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August 11, 1989

Options to Control the Health Care Costs of the Elderly

Author Affiliations

Park Clinic PC Livingston, Mont

Park Clinic PC Livingston, Mont

JAMA. 1989;262(6):774-775. doi:10.1001/jama.1989.03430060068022

To the Editor.—  I concur with Dr Schneider' that the use of age as a criterion for the rationing of health care is misdirected.The problems that face the elderly today are chronic and incurable though treatable, such as coronary artery disease, peripheral vascular disease, stroke, chronic dementing illnesses such as Alzheimer's disease, other neurological diseases such as Parkinson's disease, and disabling syndromes of the musculoskeletal system, particularly osteoporosis. Unfortunately, Dr Schneider uses as examples two infectious diseases, tuberculosis and poliomyelitis. As those of us who practice medicine are well aware, infectious diseases frequently are curable (tuberculosis) or preventable (polio). The chronic diseases previously enumerated are neither curable nor likely to be preventable with a program as cost-effective as vaccination.A more appropriate example would be coronary artery disease. Increased understanding of the etiology, pathogenesis, and treatment of coronary artery disease has led to a decline in the mortality rate