America needs to be reformed. We can be better, much better. How we live our lives and when we retire need to be re-examined. First, we need to come to grips with the fact that we generally live longer than prior generations. Second, we need to realize that challenge is compounded by unhealthy lifestyles. Third, we need to understand that our current medical insurance system is financially based on providing services, not outcomes, a costly and ineffective approach.

The longevity challenge can be effectively addressed by changing the full eligibility age for Social Security and Medicare to age 70. Half benefits could begin for both at age 65, and delayed participation could increase in 10 percent increments per year, with full benefits for the person who retires at age 70. In public safety and military retirement systems, the current 20/30-year system for half pay to full pay should be changed to a 30/40-year system. Phasing in these changes would eventually put our current system on a sound financial and actuarial basis.

Unhealthy lifestyles can be addressed by a reform effort that begins in kindergarten and recurs throughout our lifetimes, based on healthy eating and exercise. Healthy people need fewer medical services, and lead happier and more productive lives. The benefits from such changes can be both obvious and immediate.

Finally, the baby steps we have already taken regarding wellness programs need to be converted into a complete philosophical and operational overhaul of how we do medicine, and how we pay for medical services. Outcomes are key. Informed and coordinated decision-making needs to treat the whole person, with the objective of maximizing the overall health and wellness of the individual. Early on, a system of regular vacations and sabbaticals should also be implemented as an integral part of a healthy and productive life.

The above approach is a relatively simple and straightforward approach that can result in a happier, healthier and fiscally sound America. The implementation, of course, is what will be difficult. But we need to understand that the current system is broken, and that comprehensive reform is required for survival.

John W Greco,


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