Why slowing the aging process could save the U.S. trillions

Finding ways to delay the aging process wouldn’t just make people feel and look better, it could also save the U.S. trillions of dollars in the long-run. Photo by Paul Bradbury.

Finding the fountain of youth might never happen. But new research shows that slowing down the aging process could be an imminent reality — and one that should be taken seriously.

As discussed in a new study in the journal Health Affairs, research is emerging about the aging process and how it can be decelerated. From manipulating genes to altering hormone levels, it seems there are several ways that aging can be delayed. These methods and others have proved promising in invertebrates and mammals, but scientists are just starting to scratch the surface of what they could mean for humans.

One key study finding suggests that it might be possible to extend human lifespans while simultaneously reducing the prevalence of diseases like heart disease and cancer. If humans could age more slowly, it might be possible to delay the onset and progression of fatal diseases as well as add an additional 2.2 years onto a person’s life. This means that people would not only live longer, but remain healthier in their older years.

That’s what Dana P. Goldman, director of the Schaeffer Center for Health Policy and Economics at the University of Southern California, believes is one of the most important parts of delayed aging research. “Delayed aging is about adding healthy life years rather than disabled life years,” Goldman said. “We now have a situation where we really need to think about whether we want to make a greater investment in this area of delayed aging.”

But a lower risk of disease is not the only possible benefit that would result from further delayed aging research; there may be potential economic benefits as well. The study suggests that the monetary value of delayed aging is estimated to be around $7.1 trillion over 50 years — a number that’s certainly hard to ignore. But the social return could be great. More money spent on prevention would mean less money spent on treatments after the fact. And, of course, it would mean a healthier, more productive population.

So is delayed aging research something we should really be investing in? Goldman joined the NewsHour earlier last week to discuss the Health Affairs study and explain why continued research into delayed aging could open a lot of doors for the future of human health.

NEWSHOUR: Professor Goldman, thanks for joining us. To start off, can you give us a general background on what delayed aging is and its importance?

GOLDMAN: Historically, we’ve made tremendous progress in increasing life expectancy if you look over the past century. We’ve taken care of fatal and disabling diseases. But as a result of that, what we have is a population that’s living older and older. That means they’re at risk for a number of different diseases. In fact, diseases like Alzheimer’s, and to some extent cancer, reflect success in that people are living long enough so that they’ll actually be afflicted by these conditions. This rising life expectancy means that aging in and of itself is now becoming the most important risk factor.

In addition, we’re starting to learn something about the biology that underpins aging — how cells age, what’s going on at the molecular level, and how we could manipulate genes to increase life span. So the science behind the aging process is improving, and we’ve made a lot of progress on a lot of other illnesses, as well. The confluence of these trends means that we now have a situation where we really need to think about whether we want to make a greater investment in this area of delayed aging.

NEWSHOUR: You say investment. How did you come to the conclusion that this concept is one that would pay off in the long run?

GOLDMAN: We have developed a model that tries to predict the future of the U.S. population — something we’ve been working on for over a decade. We started doing scenarios with the model where we would change the diseases present in the population, and we couldn’t understand why it was that they weren’t having bigger impacts. So we started to look at the underlying reasons. And it had to do with the fact that in some cases, we’re victims of our own success.

We really need a comprehensive approach to fighting illness. It’s almost like Whack-a-Mole, where you push down on one disease and another one pops up, and we need to figure out how we can tamp down all these illnesses together. When you do that, you quickly start talking about how to deal with aging.

NEWSHOUR: What would this concept of delayed aging look like for an ordinary person?

GOLDMAN: The ideal scenario for everyone is that we live a long, healthy life, and then one night, we go to sleep and don’t wake up. This concept is termed ‘compression of morbidity’ — that is, we live life with very few diseases or impairments in our cognitive or physical function.

So, when we talk about adding years of life, we can ask: are these healthy life years or disabled life years? For example, if we improve treatment for stroke, the outcome is often one in which people have limited function and end up in assisted living. However, if we could prevent stroke, we can live that extra time in a healthy state. Delayed aging is about adding healthy life years rather than disabled life years, thereby achieving compression of morbidity or at least forestalling it.

