An elderly man goes to his doctor for a checkup.  “Well,” the doctor tells the man, “I have some bad news for you.  First, you have cancer.  Second, you have Alzheimer’s disease.”  After a few stunned moments, the man replies, “Well, at least it’s not all bad.  I could have cancer.”

I used to think that was funny.  Now, having reached age 70, it’s not that humorous.  Depending on your physical and mental health going into your senior years, aging can be a “graceful” albeit slow decline or a quagmire.  I never smoked; I don’t drink alcoholic beverages; I exercise daily; and I eat a fairly healthy diet although I’m a bit overweight.  Researching and writing my book has certainly provided mental stimulation.  If anything, I have noticed a slight decline in energy and on a cold, damp day my joints ache (which is why so many seniors seek out warm, dry climates for retirement).  So, I believe I am going into the last quarter of my life in pretty good shape.

For folks like me the good news is the older you get, the older you will get.  Average life expectancy at birth in the United States is now 78.7 years; up from 70 just 40 years ago.  Women tend to live a year or two longer than men.  However, if you’ve lived to age 70 as I have, the good news is that you have a good chance of exceeding the average life expectancy (life expectancy for someone age 70 is now 85.3 years).  Having good health going into old age increases your chances of living longer.

Mortality increases with age; however, there is a big jump in the number of deaths beginning at age 45.  Since we have conquered most communicable diseases, the primary causes of death in the U.S. are cardiovascular disease and cancers (age is a risk factor for both), although recently opioid overdoses have taken the lives of many younger Americans.  The primary contributors to early mortality are obesity and smoking, which are positively linked to both cancer and heart disease.  Obviously, healthy people can get cancer or have a heart attack before reaching retirement age (around 65 in the U.S.), but unhealthy life styles contribute significantly to premature death.

This information, along with a lot of other data about aging is important to keep in mind when discussing universal health care because we know the incidence of disease, illness, and injury increases with age; and as a consequence, seniors consume a lot of health services.  Older Americans typically experience the most decline in mental and physical health in the last two years of life and commensurately need increasing amounts of intensive, costly interventions including hospitalization, nursing home care, rehabilitative therapies, and in-home services.

My generation, the baby boomers, is the first to have a very large cohort live into old age.  Unless the fiscal health of the U.S. health care system is in good shape, this will create a significant financial burden on the system, particularly Medicare.  The universal health care system I am proposing should be able to meet this economic challenge.  For example, based on a transaction tax, revenues will grow as the economy grows.  And because part of the revenues will be invested in a trust fund, there should be a sufficient reserve to assure funds are available during economic downturns in the national economy.

As we age and reflect on our lives, one of the many things people consider is their legacy such as the contribution they make to society through their work.  Politicians have a unique opportunity to leave a more lasting legacy.  As it relates to this topic, President Franklin Roosevelt will always be remembered as the president who gave us Social Security and President Lyndon Johnson as the president who gave us Medicare.  Senator Edward Kennedy will be remembered as the politician who championed universal health care all his life.  Conversely, the following should be etched into Senator Mitch McConnell’s tombstone: (1) voted not to renew funding for the Children’s Health Insurance Program, (2) led attempts to dismantle the Affordable Care Act leaving millions without affordable health care, and (3) wants to pay for the 2017 tax cuts for the rich elite by cutting Medicare.

If we believe in universal health care, then our legacy should be to help make it happen.

“Poor Old fool,” thought the well-dressed gentleman as he watched an old man fish in a puddle outside a pub. So he invited the old man inside for a drink. As they sipped their whiskeys, the gentleman thought he’d humor the old man and asked, “So how many have you caught today?”

The old man replied, “You’re the eighth.”

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