Aging in America News

| If we’re not growing older together, we’re doing it wrong. 

| Mark Swartz

| Advances in medical research, preventive care, and age-related treatments promise to extend not just our lifespans, but our healthspans—the years we live in good health and vitality. Yet as America’s multi-trillion dollar longevity market rapidly expands, we face a troubling reality: these innovations are becoming a luxury available only to those who can afford expensive treatments and cutting-edge interventions.

“Effective biomedical anti-aging interventions will probably be quite expensive,” state Charles McConnel and Leigh Turner. “Who will have access to such therapies?” 

If breakthrough treatments remain accessible only to elites, innovation will follow the money, focusing on boutique solutions for the few rather than scalable interventions for the many. 

While the wealthy live longer and longer, millions of Americans struggle to afford basic healthcare, let alone the kind of comprehensive, proactive care that supports healthy aging. The result is a two-tiered system where your ZIP code and bank account increasingly determine not just the quality of your later years, but their very length.

Just as universal healthcare (whether Medicare for All or another form) not only aids the disadvantaged but elevates everyone, just as universal basic income would, arguably, improve the overall economy, universal longevity would foster infrastructure, research, and economies of scale.

“Framing longevity as a human right,” says Arkadi Mazin, “is natural and intuitive. Not only does it belong in ‘the Pantheon of Rights,’ but it deserves a central place there as an extension of ‘the Big Three’ from the Declaration of Independence.”

It follows that every investment, every policy, every research project should pass a simple litmus test: Is it for everyone’s benefit? Given the rise of elite longevity clinics that charge annual fees running into the hundreds of thousands of dollars, we know what it looks like when the answer is no.

In a visionary 1991 proposal for a national long-term care [LTC] program, Charlene Harrington and her colleagues call for “a universal need-based entitlement to LTC [that] would replace the current irrational patchwork of public and private programs, each with its own eligibility criteria, by age, cause of disability, and income. All income groups would be covered without means testing, which is cumbersome and costly to administer, may increase costs in the long run by causing people to postpone needed care, creates a stigma against recipients, and narrows the base of political support for the program.”

Similarly, in a Jacobin essay called “Means Testing Is the Foe of Freedom,” historian Matthew E. Stanley writes: “Universalism does not mean that every person’s needs are identical. Rather, ‘targeted universalism’ can combine common programs and a mass expansion of the public sphere (Medicare for All, free college, free housing, free childcare, etc.) with customized policy based on race, gender, disability, region, immigration status, and carceral effects.”

Capital allocation for research facilities, treatment centers, or community health programs should be driven by explicit planning that prioritizes equity. We need to correct the current bias toward expensive institutional interventions and instead invest in home- and community-based services that allow people to age with dignity in their own communities. This vision entails bringing together health planners, community members, and providers in democratic planning processes that ensure longevity resources flow toward those who need them most, not those who can pay the most.

Longevity should unite us in a shared project of human flourishing, not divide us into those who can afford extra decades and those who cannot. The coming longevity revolution will define what kind of society we are. We can allow it to become another mechanism of inequality, or we can seize it as an opportunity to recommit to the most basic of human rights: the right to a long, healthy, dignified life, regardless of wealth or circumstance.

Why bring up these ideals during a lengthy government shutdown? In our current political climate, where even basic healthcare expansion faces fierce resistance, advocating for universal longevity as a human right may seem quixotic. Yet there is never a bad time to call out the entrenched interests in our profit-driven healthcare system. There is never a bad time to question cultural narratives around individual responsibility versus collective provision. We owe it to ourselves, and to future generations, to seize the moment.

Mark Swartz is the founder of Aging in America News.