Saturday, March 22, 2008

New research on age expectancy

Found an interesting article in old favorite The New York Times today. Apparently as life expectancies for Americans, generally, are increasing, affluent people are seeing the greatest rise in life expectancy. In turn, this is creating a wider gap in the life expectancy between rich and poor. On the one hand, this is somewhat unsurprising given our lack of universal healthcare and the rising cost of private insurance. But on the other hand, whether or not this is expected, it still seems inherently "wrong." Not only does an underprivileged upbringing restrict access to education and social opportunity, but now even to the opportunity to live a full life. Quite disheartening.


After conducting a running debate with Dave the last few days, I felt it necessary to revisit this subject and clarify a bit. I do not mean to place my focus and emphasis solely on the issue of "equality." Meaning: it is not the notion that there is a gap between rich and poor that offends me. In my heart I'm saddened by a widening rich/poor gap, mostly because I do not believe the factors contributing to that gap are within the realm of control of the people at either end of the spectrum; but from an analytical standpoint I recognize that that is an argument of passion, not of logic, and that there will always be a gap between rich and poor. Any efforts to eliminate that gap pull the masses towards the bottom, rather than lifting those at the bottom toward the top. To go further with this, I also understand and accept the notion that most of the strides made towards access to healthcare at the bottom are the result of actors at the top striving towards new and dynamic approaches to medicine. Again, I accept and recognize that independently funded research by the wealthy leads to discoveries of new technologies and cures that are then put into broader use. 
The study cited specifically notes that while life expectancies for the wealthy are increasing at a more rapid rate, the life expectancy for the impoverished is also increasing. So long as baseline access is increasing in its own right, "equality" should not be the chief concern--so goes the logic.
However, I can only accept this logic if access to baseline healthcare is adequate. I am tempted to use more impassioned language describing healthcare as a fundamental human right and defining adequate as preserving the dignity of human life. But in an effort to avoid an overly passionate, bleeding-heart-liberal rant, I will stick with adequate. Aspects of the cited study clearly reflect that access to baseline healthcare for impoverished people is not adequate--one need look no further than the mention of growing infant mortality rates. Access to prenatal care and education is an area I would define as a "baseline," and if infant mortality rates are on the rise in classes defined by both wealth and race, I would say the baseline is woefully inadequate.
The answer, of course, is not to enforce policy or controls that have the effect of setting an "age-limit" on the rich (though I will admit to chuckling at that response...well played Dave). And the results of the study might not necessarily show a direct link between access for the rich and lack of access to the poor. To me, the value of the study is largely symbolic. What the study indicates is that we're capable of great things in medicine, great advances and startling new technologies. We are not a country incapable of providing for our citizens. Yet in a country where so many have so much, too many have far too little. A country capable of the advances in medical research and technology like ours should not tolerate a rise in the infant mortality rate. We are not simply dealing with a situation where more affluent people are living to 78 and less affluent are living until 72 on average. Had that been the case, I doubt I would have reacted with much vigor to the study. However, in my opinion it is not enough to say our system is "OK" because life expectancies are higher across the board when we live within a system that fails to provide such basic, fundamental medical care that we have seen a rise in infant mortality rates. And when the available data indicates that the "gap" in care and access is divided along lines of race and wealth, I cannot help but see those results and ask: Is this really the best we can do? 
Whether there is a "better" system to be had, I do not know. And the answer may be that there is not. I will not pretend to be situated in a way to rationalize all the socio-economic dominoes of socialized health care, or universal health care, or however one would label it. I will also announce in open space that I am not an advocate for a plan that follows the European system. But I think an inquiry needs to be made. And if my offense to the results of this study is based not on reason or logic but on blind passion and misplaced concern for "equality," then so be it. I will accept that my offense is simply blind passion--sometimes blind passion is necessary to illuminate issues, even if the issues are more complex than the person spewing the blind passion can realize.
And as a final note, I want to say directly to Dave: none of this is meant to "argue" with you exactly, to say I'm right and you're wrong, or to accuse you in any way, shape, or form of "caring" less than I do. I don't mean to say any of that, and I wouldn't do that as I don't believe our debate was based upon what is "right" and "wrong." In fact I have generally found from our conversations that our vision of right and wrong is fairly well aligned. The purpose of this updated post is only to explain my reaction to the study more fully and to not throw up a knee jerk reaction filled with holes. If my argument still misses the mark, so be it...but at least now I feel as if this is much fuller description of why I reacted the way I did to the study.


Dave said...

Yes, that is disheartening. The solution is pretty clear: we need to start putting limits on how long rich people are allowed to live.

BMW said...

A strikingly prudent solution in all respects. I concur.