Healthcare and the Elderly
Over the years, there have been controversies about the issue of whether to ration healthcare for the elderly. These controversies have been based on assessments done towards the likely effect on elderly health care costs evolving and increased costly medical expertise. As studies have indicated, these impacts would bring about serious problems for the future Medicare. Similarly, due to the limited supplies of organs, kidney transplantation has always brought about the requirements of rationing and the unconcealed discussion of the ethics that guide it. This has seen new reforms from the field of transplantation with compliance to the internal calls to formulate latest rationing arrangements. This is accompanied by the fact that in the recent few years, approximately 12% of the population ranges between 65 years and above. With these current trends, it is estimated that by the year 2030, the population of the aged would rise to about 21%. This is characterized by large set of age within the population aged between 80 years and above. This is the age where most of the people call for costly and severe medical attention.
With these issues in mind and the estimated demands for the growth in numbers of aged people on a medical facility which has undergone taxation to the very last point, have contributed to the questioning of the ability within the society to meet and sustain health care demands that occur in future. This is also accompanied by the consideration of the increase in forbearance of proposals for rationing. Additionally, according to studies conducted, there have been indicators that hospitals have limited the supply of medication and supplies of intensive care unit facilities. This has occurred due to the fact that in the face of organizational limits, medical practitioners withhold medication, tests or even services from a patient who might receive limited benefits from it in order to give it to a patient who would receive more benefits.
This paper will focus on arguing the fact whether healthcare should be rationed for the elderly. It will focus on the challenges that affect the aging in the community with more emphasis on the aspects that contribute to whether healthcare should be limited. Additionally, part of the paper will focus on bringing out the different perspectives that have been debated upon regarding this issue. This will be followed closely by the problems that have affected the elderly with various recommendations on how these problems may be rectified. This will be accompanied by ideologies from different sources in order to capture the right justifications and actions against age based rationing. It will focus on laying out the need for rationing based on projections of Medicare expenditure in the near future. The decision of policy makers based on the technological breakthrough will be analyzed to bring out the various forms of rationing possibilities.
To start with, we shall concentrate of the fact of why rationing healthcare to the elderly would be essential. This will occur through the support of initiatives that aim at rationing life and the extension of health facilities through grounds of age. There are those who have indicated their support for this rationing with claims that it would benefit more people. They have continued to support this idea with the belief that it would ensure increased health among the young people with relatively cheap preventive measures that range from exercise programs to education based on health. Similarly, they claim that using technological procedures that were deemed costly were to some extent ineffective in the provision of tangible benefits for either the society or even the patients. What this means is that the costs incurred in order to ensure a prolonged life for the elderly people may to some extent be intended for the treatment of a vast number of young people with medical services that can be achieved at less costly measures (Callahan, 14).
This is accompanied with the belief that there will be more benefits in the society due to increased economic productivity that may occur through abstraction of healthcare services from the elderly people as well as the retired population to the younger members of the society. Additionally, it is estimated that the governmental expenditure on this issue is more than $ 9000 on a daily basis per every elderly person. This amount is relatively higher than the amount used per every child every year as the government estimates it to be less than $ 900(Callahan, 14). This brings about a distorted allocation of the resources used in the provision of health care services. Advocates for the rationing of healthcare to elderly people claim that it is unjustified due to the fact that the elderly members of the society receive a higher rate of medical services as compared to the younger people. The young people are denied equality in the resources shared within the nation (Callahan, 14).
These claims are based on the fact that the fundamental criteria used in the determination of the amount of medical services the aged receive depend on the aspect of needs. However, when the invariable modernization in terms of technology in prolonging life at all costs are used, the requirements of the aged people do not have any limits as they tend to drain all the resources that should be availed to other age groups. According to Daniel Callahan, the issue of rationing medical care to the elderly would someday come to pass. His beliefs are based on the fact that he had worked with the Office of Technological Assessment panel in the evaluation of the likely effects on elderly medical care costs of emergent increasingly expensive medical technology. The panel involved in this evaluation concluded that the elderly would bring about severe problems for the future of Medicare. With these remarks, Callahan suggested that there would come a time when the medical care for the aged especially high technological criteria for people above 70-80 years would have to be limited (Callahan, 14).
