Living longer is only for the wealthy? That’s debatable

Advances in medicine and technology — coupled with increased empathy and more efficient levers of behavior change — will continue to democratize healthcare, ensuring that all people benefit, not just the wealthiest.

It’s a noble argument, put forth last week by Humana’s Busy Burr, Vice President of Innovation and Head of Humana Health Ventures, and Joon Yun, Managing Partner and President of Palo Alto Investors. They were partners in an Oxford-style debate presented at the Business of Longevity conference sponsored by The Economist in San Francisco.

The event aimed to “ignite a global dialogue around opportunities in aging and the most recent innovations driving the aging market. As innovations and breakthroughs in aging science increase the length of healthy lives, how will our economy and society change? And, how should policymakers respond?”

Representing the house side of the argument – that living longer will only be for the wealthy – were best-selling author Chip Conley, Global Head of Hospitality at Airbnb, and James Firman, President and Chief Executive of the National Council on Aging.

The format inspired a rigorous debate about aging, life purpose, wealth and privilege that engaged both the speakers and the audience. Busy and Joon won the argument, swinging more members of the audience to their point of view.

They argued that there are many determinants of health and longevity, and that wealth is only one small part of the whole picture. A person’s physical environment, medical care, genetics and individual behavior have dramatic effects on health.

They cited numerous medical advances that have improved public health for all, including vaccinations, antibiotics, clean water and improved sanitation. Technology has increased access, reduced costs, democratized information, improved diagnoses and made it easier to monitor patients remotely.

“The nature of health and disease is actually changing,” Busy said. “We are moving away from a health care system that is focused on acute events, such as surgical centers, emergency care and hospitals. The burden of health care, as we know, is increasingly coming from chronic disease – diabetes, heart disease – in all populations. Over 80 percent of U.S. healthcare spend is on chronic disease.

“To solve for chronic conditions requires behavior change and information and feedback,” she added. “There’s an incredible convergence happening between the needs of the healthcare system and technology. There are 2.5 billion smartphones in use globally; that’s one phone for every three people on the planet. In health, that means faster response and access. Health care technology used to mean MRI machines, emergency room equipment. Today, health innovation is about scale, mobility and putting power in the hands of everyone, not just the wealthy. This is how we’re going to drive outcomes for everyone.”
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Joon added, “We wholeheartedly disagree that living longer will only be for the wealthy. Everyone has been living longer, and this has been true for a long period of time. As people gain in longevity, inequality decreases. So one of the best things we can do for those who are disadvantaged in longevity is to increase it, thereby narrowing the gap. In fact, the disadvantaged will gain disproportionately in terms of longevity over time.”

Chip and James argued that the wealthy have always and will continue to make better gains when it comes to longevity.

“The U.S. retirement and health care systems are broken and incompatible with longevity, except for the wealthy,” Chip said. “You can’t finance a 30-year retirement with a 40-year career.”

James added: “Extending longevity is nowhere near a national priority, but optimizing longevity is the grand challenge of our time. Unfortunately, pills and gadgets are not going to help very much. The reality is that most older people are much more concerned about their health, finances and quality of life here and now than they are about living to 105 or 110.”

James noted that most Americans don’t have enough retirement savings.

“We’re talking about people who have more chronic conditions, less education, and are less able to work,” he said. “We’re kidding ourselves if we don’t recognize that what’s happening is a great divide between half the population that’s going to do fine, and the other half that’s going to have a really hard time.”

But Busy countered, saying, “The future is going to lay out amazing opportunities for people to continue to work, to continue to contribute, to continue to have purpose because those are the things that actually make people live. You live by having purpose.”

Joon said, “If you live long enough, gaps in equality will narrow. The poor are still making gains in longevity. Health is wealth. The healthier you are, the more wealth you create. One of the best ways to address inequality is to spread health innovations throughout the population.”

Busy took the argument back to its roots, saying, “I just want to go back to the house’s motion, which is ‘living longer will only be for the wealthy.’ We disagree, because we believe that everyone is going to live longer. We will concede that wealthy people may live longer than poor people. We’re not contending that it’s going to be equal, but we are contending that all boats will rise with the tide; everyone will live longer.

“Yes, the wealthy will have access to more stuff. They always have, and they always will. And their lifespans will be longer than everyone else. But … we will all live longer. We believe in the promise of the future, that health and medicine hold promise for everyone else, not just the one percent. You all came to this conference because you believe you can make a difference. A sense of purpose can drive great change. We are all going to play a role in shaping the future that we want.”

Representing the house side of the argument – that living longer will only be for the wealthy – were best-selling author Chip Conley, left, Global Head of Hospitality at Airbnb, and James Firman, President and Chief Executive of the National Council on Aging.
Representing the house side of the argument – that living longer will only be for the wealthy – were best-selling author Chip Conley, left, Global Head of Hospitality at Airbnb, and James Firman, President and Chief Executive of the National Council on Aging.

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