Open Letter to a 27-year old – Get It Together, NOW!

February 21, 2023

A curious young whipper-snapper posed this question recently on Quora.com.

What is the average or expected life expectancy for someone born in 1996?

I took a swing at it.

How would you predict it?

There are too many variables at play in longevity to say with certainty how long someone born in 1996 will live.

Speaking as a U.S. citizen, I’m confident in saying that if lifestyles and our treatment of the ecology don’t change in our culture soon, there is a good chance that the average 27-year-old today won’t do any better than the current average life span of 77 for men, 81 for women.

The average longevity in the U.S. peaked and began to turn south several years ago after over a century of meteoric change – from an average of 47 in 1910 to around 80 today. And, by the way, that downturn started well before COVID appeared on the scene.

But that rapid change in the 20th century came from picking the low-hanging fruit – improved infant mortality, reduction/elimination of infectious diseases, better water, food, education, etc.

With that done, we now are up against a new reality and, as COVID-19 is showing us, we aren’t particularly well prepared, biologically.

Know thine enemy.

Our lifestyles, terrible farm/food industry/system, broken healthcare system, and opportunistic/exploitive pharmaceutical industry are assembling a combination of dire threats to our health and longevity going forward.

So, born in 1996 and 27 years old, what can you expect? Consider a couple of choices:

1. You can adopt the prevailing lifestyle that consists of consuming the dangerous Standard American Diet (SAD) of chemically-engineered, food-like substances (C-R-A-P, calorie-rich-and-processed), sedentary living (limited movement, Facebook, voice-activated remotes, and video games), working in a stressful work environment building somebody else’s dream and doing something outside of what you are wired up to do, all while seeking comfort and convenience.

That will put you on track for a life expectancy of 80 years or less, joining a population that is experiencing lifestyle diseases such as obesity and Type 2 diabetes. The top five killers in our culture are all preventable lifestyle diseases that haven’t changed in decades. Poor diet passed smoking as the #1 cause of early death in America long ago.

You can remain ignorant of, and succumb to, the powerful profit-motivated forces in our culture that are counter to your health and longevity – named earlier – or you can take charge and be the CEO of your health.

If you choose not to take charge, you are likely to end up with an average lifespan with a poor health span.

2. You can wait for a “miracle drug” to pop out from the bio-medical field and “save you” from your marginal lifestyle and guarantee you a long healthy life with no effort.

Just a hint: nobody is coming to save you!

3. You can become a student of how your body and mind work at the cellular level and understand and appreciate the amazing, intricate, and powerful nature of the ecology you live in and the role it plays in your health and longevity. You can learn how to support the amazing 24×7 immune system that is your body and how it is impacted by what you do and don’t do to it and what you put into it and don’t put into it.

You will learn that your biology gives you only two choices – growth or decay. You can strive to appreciate the “use it or lose it” principle that is at play with your biology and thus reject a sedentary lifestyle for the duration of your life. You can become a student of nutrition. You can commit to life-long learning, understanding the importance of applying the same “use it or lose it” principle to your brain.

If I were 27 today (I’m 3x that in six weeks!) knowing what I know now, I would become a revolutionary and be a vocal (not with signs or in the streets), knowledgeable, and persuasive opponent against these forces that are teaming with other unfettered industries collectively destroying both our health and our ecosystem.

Honestly, I fear that a 27-year-old today has a slimmer chance of reaching my age because of the trend line of what we are doing to our bodies by succumbing to the corporate forces working against us and what we have already done to our own ecosystem, particularly the microbiome.

The solution is to get knowledgeable, understand what is being done around you, get outside of it, and choose to eat right, be active, and be discerning of the messages coming from the media, corporations, and the government.

Your longevity hangs in the balance.

Hi, readers! Thoughts on this topic? Love to hear from you. Leave a comment.

Who’s the Arbiter of Your Health? Please Tell Me It Isn’t Your Doctor.

February 7, 2023

Can I share some non-news with you?

This was published in the Becker’s Hospital Review on 1/31/2023 (I subscribe to try to stay ahead of the out-of-control craziness in healthcare today since I deal daily with execs in the field.)

“The U.S. spends two to four times as much on healthcare as most other high-income countries, but the health outcomes lag behind, a new Commonwealth Fund study found.

“U.S. Healthcare from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes” is an ongoing report by the Commonwealth Fund that compares healthcare spending and outcomes, health status and healthcare usage in the U.S. with 12 other high-income nations and the average for all 38 Organization for Economic Co-operation and Development members.

The U.S. remained the only nation within the OECD that does not offer universal health coverage despite spending nearly 18 percent of its GDP on healthcare, according to the report.

Here are five other findings:

The U.S. has the lowest life expectancy at 77 years compared to the 80 years average for other wealthy nations.

