I hate the men who would prolong their lives
By foods and drinks and charms of magic art
Perverting nature’s course to keep off death
They ought, when they no longer serve the land
To quit this life, and clear the way for youth.
–Euripides 500 B.C.
The American professor of Medicine Joseph Fries coined the phrase ‘compressed morbidity’ in 1980 to describe his belief that you could improve the economic health of a population by compressing the period – the morbidity – between the onset of illness and eventual mortality. It was essentially a rallying call for the medical profession to engage in preventative medicine, not just curative medicine.
Keep the ‘ageing’ healthy for as long as possible, and you reduce the cost of nursing them onto their death bed and out into the morgue.
There are two basic problems with this. One, we are all ‘ageing’; five year olds are ageing, five day olds are ageing, yet somehow the term has been reserved exclusively for those who are no longer economically active, to the point where ‘ageing’ is a euphemism for those past, say, 60. ‘Ageing’, ‘grey haired’, ‘balding’, ‘pensioner’; we have myriad terms to denigrate the needs of those who have paid the most into the NHS service, leaving the lion’s share of the pot for those who have only just woken up to the possibilities of having their ears pinned back/their appetite curtailed/ their tattoo removed, to enjoy the bounteous NHS.
Secondly, like the burning candle, you can compress morbidity from both ends. Costs can be reduced by making sure that those who have entered a period of morbidity exit through the final curtain with indecent haste. It is this latter definition which seems to have taken hold in the UK. From the legislation which transfers a Doctor’s powers to determine treatment to the legal profession with their definition of a ‘futile life’, to the widespread rationing of treatment within the NHS – compare the treatment of a debilitating stroke between a 25 year old and a 67 year old. The efforts put into making sure the 25 year old is returned to economic viability can only be justified by the utilitarian belief that this rationing brings about the greatest good for the greatest number of people.
It entirely disregards the fact that the ‘pot’ being argued over represents the savings of those elderly who were forced to pay into it in order to ensure their medical treatment when they became old and infirm. Those who are now in their 90s were once quite happily preparing for their own morbidity by voluntarily pooling their spare resources into Friendly Societies. They were ordered into the National Health Service by Lloyd George, egged on by the medical profession which sought power over all monies set aside for health provision.
The Government speedily took control of the medical profession through NICE, which effectively curtails the profession’s distribution of resources. Now the GPs are to be handed the pot once more, but not before the legal profession have been handed the reins via The Mental Incapacity Act.
Curiously, the one thing which may give some measure of control, or at least influence, to the largest stakeholders in the pot – those over the age of 60 – is the announcement from Ian Duncan Smith that he is bringing forward the date at which retirement pension is payable to 68.
There will be groans from those nearing retirement that they must work longer, but the wider effect of this will be the postponing of the age at which you are seen to be, in the words of the motor trade, ‘beyond economic repair’. You may not be able to find employment, you may have to live on benefits, but if you are still considered to be economically viable by the state, the NHS and the legal profession will be forced to rethink their definition of ‘aged’.
It is not the cost of the paltry state pension which is frightening the life out of the government, it is the cost of keeping those useless drones, we pensioners, in any semblance of ‘good repair’.