Societal Expectations of Poor Health in Elderly Contribute to Skyrocketing Costs

The media reinforces the expectation that poor health comes with age. This attitude leads to extraneous medical procedures and skyrocketing healthcare costs, which reached $2.9 trillion in 2013 and are projected to grow an average of 6% annually through 2023.  To reverse this unsustainable trend, healthcare practitioners should promote healthy habits to prevent disease, rather than simply treating the symptoms of sedentary lifestyles, according to Robert Drapkin, MD, board-certified physician in Internal Medicine, Medical Oncology and Palliative Care.

A Pew Research study finds that four in 10 adults in the U.S. are caring for sick or elderly family members. As the population ages and medical advances extend lifespans, home caregiver numbers are projected to increase; nearly half of the adults surveyed by Pew Research say they expect to care for an elderly parent or relative in the future.

The Affordable Care Act (ACA)—with tenets of quality care at every age—has abandoned the longstanding fee-for-service model, which unintentionally encouraged office visits, tests, procedures and surgeries. Instead, healthcare providers are incentivized to reduce costs while providing better quality care. In addition, doctors, hospitals, and other practitioners are encouraged to coordinate care through Accountable Care Organizations (ACOs), which have financial incentives to save money by avoiding unnecessary procedures—all changes which Dr. Drapkin says will help reverse the view that wellness is virtually impossible as an individual ages.

Seniors and their families will greatly benefit from an emphasis on improving wellness, rather than endless treatments and over-medication, said Dr. Drapkin. Without a focused effort on education, the soaring costs of healthcare, combined with a disregard for their fundamental health needs, will continue to push the burden of care onto family members. Drapkin says that a more concerted effort, throughout the healthcare system, to promote healthy habits earlier in life would help Americans avoid many of the conditions that cause poor quality of life and financial worries as they age.

He notes that the overburdened healthcare system focuses at least 25% of its resources to treat preventable diseases and disabilities that result from harmful habits, such as smoking, poor diet, lack of exercise, failure to use seat belts, and alcohol abuse. In fact, alcohol, cigarettes, and obesity cost the U.S. healthcare system a combined $177 billion per year.

Along with questions about who should pay for the consequences of unhealthy behaviors, the healthcare system will also struggle with increasing demand for services. Seventy percent of people over 65 will need some form of long-term healthcare. As a result of the ACA, healthcare providers will be seeing more patients as there are fewer uninsured people who forego healthcare. A study published by the Annals of Family Medicine reports that 52,000 additional primary care physicians will be needed in the U.S. by 2025, but too few medical residents are choosing primary care to fill this need.

“Clearly, a new approach is needed to avoid over-stressing the healthcare system and families of the elderly in the U.S. Eliminating preventable diseases through education about healthy habits would not only ease these burdens, but would also reduce healthcare expenditures and increase Americans’ lifespans. It’s a win-win approach that will produce healthier, happier seniors,” said Dr. Drapkin.

Doctors Admit that Many Medical Tests and Procedures are Unnecessary

Seventy-three percent of doctors say that unnecessary tests and procedures create a serious problem for America’s health care system. Three quarters say that, at least once a week, the average doctor orders unnecessary medical tests and procedures , according to research by the ABIM Foundation. Sixty-six percent of doctors say that doctors have a great deal of responsibility to make sure their patients avoid unnecessary tests and procedures. Yet, more than half admit that they’d give an unnecessary medical test to an insistent patient. Seventy percent say that after they speak with a patient about why a test or procedure is unnecessary, the patient often avoids it. The survey, which is funded by the Robert Wood Johnson Foundation, comes two years after the launch of a campaign, called “Choosing Wisely.” The campaign encourages doctors and patients to discuss whether certain medical tests and procedures are really necessary. Since April 2012, 60 medical specialty societies have identified more than 250 tests and procedures that are overused or inappropriate. Twenty-one percent of physicians are aware of the Choosing Wisely campaign. And 62% say they are more likely to reduce the number of times they recommend an unnecessary test or procedure. That compares to 45% of doctors who are unaware of the campaign. For more information, visit

Last Updated 01/19/2022

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