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Pick Your Poison

The French statesman Charles DeGaulle, who was never reticent about venturing an opinion, said that "old age is a shipwreck."

Presumably he was thinking about his own experience, but he could have been echoing the experience of Socrates who, when asked why he had not tried to defend himself at his trial where he was sentenced to death, replied that he preferred a lethal drink to old age, "the sink into which all miseries flow."

The vicissitudes of old age is hardly a novel theme, even here in America, land of the forever young. At the beginning of the Twentieth Century, William Osler, an illustrious physician, created a public stir when he suggested that men should be forced to retire from work at 60. Not content to leave it at that, he suggested that men older than 60 should be chloroformed.

If Dr. Osler were alive today, one wonders what he would think of his medical colleagues injecting the poison Botox into the faces of thousands of aging citizens. He might say that they merely look like they've been chloroformed, with their facial muscles frozen in a stupefied gaze of perpetual astonishment.

This is uncharitable, but I'm in a sour mood. I woke up this morning with a pain in my left hip, and I'm one year away from 60. Immediately I'm thinking, "hip replacement." Why not? My orthopedic surgeon says a guy like me should be able to play tennis, jump out of airplanes like George Bush Sr., hike the Appalachian Trail and get a trophy wife.

Leave it to me, he says. Your health insurance will pay for it.

My mind and body tell me one thing, but the hawkers of medical and technological progress say another. That's part of the dynamic behind results from St. Luke's Health Initiatives' report on The Coming of Age. Arizona Boomers see all sorts of problems coming down the road for them personally - big medical bills, little money saved for retirement, shaky social security and Medicare systems, no one to take care of them when they're frail and feeble - but the great majority of them remain optimistic about growing older.

That's because they've been prepped by decades of medical advances and rosy predictions of the future. Time and again, focus group participants told us that all these problems will create new opportunities, new markets, new social and economic arrangement, longer and more full lives.

They believe this will happen. They're just fuzzy on the details. God forbid it would require include raising their taxes.

But we all know where the Devil resides. We're approaching the point, if we aren't there already, where we will be forced to talk about the details and make hard choices. The U.S. has one of the most inefficient health care systems in the world, driven by a private insurance market that encourages over consumption of medical services as a result of someone else picking up most of the tab. The health care buck is now starting on a vicious circle back to the consumer: some insurance plans predict that premiums could approach 20 percent of the take-home pay of the average American worker in the next five years if health care costs continue to balloon at current rates.

Health stock analysts glibly trumpet the "sound market fundamentals" of big health plans while a demographic steamroller rumbles blindly down a yellow brick road of medical advances floating on the financial quicksand of state and federal budget deficits, 40 million uninsured, and a global economy stuck in park. We're out of our minds if we think Wall Street is the future.

With the coming of age, DeGaulle and Socrates aren't bad company. They had a taste for fatalism, and a sense of the transitory and ephemeral nature of human affairs. If I had to pick a poison, I'd take it over Botox.