intergenerational equity


Robert Frost and the Decline of the Medical Profession

The title of this post is deliberately mysterious, but you’ll understand it at the end. At my 50th medical school reunion in June, my classmates agreed that while the goals of medicine are as valid as ever, the profession itself is in decline. Here’s a quote from the Preface to our reunion book: “A frequent […]

Arnold Relman: 1923 – 2014

Dr. Arnold (“Bud”) Relman died yesterday at 91. He was the most esteemed leader among those who have been dismayed by the commercialization, fragmentation, excessive cost, and relatively poor quality of the U.S. health “system.” In 1980, as editor of the New England Journal of Medicine, Bud sounded the alarm about a danger he fought […]

Grandparents and Grandpresidents

Disclaimer: This blog is not an endorsement for Hillary Clinton. Far from it. We don’t even know if she is running for President yet. But we do know that she is projected to be a grandmother. Who knows? Even if she does run, she may run against someone who is also a grandmother or grandfather. […]

When is a Good, or Tolerable, Time to Die?

As someone who has spent many years writing about end-of-life care, there is one question that has long intrigued me, but it is rarely posed in that context. When is a good, or tolerable, time to die? I do not mean when one is in pain or suffering, which is the way that question usually […]

Age and Judgment

I was struck recently by the concluding sentences of an article written by Nathaniel Morris, a Harvard Medical School student. Note his final words. “. . . health care providers must discern when to apply the powerful instruments at their disposal and when to carefully hold back. It often just comes down to clinical judgment, […]

Social Security: Don’t ‘scrap the cap’

By I fancy that I stay abreast of what’s happening in the Social Security policy arena, so I was taken aback during a trip to Washington, D.C. to learn that a whole movement has developed to eliminate the bulk of Social Security’s 75-year deficit by scrapping the cap – that is, eliminating the earnings cap […]

Honor Thy Mother and Father

The Japanese have the right idea. Their Prime Minister recently announced his government would invest in the development of “nursing care robots” that help older people with everyday tasks. With just over 20% of its people over age 65, Japan has the largest proportion of elders of any country in the world–the corresponding number for […]

A Letter to Our Grandchildren

Dear beloved grandchildren, As I get older, I think more about what I want to leave you in the way of advice. Of course, I have been doing some of that all along. My son Evan thinks that I “opine” too much, but I thought it might help to have things in writing that you […]

Setting Generational Priorities

In the mid-1980s, just as I was becoming interested in health care for the elderly and the future of Medicare, Samuel Preston, a distinguished social scientist at the University of Pennsylvania, give a 1984 presidential address to the Population Association of America. His topic was the growing disparity between health and other resources for children […]