September 21, 2008

The Axis of Alzheimer's: Global prevalence is on the rise, while domestic Medicare policy changes fail to ease the financial burden of long-term care

This past Thursday, the world's oldest man celebrated his 113th birthday. It is fitting that Tomoji Tanabe, who wants to live "another five years or so," lives in the world's oldest country, Japan. Over a quarter of Japan's 127 million plus population is over the age of 60, and that number is expected to grow to 44% by the year 2050. Although Tanabe has been fortunate enough to enjoy relative good health in his late years, millions of others have not been so lucky.

Today, September 21, is World Alzheimer's Day. While enormous strides have been made in the understanding and treating of this harrowing disease, doctors, patients, and caregivers the world over champion for greater awareness and action. They continue to stress the need for increased research and care funding, as the United States and other countries struggle to assist those afflicted, a demographic bound only to increase as the world's population of elderly individuals grows. As the world observes this day of awareness, a reflection on a recent change to Medicare and the diminishing role of health care in the upcoming election indicates a need for increased focus on the financial aspect of long-term care for those suffering from Alzheimer's here in the U.S.

The most common form of dementia, Alzheimer's currently affects some five million Americans, and 26 million people worldwide. With the cause uncertain and no known cure (at best, current treatments have proven only to slow the loss of function associated with the disease), Alzheimer's is the sixth leading cause of death in the U.S. Alzheimer's is a degenerative disease of the brain, resulting in the loss of memory and cognition, and ultimately, the loss of bodily functions. Although the prognosis and duration can differ from person to person, Alzheimer's ultimately leads to death.

Despite the fact that Alzheimer's is commonly known as a disease of old age, a mounting number of cases are being diagnosed in patients in their 30s and 40s. That, combined with the growing proportion of Americans living longer makes for an estimate of 16 million that will be afflicted with the disease by the year 2050.

The crisis of how to handle elderly health care is an international one. As Japan struggles to finance health care insurance for their large population of senior citizens, France, Britain, and Germany are experiencing similar demographic shifts skewed toward the older populations that will mirror Japan's in the years to come. The charts on the right depict Japan's population based on age and sex. The one on the far right, projecting Japan's population in 2050, is in the shape of an inverted pyramid, demonstrative of a nation facing an increasing proportion of the elderly relative to younger and middle-aged adults. Here in the U.S., the state of Florida already has an elderly population proportional to Japan's, with Colorado expected to follow in 2020. As expected, greater numbers of aged individuals translate to greater numbers of Alzheimer's patients. Asia hosts half of the world's Alzheimer's cases with 12.6 million suffering from the disease, a number projected to jump to 62.8 million in 2050. Even developing countries, where prevalence rates of Alzheimer's were once incidental due to low life expectancies, are faced with how to deal with the epidemic as newfound prosperity increases longevity.

On Friday, the federal government stated that, for the first time since 2000 and only the sixth time in the history of Medicare, outpatient premiums will not increase in 2009. The premiums staying constant at $96.40 fall under Medicare Part B, which covers doctors' visits and other outpatient services. Although many Medicare recipients may see this as a positive step toward easing the cost of health care on the individual, it is doubtful this plan will assist those suffering from and caring for patients of Alzheimer's. Out-of-pocket nursing home care deductibles, an expense more commonly associated with caring for patients with Alzheimer's, will rise $44 to $1068 in 2009. Additionally, as it stands now, Medicare covers only skilled nursing facility or home health care deemed medically necessary, denying coverage for most long-term care. The pie chart on the left represents the national health expenditures for 2006. Most long-term care needs (those most commonly associated with Alzheimer's and other chronic illnesses) fall under the categories of home health care (3%) and nursing health care (6%). An offshoot of Medicare, Medicaid currently provides long-term coverage for low-income individuals and families, a program currently under reform with hopes of increasing choice in care options available to patients and families, improving the quality of long-term care offered, and reducing costs and supporting government tax law changes to provide for the private funding for long-term care needs.

For the millions afflicted with Alzheimer's here in the U.S., and the millions more in charge of their care, something in the way our government provides health care has to change. As the presidential election approaches amid crises in the stock market and mortgage industry (both of which make affordable health care that much more important as food and gas prices rise, often disproportionately affecting the elderly), health care reform advocates struggle to remain at the forefront of issues. While long-term care, particularly related to caring for those with Alzheimer's, isn't specifically the focus of the health-care debate, increased attention and insistent action from the American people can only stand to benefit the progress being made fighting the disease and caring for those who suffer from it here in the United States.

6 comments:

Nicole Choi said...
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Nicole Choi said...

Your blog post on Alzheimer’s and the rising numbers of those it affects was truly eye-opening. I was not aware of how many people were affected by this disease and how much strain it puts on the economics of healthcare. As a member of a family of pharmacists and doctors, I often hear discussion on topics such as Medicare and how patients are always concerned about its cost and coverage; however, I never paid close enough attention to understand what the issues were. Your post clearly indicates the long-term problems with Medicare, even though the mentioned federal government decision has lessened the financial burden on the elderly in the short run. Not only was your first paragraph amazing in the content itself, but it successfully assisted in bringing to attention the major cause of the Medicare plan: people are living longer. Not only that, the piece of information I found most interesting and surprising was the fact that “a mounting number of cases are being diagnosed in patients in their 30s and 40s”. This is not only frightening but also necessary to raise awareness of the importance of the issue. I also found it beneficial that you briefly explained Alzheimer’s itself and what fraction of healthcare money is being spent on the elderly due to this disease. These paragraphs effectively lead up to your thesis that healthcare provision by the government needs to improve. Additionally, I found that the links that you seamlessly included in your post were relevant, informative, and helpful in the case that one might want to delve deeper into some of the topics you mention.

Because your post was both clear and effective, there are only a couple pieces of advice I can offer regarding the critique of this post. The post title, though completely relevant to the topic of your post, may be more effective if made more concise by being shortened. It includes your thesis, which prepares the reader for your post, but it may help to just briefly mention the topic in the title to catch the reader’s attention. This may make the reader more inclined to see what you mean by your title and continue reading the post to find an answer. Additionally, I thought you could bring the thesis more into the body of the post, which may assist the reader in knowing where your introductory descriptive paragraphs are going. Overall, your post was enjoyable and informative, and I look forward to reading more by you!

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Although the prognosis and duration can vary from person to person, Alzheimer's disease ultimately leads to death without pain ....

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It is a pity that we are growing older in the world. People don't want to have babies.they prefer to focus in their professional lives instead of raising a kid.

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May Garber said...

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