The U.S. has the highest rates of avoidable deaths from causes such as diabetes, hypertensive disease and certain cancers.

The U.S. has the highest COVID-19 death rate among high-income countries, at 3,000 deaths in every 1 million cases between Jan. 22, 2020, and Jan. 18, 2023.

Physical assault, which includes gun violence, is seven times higher in the U.S. than in other high-income countries, except New Zealand.

U.S. infant and maternal deaths are more than triple the rate of most other high-income countries.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” lead author Munira Gunja, senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovations, said in the report. “To catch up with other high-income countries, the administration and Congress would have to expand access to healthcare, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

I bolded the last part of Mr. Gunja’s comment because it’s the same ‘ol, same ‘ol chant that we hear from everyone jumping on the “let’s fix healthcare” bandwagon.

Expand access
Control costs
Invest in health equity

All valid. All doable. All sensible.

ALL DOWNSTREAM!!!

Sorry, you’ve tolerated my rant on this before, but I’m not stopping even though I’m a voice in the wilderness.

We’re not solving the problem. We’re fixing the results of the problem. And threatening to bankrupt the country.

At some point, we need to turn off the spigot instead of spending society-crippling amounts of money mopping up the water.

There’s no end to gullibility!

Here’s another example.

I read an article recently in which a board-certified pediatrician is advocating bariatric surgery and diabetes drugs for overweight children, claiming that the main cause of child obesity has a genetic origin.

Do I smell an element of “follow the money” here? Does she really think we are that naive? Couldn’t she be bold enough to shed her “drug it or cut it out” indoctrination and advocate for that ghastly model-busting concept called – wait for it – PREVENTION.

How many kids were obese when you were in grade, middle, or high school? I remember two in my high school of 95 kids. And they weren’t really even obese by today’s definition. But then that was pre-McDonalds.

What does it say that the average American woman today weighs the same as the average American male in 1960? Or that the average American male is 32 pounds heavier that the 1960 American male? And neither of them is any taller. Or that we are now beset with epidemic levels of overweight children?

I’m not a scientist or a geneticist but I do know enough to say confidently that genetics don’t change in a 40-50 year span to make all that happen.

We know the problem and choose to ignore it.

We let the food industry get away with murder with their deceptive practices and food-like products. We provide them with cover with senseless government policies.

We provide insane subsidies to the industries that provide the food components that are killing us.

We build massive, monolithic healthcare institutions that know only “cure” and can’t or won’t learn to spell, pronounce, advocate, or train for prevention.

This is Sisyphean

Is it too big and too late to change? I believe so.

I’m guessing this will be a pivotal and disruptive year in healthcare. The big systems are shoveling money out the door by the trainload. Major disruption is starting and will intensify. Amazon, Walgreens, CVS, Walmart, Optum – all are circling like vultures over this wounded carcass looking for a way to swoop in and intercept the incredible cash flow the government doles out by using their technologies to get to that stream faster and at lower costs. Some of that lower cost may even be passed on to the victim – er, the patient. All under the guise of providing “better patient care.”

They’ll be able to increase the convenience and lower some of the costs of mopping up the water. Count on them being able to get us in and out faster and at a lower cost to allow us to continue on our life-sapping, unhealthy habits with not a modicum of advice like “get you arse out of Whataburger and over to Planet Fitness.”

That doesn’t fit the dying model nor the emerging one.

The solution? Avoidance!

It’s unfortunate and an anomaly, but the last place to go to get counsel on how to stretch your health span across your lifespan is your health system-affiliated physician. They are not trained, equipped, or motivated to provide advice on the metabolic processes that enable that extended health span. And, if employed in a system, they are under pressure from a financially-strapped mothership to treat you as a number with a fifteen-minute visit limit.

My primary care physician is in his early 60s, has two artificial knees, is 30 pounds overweight, and is blind in one eye from an as-yet unexplained cardiovascular event. I love the guy – I’ve been seeing him for over 25 years. We have great conversations about the industry and his photography from his twice-a-year ventures to Lake Powell. He has helped me numerous times with the right solutions to my downstream problems.

I do my darndest to avoid seeing him. It’s usually just once a year for the blood panel review, a quick look in the ears, nose, and throat, and the rubber glove bit.

He’s never asked about my diet or exercise regimen – nor would I listen if he volunteered.

It’s nice to know he’s there and competent if my wheels skid off the rails.

He’s a partner in my health when I need him – not the arbiter.

I’m counting on my immune system to do the heavy lifting by giving it what it needs to perform optimally.

Nobody’s coming to save us.

We’re left with little else but to take responsibility for acquiring the knowledge of how to protect our birthright of good health, regardless of where we are on the age spectrum.

