Monday, August 20, 2012

How much of America's healthcare crunch is dementia care?

US healthcare costs were 2.6 trillion in 2010; about 18% of the 2011 US economy. Of that, dementia care costs about $200 billion, or about 8% of our total health care bill.

Demographics, and our failure to prevent brain deterioration, means dementia costs will grow. Since demented patients often exhaust all personal and family financial resources, these costs will show up as medicaid expenditures.

Even so, dementia is less of a problem than I had long thought. Even if costs were to increase by another 50% over the next decade, it still wouldn't break the bank.

Faced with the facts, I'm now forced to examine my unexamined assumptions. I can now imagine why dementia might turn out to be a bit of a bargain.

Many, if not most, dementia patients no longer receive aggressive medical care. They do need hands-on care, but in the modern economy there's no lack of people reasonably happy to do that work for comparatively little money. Demented people don't eat that much, and they don't require costly ingredients or food preparation. They don't demand the latest gadgets or costly bandwidth or cutting edge architecture or modern art on the walls. They can live where land is cheap.

In many ways, demented people are cheaper to maintain than non-demented people of similar ages. Given that neither produce wealth, from an economic accounts perspective dementia might be a money-saver.

Even as our dementia population grows, increasing costs may be offset by advances in robotics and remote monitoring, and, in time, by widespread acceptance of euthanasia [1].

Of course dementia and pre-demential can bankrupt individual families, but in our income skewed economy those bankruptcies don't add up to all that many billions.

To answer my title question then, dementia care does not appear to be a uniquely large part of our healthcare crunch. Obesity, for example, may be more important.

That's too bad, because many of us have a personal interest in a business case for dementia prevention...

[1] I want my kids to have a robust financial incentive to pull the off switch on my future demented self.

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