Tuesday, August 26, 2014

When adults go commando ...

The end of August leading up to Labor Day is traditionally slow news time here in America.  Even C-Span has to resort to reruns!

(I know what you are thinking: Don't I have better things to do than watch C-Span? You don't know what you are missing out on, dear reader!)

A senator--of course, an old, white, male--was introducing Seth Rogen.
Yes, that Seth Rogen.
At the US Senate!

He had his glasses on--the typical celebrity approach to coming across as serious and intellectual and ready to utter something moving and profound.  These movie people literally live up to "all the world's a stage."

I decided to watch anyway.

One of the best things I could have done.  In fact, I would recommend that you, too, watch it.

Seth Rogen told a wonderfully warm story about a horrible aspect of life--his mother-in-law was diagnosed with early onset of Alzheimer's when she was only 54.  Fifty-four!  It has been downhill since then for her.  Unlike other top ten reasons for death, Rogen noted, "there is no way to prevent, cure, or even slow the progression of Alzheimer's Disease."  He commented about how it was way more expensive than treatment for heart conditions, which are expensive to begin with.

I suppose this discussion continues, in a way, from where the ALS Ice-Bucket-Challenge post ended.  But then, as my links to posts from the past show, the conversations on any of the topics have not ended, have they?  Nor is this the first time that I have something to say about Alzheimer's and dementia.

Alzheimer's is one awful disease.
For the patient.
For the family and friend.
And, yes, for the bank balance too.
In 2012, one out of every eight people aged 65 and older in the U.S. – more than 5 million – had Alzheimer’s, and payments for health care, long-term care, and hospice services were estimated to be $200 billion (not including the work of unpaid caregivers).
By 2050, barring the development of medical breakthroughs to prevent or more effectively treat the disease, the number of Americans with Alzheimer’s may triple to 16 million, with annual costs of care projected to reach $1 trillion. Without disease-modifying treatments, the cumulative costs of care for people with Alzheimer’s from 2010 to 2050 will exceed $20 trillion, in today’s dollars.
The article notes that this is a projection and it does not mean that we should start setting aside twenty trillion dollars.  Instead, and wisely, the author compares it with the case of polio:
From 1940 to the mid-1950s, polio struck 400,000 American children and millions more worldwide. The epidemic peaked in the early 1950s with 58,000 new cases in 1952 and another 35,000 in 1953. But, thanks to the Salk polio vaccine, by 1957, new polio cases had been cut by 90 percent, and by 1960 the disease was almost entirely eradicated in the United States.
Michael Milken has pointed out that, in the early 1950s, the cost of polio care in the U.S. was predicted to be $100 billion by the year 2000 – back when a billion dollars was a lot! In fact, he says, “today’s polio immunization programs cost one thousand times less than that and have virtually eliminated the disease.”
Yes, it will require many more Salks.

NPR reported that one group that is helping us with the research for treatment of this awful disease is people with Down Syndrome.
Down syndrome is a genetic disorder that's best known for causing intellectual disability. But it also causes Alzheimer's. "By the age of 40, 100 percent of all individuals with Down syndrome have the pathology of Alzheimer's in their brain," [Michael Rafii director of the Memory Disorders Clinic at UCSD] says.
A depressing post on a warm summer night, yes.  But, life is not all fun all the time--even Seth Rogen knows that.

4 comments:

Ramesh said...

I am not going to read this post. Boooooo .

Sriram Khé said...

What a wimp you are!!!

Anne in Salem said...

I don't follow the math. 5 million patients cost $20B now, but triple the patients to 16M and costs increase 5X to $100B? How high will employment taxes have to increase to cover all of that Medicare? Not a pretty picture.

The conversation is personal for me - my mother is declining. In ways, the emotional toll is far worse than the toll on the bank account.

Sriram Khé said...

Oh, sorry about your mother ... yes, these are intensely taxing on the family who are caregivers for the patients.

A typical fear among the elderly in India is that they will come down with dementia ... as I have often blogged about, longevity can become a curse as well ...

The increasing life expectancy into the future is one big reason why the cost per patient increases into the future, on top of the inflation. As a society, we are not thinking much about this at all .... but then it should not surprise us--we Americans are becoming more and more myopic and are becoming increasingly fascinated by anything that is instant gratification. Thus, a typical American who does not even worry about retirement, well, trying to talk about old age diseases is a terribly wasteful exercise. Of course, the politicians are also doing their best to keep the voter happy, which means a convenient bypassing of any serious talk on social security and Medicare.
BTW, I don't know if Medicare covers all the costs--a former colleague in CA continued to work past his retirement primarily because he had to keep up with the cost of care for his mother who was in a Alzheimer's care home--those are terribly, terribly expensive ...