Doctor Walter M. Bortz on the Challenge of Financing Human Longevity

Couple running with dog

Walter M. Bortz II, M.D., is a Clinical Associate Professor of Medicine at Stanford University School of Medicine and a graduate of Williams College and the University of Pennsylvania School of Medicine.

Recognized as one of America’s leading scientific experts on aging and longevity, Dr. Walter Bortz's research has focused on the importance of physical exercise in the promotion of robust aging.

Dr. Bortz has published over 130 medical articles and authored numerous books, including We Live Too Short and Die Too Long, Dare to Be 100, and Living Longer for Dummies, and Diabetes Danger.

Annuity Digest: The health system—particularly the method of financing healthcare—is a common theme in your writing.  You discuss the medical industrial complex and the overemphasis on addressing disease or sickness versus encouraging health.  What are your views on the recent health reform legislation which appears to simply build on top of this broken system?

Doctor Bortz: Health reform is barely cracking the door.

The way I read it is that it just starts to approach quality and access by providing universal coverage.

Providing access is a first and necessary step, but we need to move towards health and prevention with our resources rather than treatment of disease and sickness.

The key question with respect to access is: access to what?  Are we actually providing access to health or are we continuing with the disease-centric model that contains incentives to be sick?

We need to re-emphasize and re-frame so that the focus is on health rather than disease.

Annuity Digest:  Can you comment on the above question in light of your forthcoming book titled Next Medicine: The Coming Revolution That Will Save American Healthcare?

Doctor Bortz:  My most recent book, The Roadmap to 100, discusses the human potential: specifically, how long is it. 

We have come to conclusion that 100 is the scientifically legitimate end-point for the human lifespan.

So, establishing the science of aging is focus of The Roadmap to 100.  This took quite a bit of effort.  When I told people I expected to live to 100 thirty years ago they thought I was crazy.

The next book, Next Medicine: The Coming Revolution That Will Save American Healthcare, will address how we deal with and manage this new, legitimate longevity potential.

We cannot frame this challenge in terms of repairing the human body because we cannot change the fact that we age.

What is needed is a reframing of the issue.

Fitness is how we address the practical reality of human longevity.

The financial system needs to get into this business of rewarding people for good genes that are well expressed, and fitness is the key to well expressed genes.

The critical factor is not so much the genes you start with, but rather the genes you end with.  This healthy expression is entirely dependent on lifestyle and an active, interventionist strategy.

We are at tipping point and we must demand and encourage personal responsibility for health.

Annuity Digest:  Do you have recommendations for funding for retiree healthcare expenses?

Doctor Bortz:  It all should be prepaid—the government should have a flat platform to take care of encouraging people to be healthy.

I do believe in risk adjustment.  In other words, people should be charged more for risky behaviors such as a sedentary lifestyle or smoking.

We now know what health is and it is a science, so when insurers start to get into the metrics of the health business rather than the sickness business we’ll have something to talk about.

The end game is health and not disease.

Annuity Digest:  Longevity is expensive—how as a society do we fund and afford longevity?

Doctor Bortz:  This is the hook.

I have the data that says you can live to be 100.  The question is how to finance this.

Richard Branson has looked at my work because he is in both the insurance and the health club business.  As a result, he is able to provide real financial incentives for healthy behavior.  In other words, his customers’ health costs are less if they exercise more.

Very few insurance businesses are realizing this relationship between health and wealth in practice.  I do remember, though, an Indianapolis-based insurer charging their customers less if they ran the Indianapolis marathon.

We should encourage people to be healthy because they will live a long time.

Insurance companies need to have a social dividend and charge people less if healthy.

It is all about incentives, opportunity and information.

Annuity Digest:  What are your views on use and value of private annuities?

Doctor Bortz:  I really don’t feel qualified to answer this as I do not know an annuity from a peanut splitter.

Annuity Digest:  Would you agree that there is a correlation between socioeconomic status (wealth and education) and lifestyle decisions and related health outcomes?  If so, how do we address this seemingly regressive outcome? 

Doctor Bortz:  Yes, unquestionably.

The term I use is “common health.” 

I would take half of our current 2 plus trillion dollars in health spending and dedicate it to health education.

Everyone defaults to the medical system for answers to health when it (access to medical care) is a relatively minor contributor to health outcomes.  Medical science says that access to medical care has about 20 percent to do with health outcomes.

The reality is that health outcomes have more to do with how much television you watch.

I participate in a youth program in Santa Clara called “Fit for Learning.”  Through this program we teach schoolchildren to walk to school and watch less television.  This is where health comes from.

You cannot buy health – it is all about health literacy and related lifestyle decisions.

Annuity Digest: Thank you very much for your time Dr. Bortz.

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