NEWSHOUR: So why do you think that, up until this point, the scientific community hasn’t invested much into delayed aging research?

GOLDMAN: That is actually a function of two things. The first is that the science wasn’t quite there. But I think a second and much more important point is that there’s no reimbursement model for these types of treatments. Suppose someone does come up with an anti-aging pill, let’s say, something that can delay aging or modify genes. It’s not really a sickness and it’s not really covered by health insurance. So actually, the table has been tilted towards treating disease rather than keeping people healthy. In fact, that’s why we grossly under-invest in prevention of disease — because there’s no money in prevention. If you give someone a pill when they’re healthy, you can’t charge the insurance company for it. When it comes to research and development, the playing field is tilted away from prevention and towards treatment.

But things are starting to change. Larry Page, the CEO of Google, and Art Levinson, who is the former CEO of Genentech, one of the most successful biotechnology companies, have just decided to develop a company called Calico to explore this type of science. I think the market has decided that this is an area worthy of investment. And so in some sense, we’re just reflecting decisions that are being made in the private sector now.

NEWSHOUR: How long do you think it will take for it to become a reality?

GOLDMAN: I don’t want to prognosticate — I can’t even tell you who’s going to win the Super Bowl. But what I can tell you is the following: if we were successful, the value to society could be as much as $7 trillion over the next 50 years after you take the health benefits into account. So even if there’s only a 1 percent chance, that suggests we should be investing $71 billion to try to make this happen. Even if it’s only a 1 in 100 shot — and I think it’s much better than that — we should be taking the risk, because the value to society is so great.

NEWSHOUR: Give us a scenario. Let’s say a miracle delayed-aging pill comes out. How would it affect a particular individual’s quality of life and life span?

GOLDMAN: What they’d see is they would have better functioning into older ages. In fact, it would really reflect a trend that we’ve seen over the last 20 years. You’re going to see a lot more people active into older ages, and they’ll also have greater work capacity. A lot of people, when they reach age 62 (the early retirement age for Social Security), they don’t have the physical stamina and the ability to continue to work. But you’re going to find that both cognitively and physically, people are able to function better into older ages. Also, people living into triple digits won’t be such a rare thing — so you could see things like multi-generation households.

I do think it raises some questions about social cohesion. The question is really not whether we should be trying to do this, but rather how this will fray the social fabric if some people are living like that while others can’t afford the treatment. We talk a lot about income inequality, but if you look at the data, there’s quite a bit of health inequality in this country, too. If we don’t find the right safety net, what you’ll see is that that health inequality is going to be greatly exacerbated over the next 50 years. That’s a reason to start addressing fiscal policy in such a way that you provide that safety net and even provide access to these treatments. A simple example would be: should Medicare cover them?

NEWSHOUR: You’ve briefly touched upon some of the economic impacts of delayed aging. Can you give us a broader sense of what those impacts would be?

GOLDMAN: The economic impact is very dependent on social policy, as I mentioned before. If you were to index Social Security or Medicare to the amount of life remaining, what you’d see is people working longer and paying more taxes. The consequence for the fiscal debt and deficit would be relatively minor. But if we continue to have the policies we have today, what you’re going to see are a lot more people living to older ages. They’re going to continue to get their Social Security payments, and to some extent Medicare and Medicaid, into older ages, as well.

Social Security is going to end up having to pay out for a lot longer. Just like any other pension program, that’s going to cost a lot of money, and you need workers to pay for that. You’ll need to either see taxes rise or debt being put on future generations, and that’s going to create some tension.

The reality is, a change doesn’t happen overnight — it’s not like suddenly, everyone lives 15 more years. We’re going to make progress and come up with research, improve health a little bit, and then refine it to make it better. We have an opportunity to figure out how we deal with an aging society over a longer period. I’m optimistic that we’re going to get this right.

NEWSHOUR: Professor Goldman, thank you very much for speaking with us.

GOLDMAN: Thank you.

This interview has been edited for clarity.