SHOULD WE GET OLDER? WHY?

Richard Reeves

The International Herald Tribune is gone after more than 125 years as the American paper in France and then all over the world. Two months ago, it was renamed The International New York Times. That's a bit sad for someone like me who began at the New York Herald Tribune before it folded in 1966. Luckily, I was picked up by The Times, so my loyalties are split.

Then, quelle surprise! The "The Trib" lived one more day last week while I was in Paris. A glossy insert called the International Herald Tribune Magazine miraculously rose from the dead as an insert in the International Times. Maybe it will never be seen again, but the IHT magazine was a fine piece of work, edited by Serge Schmemann, formerly of The Times and the editorial page editor of the IHT.

So there I was reading The Trib one more time, especially a round-table discussion about aging moderated by Schmemann. A few quick facts:

-- "Around 1900, average life expectancy was between 40 and 50 years in the developed countries of that time. Now, life expectancy in developed countries reaches 80 years.

-- "One-third of China's population in 2050 is expected to be 60 or older.

-- "By 2030, 23 percent of the Chilean population will be over 60."

This is the biggest story in the world. What are we going to do with all these old folk? What are they going to do for themselves? In the United States, we built social and medical systems designed for people who died at 65. Now they're healthy and even marrying in their 80s.

After Schmemann opened with this -- "Basically, is living longer a blessing or a cost?" -- panelists had some interesting thoughts, including these:

"In a way, that's good because it means that earlier predictions we used to have of reaching a global population of about 25 billion people have come down to 10 or 11. That's better for the planet. But it also means that fertility is falling so quickly," said Sarah Harper, a British gerontologist.

"The way we should treat older people is to say, 'Get off your butt and learn to swim.' But we just let them get old and treat them like the equivalent of a pet," said Ruby Wax, a writer and mental-health campaigner.

Harper said we'll adapt. "A hundred years ago there were very few women over 45, because most women died in childbirth," she said. "Suddenly women started not dying in childbirth, and so we had to create a society which had adult women who were still active, and that's why we put women into the labor market."

That sort of worked for a long time. But now there are serious questions about whether older people can compete in a fast-changing world, and whether they can survive at all against younger competition in fields like communications.

When I came back to New York, I saw a Times article by Daniel Callahan, co-director of the Yale-Hastings Program in Ethics and Health Policy. He was harsher than the European scholars:

"Even if anti-aging research could give us radically longer lives someday, though, should we even be seeking them? Regardless of what science makes possible, or what individual people want, aging is a public issue with social consequences, and these must be thought through. ...

"I have often been struck, at funerals of the elderly, of the common phrase that while the deceased will be missed, he or she led a 'full life. Adding years to a life doesn't necessarily make it any fuller."

Then Callahan got personal, very personal:

"Modern medicine is very good at keeping elderly people with chronic diseases expensively alive. At 83, I'm a good example. I'm on oxygen at night for emphysema, and three years ago I needed a seven-hour emergency heart operation to save my life. Just 10 percent of the population -- mainly the elderly -- consumes about 80 percent of health care expenditures, primarily on expensive chronic illnesses and end-of-life costs.

"Historically, the longer lives that medical advances have given us have run exactly parallel to the increase in chronic illness and the explosion in costs. Can we possibly afford to live even longer -- much less radically longer?"

So we have a lot to look forward to -- or do we?


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