This is based on the fact that there is a combination of sharply growing numbers of the elderly with more expensive technology that would bring about financial constraints. He suggested that he aimed at creating awareness among the public in the anticipation of the possibilities of limiting the medical care given to the elderly. These notions have received much criticism although Callahan believes that the people above the ages of 70s and 80s have lived a natural life span, which has been characterized with the achievement of most possibilities and goals in life. Therefore, they should not seek medical services with the aim of extending their livelihoods without considering other people’s achievement of their life goals (Callahan, 14). Additionally, it is true that everyone grows old however, if we would embark on treating the young people in one way and the elderly in another, in the end everyone would end up being treated in a similar way. This will bring about the development of medical service strategy which aims at treating the young and the old in different ways, which would eventually result to equal treatment (Callahan, 14).
Callahan’s arguments are supported by the trustees of the Medicare program with their projections of insolvency within a period of eight years and within the span of a decade, the overall national health care costs are estimated to double. They believe that now is the right time to act on this issue as Medicare has been observed to decline from the present ratio of 3.7 to 2.9. This will bring about increased costs from $ 503 billion to about $ 937 billion an estimated 93% increase (Callahan, 14). These facts are based on the statistical analysis conducted by health economists and policy analysts. They indicated that as of 2008, there were about 44,831,390 Medicare beneficiaries. Their estimates were that between the year 2010 and 2030, the numbers would significantly increase from roughly 46 million to about 79 million resulting lead to a 17.7% increase in a period of just 20 years. This will also be characterized by a decline in the in the ration of workers who pay taxes for Medicare as compared to the retirees. These facts will contribute to the increased costs incurred (Callahan, 14).
In addition to this, advocates for the rationing of the healthcare to elderly people claim that over the next decade, the number of those who retire will increase and bring about a medical world that is more expensive in terms of technological means of keeping them alive. It will also lead to more reliance of medical benefits towards the elderly people (Halter, 30).
This is characterized by the fact that, curing the dominant diseases that bring about aging has not been any success. The only thing that has been prevalent is the ways of keeping patients alive. I am not implying that taking care of the elderly is a bad thing; all I mean is that the extensive ways that have been deployed in treating elderly people have only incurred huge costs. This requires the nation to deal with the unfavorable options head on which may occur through reducing the benefits endured to the elderly (Halter, 30).
However, since every coin has two sides, it is also important to consider the aspects against the age based rationing. This issue has brought much disagreement by advocates who believe that rationing medical care to the elderly is unjustified. These disagreements are based on the fact that rationing would breed huge balance of gains for society. Advocates against this issue claim that any policies that aim at limiting the medical benefits would deprive the elderly of life-saving medical care and bring about huge costs with limited benefits. They also attribute their claims with allegations that these policies would bring about increased tension among the young people during their development stages. Similarly, they would also inflict fear among the elderly, as they would not be willing to die, as they would feel neglected by the society thus bringing despair (Fisher, 437).
Additionally, advocates against the issue of rationing believe that for the achievement of savings through the rationing of medical care given by age, there would be no guarantees due to the country’ political system. This brings the notion that lack of guarantee does not necessarily mean that the savings gathered from rationing medical care to the old would be directed towards the young (Fisher, 437). It does not also guarantee the fact that these savings would be used in improving the entire health systems across the country. It would require clear guidelines that lay out the actual benefits that rely on the aspect of the resources would be shifted to various ways of care. This brings about the argument with the opponents of the rationing issue through the way they argue other policies are seemingly less harmful to the society. They argue that these other policies would be adopted in dealing with the enhanced requirements that occur from the elderly with regards to the medical services. They apply an instance in which society would transfer funds from military expenditure up to medical services as well as the enactment of reforms that aim at improving efficiency and reducing the expenses that occurred in the medical services (Fisher, 437).
The oppositions are also prevalent through the way advocates against the issue of rationing medical services due to age have claimed that by simply considering the benefits and costs incurred, fails to value other important moral consideration. This brings about the issues of justice and rights where justice is argued in terms of requiring the people to receive equal treatment unless there are moral reasons that suggest otherwise (Fisher, 437). This should be coupled with the fact that the determination of who should and should not receive medical care requires the relevant consideration of the individual requirement of medical services. This should be accompanied by the possibility of that person recovering or the possibility of improving that individual’s life standards. However, the mere consideration of age reveals very less concerning the individual’s requirements for healthcare and prognosis. It should therefore not be used in influencing the distribution of healthcare as compared to aspects such as race and sex (Fisher, 437).
