Substantial health and economic returns from delayed aging may warrant a new focus for medical research

Abstract

Recent scientific advances suggest that slowing the aging process (senescence) is now a realistic goal. Yet most medical research remains focused on combating individual diseases. Using the Future Elderly Model--a microsimulation of the future health and spending of older Americans--we compared optimistic "disease specific" scenarios with a hypothetical "delayed aging" scenario in terms of the scenarios' impact on longevity, disability, and major entitlement program costs. Delayed aging could increase life expectancy by an additional 2.2 years, most of which would be spent in good health. The economic value of delayed aging is estimated to be $7.1 trillion over fifty years. In contrast, addressing heart disease and cancer separately would yield diminishing improvements in health and longevity by 2060--mainly due to competing risks. Delayed aging would greatly increase entitlement outlays, especially for Social Security. However, these changes could be offset by increasing the Medicare eligibility age and the normal retirement age for Social Security. Overall, greater investment in research to delay aging appears to be a highly efficient way to forestall disease, extend healthy life, and improve public health.

Keywords: Financing Health Care; Health Spending; Medical Technology.

EXHIBIT 1. Millions Of Nondisabled And Disabled Elderly Americans In Various Scenarios, 2010–60

SOURCE Authors’ calculations using the Future Elderly Model. NOTES The exhibit shows the number of elderly Americans (age sixty-five or older) projected to be either nondisabled or disabled according to the various medical progress scenarios. Disabled is as having one or more limitations in instrumental activities of daily living, having one or more limitations in activities of daily living, living in a nursing home, or a combination of the three. The delayed aging scenario resulted in a substantially higher percentage and number of nondisabled people than the delayed heart disease or delayed cancer scenario.

EXHIBIT 2. Change In Medicare and Medicaid Spending On Health Care In Various Scenarios Compared To Status Quo, Billions Of Dollars, 2010–60

SOURCE Authors’ calculations using the Future Elderly Model. NOTES All spending is in 2010 dollars. The exhibit shows per period (nondiscounted) projected spending on Medicare and Medicaid under various medical progress scenarios, relative to the status quo scenario for Americans aged fifty-one or older. Spending is much higher in the delayed aging scenario because of the larger increase in the total population, even though per period costs for Medicare are lower.

EXHIBIT 3. Change In Income Support Spending In Various Scenarios Compared To Status Quo, Billions Of Dollars, 2010–60

SOURCE Authors’ calculations using the Future Elderly Model. NOTES All spending is in 2010 dollars. The exhibit shows per period (nondiscounted) projected spending on income support under various medical progress scenarios, relative to the status quo scenario. Income support includes all Old-Age and Survivors Insurance, Social Security Disability Insurance (OASDI) and Supplemental Security Income (SSI) spending on Americans age fifty-one or older. Spending is much higher under the delayed aging scenario because of the larger increase in the total population (Exhibit 1).

EXHIBIT 4. Change In Major Entitlement Spending In Various Scenarios Compared To Status Quo, Billions Of Dollars, 2010–60

SOURCE Authors’ calculations using the Future Elderly Model. NOTES All spending is in 2010 dollars. The exhibit shows the cumulative fiscal impact of spending on Medicare, Medicaid, OASDI, and SSI (discounted at 3 percent) of various medical progress scenarios relative to the status quo scenario. The fix is a gradual increase in the eligibility ages for Medicare and Social Security. The inclusion of the eligibility fix would result in no additional entitlement spending relative to that in the status quo scenario, despite much larger increases in the older population (see Appendix Exhibit S4; Note 24 in text).