If you’ve tracked with me for a while, you know I’m a fan and advocate of “Harry’s Rules”, the appendix in the book “Younger Next Year” (affiliate link) that was written by the co-author, the late Dr. Henry Lodge.

It seems a good time to resurrect them.

Harry’s Rules

Exercise six days a week for the rest of your life.

Do serious aerobic exercise four days a week for the rest of your life.

Do serious strength training, with weights, two days a week for the rest of your life.

Spend less than you make.

Quit eating crap!

Care.

Connect and commit.

Can you imagine these rules hanging in your doctor’s office?

Don’t hold your breath!

Are they hanging in your office?

Thanks for reading. What are your thoughts or observations on this topic? Love to hear from you. Also, if you haven’t joined our list for this free weekly newsletter, you can do so at www.makeagingwork.com.

Who Wins the Diet-versus-Exercise Longevity Debate? Let’s Call It a Draw.

January 10, 2023

It’s nice to be back from my two-week writing sabbatical. I doubt I’ll do that again – I hope the rust isn’t apparent with this first article of 2023.

I got some pushback from a few readers on my 12/6/2022 post (see here) in which I claim diet to be the biggest determinant of a longer, healthier life.

Exercise, they claim, is more important than diet.

My argumentive side is inclined to invoke the Jim Fixx story to illustrate otherwise. You remember him – the guy credited with helping start America’s fitness revolution by popularizing the sport of running. Fixx claimed that diet mattered not if you exercised enough. He was a 240 lb, two-pack-a-day smoker before he became a runner. Despite losing 70 pounds, Fixx continued with a marginal diet, espousing that it didn’t matter what he ate.

He died of a heart attack at 52 after a morning run. The three main arteries leading to his heart were almost completely blocked with plaques, and his other arteries were filled with plaques as well.

But wait, why argue –

-over two things that both contribute to healthy longevity? How ’bout we avoid either-or thinking and go with both-and?

I’ve revealed my hand on what I think is most important. But let’s look at the arguments in favor of the other side.

Here’s a quote from a young man I follow on Medium.com, Gunnar De Winter:

“The closest thing we have to an anti-aging pill is not some fancy supplement, but physical activity. Exercise keeps your blood, your brain, and everything in between young, down to the (epi)genetic level.”

But what is the optimal level of exercise. That’s where it gets interesting – and challenging for us generally sedentary second-halfers.

You might want to sit down for this:

An article in Springer Open addresses “optimal” exercise for longevity, stating the following: (the bolding is mine):

Regular physical activity (PA) represents the most important lifestyle component associated with cardiorespiratory fitness, healthy aging and longevity. In order to induce general health benefits, public health guidelines recommend, beside strength and balance exercises, at least 150–300 min of PA at moderate aerobic intensity or 75–150 min at vigorous intensity per week [1, 2]. Much more engagement in PA, however, is necessary to achieve maximal benefits on longevity [3]. For instance, a large prospective cohort study demonstrated maximal longevity gains at about 700 min of moderate or 350 min of vigorous PA per week [4]. The accomplishment of this objective is challenging in particular when considering that even minimal PA recommendations are difficult to achieve in the aging populatio

Raise your hand if you can get motivated to find 100 minutes a day for moderate exercise or 50 minutes a day for vigorous exercise.

It’s a tall order for all of us. But the benefits are well documented.

My unassailable weekly exercise regimen amounts to about 550 minutes/9.2 hours of combined vigorous and moderate exercise. It seems like a lot until you think of it as a % of your week:

9.2/168 = 5.4% of my week.

I don’t find 5% to be much of a sacrifice in order to feel good and mostly pain-free every day and enhance the chances of putting more years in my life along with more life in my years.

Borrow 11% of average TV viewing time.

Ken Dychtwald’s research for his book “What Retirees Want” A Holistic View of Life’s Third Age” revealed that the average retiree in the U.S. spends 49 hours watching television.

If exercise is, in fact, the most important thing we can do to live a longer and healthier life, it wouldn’t seem to be too great a sacrifice to rechannel a bit of that sedentary habit into moderate or vigorous exercise.

I don’t think twice about 5% of my week going to exercise because it’s so ingrained as a habit I started nearly 40 years ago.

If it ain’t on the calendar (mental or physical) it ain’t gonna happen. It never leaves my mental calendar.

I know vigorous exercise isn’t for everybody in my cohort. I’m still waiting for another octogenarian to join me in the deadlift area at Lifetime Fitness.

It’s never too late to start, but always too early to quit.

There’s no arguing that statement.

Nor is there logic in arguing which is best – diet or exercise.

Let’s table the argument and max out with both.

