Vital Signs

The Death of Natural Causes

Let us begin with the obvious: sooner or later, everyone dies. Even Bill and Hillary say they know that. No amount of money will head off the inevitable. We cannot "cure" death like we might rebuild our inner cities or clean up the air. At best, we can use modern medicine to cheat death for a few years. Instead of dying at 50, a person may die at 70. Obviously, however, there are biological limits to this cheating. More importantly, the costs for such cheating rise astronomically with each increment in longevity. A few simple public health measures, an improved diet, and regular vaccinations can have a major impact on those under 50. Keeping a single seriously ill 90-year-old alive can cost a fortune. And this fortune squeezes out only a few more years at best.

It is the attempt to add a few more years of life to people who are seriously ill that escalates the cost of medicine. A sickly person, especially one of advanced age, not only requires more and more expensive health care, but for several reasons, he or she is also more likely to burden the government with this cost. Moreover, thanks to the onward march of high technology this situation will get worse. In the past there was relatively little that could be done for a person with a serious heart condition—some medication, a new diet, and advice to avoid strain constituted the treatment. Today, the same person might be given a new natural or artificial heart. What...

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