Americans are staying healthier and suffering fewer disabilities through the end of their lives, a development with significant implications for the future of health care and fiscally strained government health programs.
A study released by the National Bureau of Economic Research Monday finds significant compression of morbidity into the period just before death in the U.S., meaning that Americans are suffering fewer disabilities and coping with diseases better as they advance in age.
The research was conducted by David Cutler, a Harvard Economist and former health care adviser to President Obama who helped design the 2010 health care reform law, with Mary Beth Landrum of Harvard Medical School and Kaushik Ghosh of the NBER. They examined data on Medicare beneficiaries to determine how many diseases and functional limitations, such as being able to exercise or take care of day-to-day household tasks, seniors experience in different years before death.
The authors found that “time spent in poor physical functioning is being increasingly compressed into the period just before death.” The prevalence of diseases is rising, “but the severe disablement that disease used to imply has been reduced.”
Consequently, disability-free life expectancy is rising for Americans. Those results apply across many demographic categories, including both men and women and whites and non-whites.
Although the authors do not delve into the specific factors behind the trend, some combination of better health care and healthier lifestyles is allowing Americans to live healthier for longer.
Health care costs are a major strain on personal budgets and on the federal government’s finances. Federal spending on Medicare, the federal health insurance program for senior citizens, is supposed to rise from 3 percent of gross domestic product to 3.5 percent in 2023, according to the Congressional Budget Office. Raising the retirement age for the program from 65 to 67 is one of the provisions that President Obama and House Speaker John Boehner agreed to in 2011 as part of a fiscal “grand bargain” that ultimately failed.