Some ideas can be bad for your health
Why some memes are bad for our health care system
A version of this commentary appeared in the Vancouver Sun, Winnipeg Free Press and the Telegraph-Journal
Feeling anxious that Canada’s publicly funded health care system is soonto be crushed by the aging tsunami sweeping the nation?Then take some comfort in knowing that your anxiety may not be due toyour genes, but your memes. What’s a meme, you say? British scientistRichard Dawkins defined it as a unit of cultural transmission, analogous toa gene. Genes transmit biological information, whereas memes are ideasthat transmit cultural information. Malcolm Gladwell said that a meme“behaves like a virus that moves through a population, taking hold in eachperson it infects.” Just as some people blame their ill health on bad genes,it’s time we blame the poor health of some of our public institutions onbad memes.Memes transmit current notions and ideas about health care and they canbe highly communicable, spread pandemic-like, and infect quickly andbroadly. They can also be extremely virulent and hard to subdue, evenwhen patently false. They can be destructive by raising unnecessary panicand fear, and fuel irresponsible political responses.“The aging of the population will destroy public health care” is a pernicious meme invoked by demographers,politicians, economic pundits, media columnists and others. Wielding stark demographics, they say babyboomers will soon launch a terrifying tsunami-like assault on our public health care system. Call itdemographic demagoguery, but the implications are clear: prepare for disaster!
Boomers are not to blame for rising health costs
But before you go scurrying for higher ground, you’ll want to know, is the “greying tsunami” meme even true?The answer in a nutshell: not really. Statistically, health care spending has risen quite a lot in the last fewdecades, and the key culprits are general population growth (there are more of us), inflation (things costmore as time goes by), aging (as we get older we use more medical services) and utilization (we are all usingmore health care stuff, including drugs, doctor visits, screening and diagnostic tests, and hospitals).The aging population might be causing health care costs to rise, but by how much? Independent researchersand economists conclude that about 1% of the annual increase in health care spending is due to “aging.”Which is to say if overall health spending grows at an annual rate of 5%, about one-fifth of that is becausemore of us are getting old. In fact, numerous studies indicate that the aging of the population is too gradualto rank as a major cost driver in health care, that it’s more a glacier than a tsunami. Others say the currentgeneration of seniors is extraordinarily healthy, so it’s difficult to predict how much they’ll cost the healthsystem in the future.
Real costs of rising healthcare: Drugs, screening tests, doctor visits
While the aging population is contributing to increases in health care spending, increased utilization (more