Health care and health insurance have been major topics of discussion and divisive issues ever since President Obama decided to make health insurance reform a priority of his first term in office, and were high concept topics for decades before that. One of the most common aspects of this topic is longevity, as a metric of health care performance, as a cost driver, and as a priority in general. It’s treated as a given that people want to wring every last day they can out of their mortal existence, that proper lifestyle choices should be rooted in a desire to live longer, that end of life medical care should be heroic and interventional, and that anyone who acts or thinks contrarily is either wrong or somehow not of sound mind. It’s found in the broad-based societal opposition to suicide, governmental intervention against suicide, assisted suicide, to opposition to “death with dignity” laws, and in limits imposed on the principles of self-ownership and self-determination when it comes to things medical (including restrictions on the medicines we’re permitted to take).
So many of us, however, lead lifestyles at odds with such a priority. If longevity was truly a top priority we wouldn’t eat the way we do, live the sedentary lives we live, and in many cases take the risks we take. Instead, we eat, drink, smoke and engage in other behaviors that are likely to shorten our lives. Why? Because, perhaps, some embrace John Mortimer’s sentiment:
I refuse to spend my life worrying about what I eat. There is no pleasure worth forgoing just for an extra three years in the geriatric ward.
Because enjoyment of life is more important to us than living longer at the expense of that enjoyment. Certainly, we want both, and certainly, we can be quite hypocritical in our behaviors and demands, but our behaviors do ultimately demonstrate what we prioritize.
Life is not measured on a scorecard, either objective or defined by others. You don’t “win” if you manage to live past a certain age, not if achieving that age has come via self-imposed misery. Living under a premise of liberty and self-determination means that each of us can choose paths toward happiness, paths that may vary widely from those others choose. Many do indeed wish to live long and healthy lives, to have more time with their spouses, their children, grandchildren and great-grandchildren, to explore the world, to build a life’s work, to pursue interests and hobbies, or simply to enjoy the human experience as long as possible. That goal of a long life usually requires some “work.” Moderation in diet, some amount of exercise, health and medical maintenance, all can contribute to longevity. And while nothing’s certain, living a certain way improves the odds.
Some people, however, choose a different set of priorities. Whether overtly or as demonstrated by their actions, they put a lower priority on longevity. The overweight and obese know that being fat will likely shorten their lives, smokers know they increase their odds of suffering certain ailments and living shorter lives, commercial fishermen and loggers know their jobs are more likely to get them killed, and “extreme sports” like hang gliding and BASE jumping come with a higher risk of injury or death than playing ping pong or bocce, yet people still choose to participate in them.
People are not purely rational beings, and there are chemical processes in our brains that reward choices and behaviors that are at odds with longevity. People also want things both ways. We’d love to eat and drink to excess, take all sorts of risks, engage in all sorts of dangerous but exhilarating behavior and not suffer any consequences. That’s fantasyland, of course, despite the endless efforts by all sorts of salesmen, hucksters and politicians (but I repeat myself) to convince us otherwise. Yet people do fall for the fantasy, especially when it comes to health insurance. Big-government advocates routinely trot out longevity statistics in other nations that have socialized medicine as proof positive that this nation’s health care should be socialized, but they conveniently omit the countless differences between our society and, say, Japan’s. The Japanese, on average, outlive us by 5 years, but concluding that this is a result of socialized medicine without considering other disparities (e.g. Japan’s obesity rate is 3.5% while America’s is 30%, they eat fish while we eat bacon) doesn’t pass any rational test.
Risky behaviors aside, some people simply have better genetics than others. We’ve all heard tales of nonagenarians and centenarians who have been doing all the “wrong” things all their lives – eating wrong, drinking, smoking, leading sedentary lifestyles. We’ve also all heard tales of health and fitness fanatics who’ve died “before their time.” Jim Fixx, a runner and author who was one of the early icons of the fitness movement, died at 52 years old from a heart attack. While we mustn’t make the mistake of using outlying data points to generalize incorrect conclusions (that 98 year old who’s been smoking a pack of Camels a day for 85 years doesn’t mean you’re not far more likely to get sick and die young by emulating him), we can learn a lesson: there are no sure things in life. We can live ascetic lives, deprived of all the things we might enjoy that are “bad for us,” and not guarantee longevity as an outcome. We can improve our odds, certainly, but if we choose to do so, we should do so for ourselves, not because some social scolds or bureaucratic busybodies tell us to.
This brings us to the end-of-life quandary. Once we reach our declining years, once we start to degrade, when the body starts to go, when the brain starts to go, when everything hurts, when illness dominates, what will our choices be? What will guide those choices? Are we less likely to be firm in our wants and more likely to act in ways that others want, that we chase extra days or weeks or months or years via heavy amounts of medical intervention. Do we put ourselves through the toil and suffering of long hospital stays, the side effects of multiple heavy medicines, and, yes, the massive end-of-life medical costs? Who are we living those extra days for, anyway? If we choose to implore modern medicine to get us every last breath, that should be a choice we make for ourselves, not to validate some outside notion that longevity is the end goal. If we, instead, choose to spend our final days doing what we want and being with whom we wish to be with rather than lying in a bed with needles in our veins and wires all over our bodies, no one has the right to tell us we’re wrong.
We are individuals, with individual goals and desires. We have been gifted with free will and self-determination, and while many of our fellow humans would like nothing more than to take our self-determination away from us, they can only take what we’re willing to give away. Life is a series of choices, each with benefits and drawbacks. We should make those choices based on what we want, not what we’re told we should want. We should recognize that our choices may affect our futures, and not pretend that someone can absolve us from the consequences of bad ones. But, we shouldn’t let someone else’s vision of how a lifespan should be lived decide how we live ours. Longevity may be your goal, or my goal, or his goal, or her goal, but it’s not everyone’s goal, and we as a society shouldn’t look to chastise or shame those who’ve prioritized other things. Some will claim that those who don’t chase longevity during most of their lives will want it at the end, and therefore burden society with those massive end-of-life costs. Isn’t it society’s choice, however, to assume those costs? Isn’t it “bootstrapping” to tell someone how to live because you’ve declared that you’ll pay for his late-in-life health care costs? How does that align with free will and self determination?
In closing, I’ll share the words of Sergeant Major Daniel Daly, who screamed at his men prior to leading a charge against German lines in World War I:
Come on, you sons of bitches, do you want to live forever?
Loading ...
Active Comment Threads
Most Commented Posts
Universal Background Checks – A Back Door to Universal Registration
COVID Mask Follies
When Everything Is Illegal…
An Anti-Vax Inflection Point?
“Not In My Name”
The Great Social Media Crackup
War Comes Through The Overton Window
The First Rule of Italian Driving
Most Active Commenters