The opposition of the issue relies on claims that medical liabilities are the ones that are supposed to be associated with old age but not age. This gives the relevant reasons in the way people are treated differently. Similarly, opposition to this issue claims that if the main aim was to effectively use costly resources, then treatment should be denied to everyone who has indicated signs of living for a short while, fatal disorders and minimal enhancement in their life standards (Aaron and William, 44). This would eliminate the consideration of age as the basis of rationing medical care. Additionally, the issue of limiting healthcare with the basis of age tends to favor one age group against the other as it aims at favoring some people and unfairly denying the other group the same benefits. However, advocates against the issue do not imply that it would be unfair to increase the expenditure on children’s education than on adults, they only purport the fact that it would be fair to spend more funds on healthcare among the aged than younger people would. This notion would only hold if only every individual was to get the same access to Medicare over the course of life (Aaron and William, 44).
In addition to this, the advocates against this issue argue that claiming that the preservation of young people’s lives as compared to those of the elderly brings about the assumption that the aged are less valuable than that of the young people. This is coupled with the argument that medical care rationing in the modern society denies the elderly their fundamental right to medical care that is necessary for maintaining good health and rational quality of life. This is a requirement that does not rely on racial, religion based, gender and even age characteristics. This stands to mean that the liberty to medical services is not moderated with age since the elderly are also attributed to medical services. Therefore, rationing the medical care based on age would unequivocally violate the basic rights (Fisher, 437).
Advocates against this issue believe that with the advancement of technology, instances of the elderly will continue increasing due to the competition for scarce healthcare resources. This will lead to the confrontation of the issue of the care rationing or even the problem of equitably distributing the limited resources. It may also bring about the adoption of strategies that attempt to standardize the requirements of a varying population to the provision of resources. It may also bring about the establishment of important precedents with implications getting to heights of the health care field (Fisher, 437).
Problem and Solution
The issue of rationing medical care services to the elderly has brought about an increased urgency in the services that meet the health care needs. However, the issue has been found to be alarmingly rare. The challenge in this case is that the traditional family structures have changed as the roles of the women in the society have transformed. This thus brings about the issue of elderly people being left the women’s off springs, which relatively increases severe health and psychological needs that are difficult and at times impossible to achieve. The solution to this is that there should be well-established home health programs that offer increased quality of life for the elderly. These homes should be reduced unnecessary in ways that are cheap. This would contribute to the stabilization of family environment and allow women to continue working outside their homes. It would also raise the overall family income (Fisher, 437).
The issue of whether to ration the healthcare to elderly people brings about the consideration of many factors that are involved in this field. They analyze the facts about how the limits would benefit the society and since there have not been any guarantees given I strongly believe that it is inappropriate to limit the elderly from healthcare based on age. As indicated in the above arguments, it would be also morally wrong. At one point or another we will all get old but the fact to consider is do we want our children to neglect us simply because we have more demands in terms of medical attention? I think it would be appropriate to find a way to balance the medical care provided to the elderly and the youth as it would ensure harmony.
Aaron, Henry J, and William B. Schwartz. Can We Say No? The Challenge of Rationing Health Care. Washington, D.C: Brookings Institution Press, 2005. Print.
Callahan, Daniel. “Must We Ration Health Care for the Elderly?” Journal of Law, Medicine & Ethics. 40.1 (2012): 10-16. Web.
“Centre for Health Care of the Elderly | Capital Health.” Capital Health Nova Scotia. N.P., n.d. Web. 11 Mar. 2014.
Fisher OP, Anthony. “Fair Innings? Against Healthcare Rationing in Favor of the Young over the Elderly.” Studies in Christian Ethics. 26.4 (2013): 431-450. Web.
“GovHK: Health Care for the Elderly.” GovHK – one-stop portal of the Hong Kong SAR Government / 香港政府一站通. N.P., n.d. Web. 11 Mar. 2014.
Halter MP, “When is it OK to ration healthcare? We must rationally and fairly make decisions about life-saving resources.” Healthcare Executive [Health Exec], ISSN: 0883-538119.6 (2004): 30. Web.