During the health care reform debate, it is common to encounter the “unplugging granny” metaphor. This rich mental picture causes one to envision hospitals full of older Americans kept alive on ventilators. It also feeds the caricature of the most elderly population as decrepit, of no use, and a burden on the rest of society. Ageism is, of course, characterized by negative stereotypes that subsequently lead to discriminatory actions such as reduction in medical services.
Not only is the “plugging in the elderly” discussion insulting, it has no relation to reality. In accordance with the International Code of Diagnoses and Procedures, “plugging in” refers to “intubation and ventilation.” Having access to the latest database of hospital admissions and discharges in the U.S. (approximately eight million or 20% random sample of 2007 cases), I have looked at this procedure by ten-year age categories. The following findings are surprising to practically everyone with whom I share them:
- The largest proportion of patients on ventilators in 2007 was in the 0 thru 9 age category (18%).
- Only 3% of patients on ventilators were 90+.
- The 80 thru 89 age group was responsible for 12.4% of patients on ventilators.
- A smaller proportion of patients on ventilators was in the 80 thru 89 and 90+ age categories than the 50 thru 59 (13.7%), 60 thru 69 (16.4%), and the 70 thru 79 (17.5%).
- Disaggregation of the really expensive ventilator charges ($126,000+) by ten-year age categories indicates that 29% are in the under 10 age category while only 2.1% are in the 90+, and 10.3% are in the 80 thru 89 age category.
The point of this post is not to shift blame from an older to a younger age group. The point is to stop blaming patients in any age category for health care costs. Babies bear no more responsibility for health care costs than the elderly. Patients at any age should receive the care they need – nothing more, nothing less.