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Couldn't agree more. If you strip away chronic maladies that are directly due to poor lifestyle choices, you get rid of 50% of medical spend annually right there. If you then also exclude last two years of life care, you're at something like 90% of medical spend annually. And these two things interact. Getting old sucks, but it shouldn't be particularly painful or burdensome - but it is because people are getting obese first, then developing metabolic syndrome, and then getting old. Modern medicine and ethics keeps them alive, albeit with drastically reduced quality of life, pretty much up until the whole body just gives out.
Eventually, social security, medicare, and medicaid are going to run out of money. And, as this thread discusses, we're playing with the idea of a fundamental medical care shortage a la the NHS in Britain. If we don't grow our way out of this / come up with some seriously amazing medical technology innovations, I have two predictions:
The cohabitation with an elderly parent will become ubiquitous in American society outside of the top 5%. For the top 5%, assisted living and retirement communities will become even more opulent and lavish then they are now. The wealthy elderly will become bizarrely hedonistic.
There will be a large scale campaign for legalization of assisted suicide. It's already happening as a movement in the USA and they're already doing it in Canada.
I hate both of these things, personally. But I still believe they will happen. Getting wealthy in the next 50 years will be as simple as staying healthy, getting and staying married, staying employed (at pretty much any wage level that isn't working poverty), and caring about your children and family. Individualism will claim at least a third of society, perhaps more.
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