
The primary construct of most modern cultures is to prolong life. UN estimates that human life expectancy will exceed 100 years over the next century. The cover story of the February 23, 2015 issue of Time Magazine was, "This baby could live to be 142 years old". (4) The question arises: who would want to live that long?
The same question could have been asked in 1880, about living to 75, when life expectancy was only 40. And the same answers would be given: "Is that good?" and "Why would anyone want to live that long?"
Medical care will continue to advance steadily and life-extension technologies will continue to proliferate because it makes economic sense to keep people alive and productive as long as possible.
For most of human history, people worked as long as they were physically able and died soon thereafter. In some parts of the world the period between no longer being able to work and dying was longer for people who had families to care for them. (5)
This began to change in the 19th century when industrialized agriculture started allowing farmers to feed their families and still have food to sell. Then support for older folks was shared between families and governments; programs like Social Security were created that guaranteed some income to the retired. Businesses did the same with pension plans. People who reached retirement age could stop working and depend on a combination of 3 things: (a) their own savings or pensions; (b) government; and (c) family (mainly their children).
While still in relatively good health, many older people do not retire. With life expectancy over 100 years, they continue to work and live comfortably on savings, pensions and Social Security. Older people are enjoying better health in their later years than their parents did. They work longer simply because they can and because they enjoy it and have little else to do. Many who are fortunate enough to own a home can use it as a retirement asset, either by selling and downsizing, or by getting a reverse mortgage.
Retirement problems are not just a US issue. Much of Europe and the developed world will be going through dramatic changes in their entitlement and retirement programs as budgets and debt escalate in the coming years.
Retirement age is rising, but not as much as life expectancy advances. Retirees need more because (6) healthcare costs are high and rising. Low interest rates reduce what retirees can earn from savings, so they must make principal withdrawals.
In the US, the average net worth of somebody between 55 and 64 is $46,000 and many realize that they don’t have enough money to retire at 65. Because they expect to live a lot longer, they typically need more than they can afford. Many are dependent primarily on Social Security and have almost nothing to fall back on. This is quite scary for those who are approaching retirement age and haven’t saved enough.
Financial problems started when interest income became virtually nothing, pensions were reduced or eliminated, savings were lost in stock market declines and expected Social Security increases stopped. Older people started to work again, to boost their income – witness the Wal-Mart greeter.
US Health Care Spending
Consider this: 5% of the US population generates 50% of overall health care spending. 65% of medical expenses are for the elderly. In the US, health care costs today amount to 17.5% of GDP compared to 9% in 1980. Projected increases exceed GDP growth and the total will increase to almost 20% over the next decade. Many think this is collusion between health insurance and pharmaceutical companies.
Complications arise when health problems occur. Some elderly people may have to pay hundreds of thousands of dollars just for medical treatments. At some point they are unable to work and must draw on their assets, or get family support. Without family assistance, many simply decline into poverty, or die.
Some families may feel obliged to take on the costs of medical treatment for uninsured elderly relatives, which could be a considerable amount. This may extends life for only a short time. One couple went deep into debt to save a parent who died soon after. One doctor remarked cynically: The cheapest patient is a dead patient.
Old Age Ailments
After the age of about 60 many diseases and infirmities come into play: Osteoporosis, hypertension, diabetes, arthritis, cardiovascular disease, cancer, Alzheimer's, Parkinson’s – the list goes on. The incidence of all of these diseases increases rapidly with aging.
In his new (2016) book: Old Age: A Beginner’s Guide, (7) Michael Kinsley writes about how he is handling his own early-onset Parkinson’s disease – he was diagnosed at age 42. He writes, “Sometimes, I feel like a scout from my generation, sent out ahead to experience in my fifties what even the healthiest Boomers are going to experience in their sixties, seventies, or eighties.”
End of Life
Aging and death are realities in every life. No insurance policy, gym membership, or super diets can fully protect anyone against a frightening, sad, depressing, or burdensome trajectory in the final days. These issues need to be considered before they eventually demand attention. (8)
Ezekiel J. Emanuel, an oncologist and bioethicist, wrote an article in The Atlantic, October 2014, with the title, Why I hope to die at 75. Says Emanuel, when he reaches 75, he won’t actively end his life, but will stop seeking medical treatments to actively prolong it. The blunt, unsentimental humanity with which he presents his case is admirable. He was 57 when he wrote this; one wonders whether his views will change as he nears 75. (9)
Recognizing the problems of old age and the inevitability of death, an important question remains: When would you prefer to die? (10)
Please answer the following questions for yourself. If you wish, you may share them via the blog. Or, send your responses to me, and I’ll publish on the blog.
- How long do you wish to live? Or more bluntly, when will your life end?
- Would you like to know when (at what age) you will die? Or, would you prefer not to know in advance?
- Here’s an insightful exercise. If you prefer not to answer, why?
- You are informed that you will die within a week – Sunday, at noon. Please respond to the following questions:
a. What will you do immediately? Will you keep it a secret? Why?
b. Will you inform your loved ones? Anyone beyond immediate friends and family?
c. Will you stay at home? Or travel to share the news with other?
d. Do you think you’ll be able to sleep soundly? Why? Why not?
e. Will you try to lead a normal life? Still go to work? Watch TV? Go to the movies?
f. It is Saturday – you know you will die tomorrow. What will you do today?
g. Sunday morning arrives. You know you will die at noon. Will you stay in bed to wait the inevitable? Or, will you go for a walk – on the beach perhaps, or a place you enjoy? Will you go alone? Or, with someone you love? Will you return to bed to spend your last moments? How will you choose to make your exit?
- Did this exercise make you uncomfortable? Why?
- John Mauldin: Welcome to the Pale Gray Dot: http://goo.gl/gBAE2C
- US Census Bureau report, An Aging World 2015: https://goo.gl/1YWNBg
- People 65 and Older Will Outnumber Children Under 5: http://goo.gl/TTXYTN
- TIME: This Baby Could Live To Be 142 Years Old: http://goo.gl/hx4F8l
- Will Baby Boomers Change the Meaning of Retirement? http://goo.gl/MmN0ru
- Retirement Crisis Is Getting Worse for Average Americans: http://goo.gl/RjwPnA
- Old Age: A Beginner's Guide: http://goo.gl/zYdBS4
- JimPinto blog: Death Dynamics: http://goo.gl/Jk4i98
- Ezekiel J. Emanuel - Why I hope to die at 75: http://goo.gl/zWq7Mg
- Death Clock - Calculate when you’ll die: http://goo.gl/vqq7q6