What’s your exercise regimen look like? What works for you? What can we learn from you about how you come down on diet versus exercise? Leave a comment or drop a note to gary@makeagingwork.com. If you haven’t joined the Makeagingwork tribe, trip on over to www.makeagingwork.com and sign up to receive a free article each week on the topic of successful aging, longevity lifestyle planning, and health & wellness for folks over 50.

The Single, Most Important Thing You Can Change to Ensure a Longer and Healthier Life.

December 6, 2022

If we simply look at the stats behind the most prevalent lifestyle habits that cause early death, we have to come down on diet as the one most responsible for shortening our lives.

As this chart points out, the combination of poor diet with inactivity has now surpassed smoking/tobacco as the main cause.

Choosing to change our diet to one that is more plant-based with lowered intake of meat and dairy is most likely the one habit that will contribute the most to a longer and healthier life.

Check out the many excellent articles and videos on this topic available from Dr. Michael Greger at www.nutritionfacts.org.

There are those who would argue that exercise is the one thing that would have the most impact. I would argue to the contrary, but submit that the combination of a nutritional diet and a disciplined exercise program is the best one-two punch for a longer healthier life.

I can use personal experience to substantiate the claim that exercise alone is inadequate.

I smoked for 18 years until age 37 at which time I quit and truly became a gym rat, an exercise devotee. However, I didn’t change my diet away from the Standard American Diet (SAD) of calorie-dense, processed foods, and was not into fruits and vegetables. I became aware of the need for a diet change (with help from my Weight Watcher-devoted wife) in my late-50s.

Since then, it has evolved to a diet more balanced with significant levels of fruits, vegetables, and lean meat or fish. I’ve also reduced dairy, but confess that butter is still too tempting to avoid altogether. (I rationalize that by cooking vegetables in butter).

At age 73, at the suggestion of my primary care doctor, I had a carotid and heart scan simply as a precaution since I had never had one. Despite being in great physical condition, the heart scan revealed that I was in the high-risk category for cardiovascular disease(CVD) with the scan showing significant artery calcification.

Fortunately, subsequent nuclear stress and echo stress tests revealed that the calcification was “distributed” and was not causing significant blood flow issues. Fortunately, my left anterior descending artery (LAD), commonly known as the “widow maker” appears to be clear. I am lucky – I can continue my six-day-a-week exercise and strength-training regimen.

But the message was clear. My previous 5–6 decades of naivete about diet and my generally poor eating habits had contributed to this condition. I’m confident that I have stopped the progression of the calcification with my diet change and with my exercise program.

But, have I reversed it?

There are some who claim that CVD can be reversed (see Dr. Dean Ornish or Dr. Caldwell Esselstyn). Their evidence-based positions call for going totally vegan. I tried it and found it to be too much for me. So I’ve become a “flexitarian” with reduced animal-based products and a diet heavy on fruits and vegetables.

You may have heard of the story of Jim Fixx, the famous long-distance runner credited with helping start America’s fitness revolution by popularizing the sport of running and demonstrating the health benefits of regular jogging. Fixx had a family history of heart disease yet refused to change his diet away from heavy animal-based foods, claiming that what you eat is irrelevant as long as you maintained a high level of aerobic exercise. He died at 51 of a massive heart attack while on a run. The autopsy revealed that atherosclerosis had blocked one coronary artery 95%, a second 85%, and a third 70%.

So, diet is where I would focus first if health and longevity is your goal.

Be aware that we are up against formidable foes in being able to maintain a nutritional diet. Our food industry doesn’t care about our health and produces mostly C-R-A-P (calorie-rich-and-processed) foods. The industry has done a masterful job of taking our taste buds captive with their creative combinations of unhealthful components – sugar, salt, and fat.

Plus, we love our restaurants where the calorie content is 20–40% higher and the sugar-salt-fat content is higher than meals cooked at home.

Put that together with a healthcare system in which doctors receive no training on nutrition and care little about what we eat, you see that we are sort of in this boat alone when it comes to sustaining our good health.

We can keep it simple.

Protect the liver,feed the gut. That’s the advice of endocrinologist, Dr. Robert Lustig, from his highly educational book “Metabolical.” More simply stated, he’s saying eliminate the sugar and increase the fiber.
Ratchet up your exercise. Try to get to 300 minutes of aerobic and anaerobic exercise per week.
Find a purpose for your life. Don’t let loneliness and isolation creep in – they are killers too.
Never stop learning. And make understanding how the body and mind work part of that learning.

Not a lot of magic here. Put the odds in your favor with this simple plan.

I’m Still Alive Because I Traded COPD for CPD.

November 22, 2022

On June 5, 1979, I was on track for COPD – chronic obstructive pulmonary disease.

I had been a serious smoker for 18 years. I’m talking 2-packs-a-day in Marlboro country for nearly two decades.

On June 6, 1979, I jumped off that track and opted, instead, for CPD – continuous personal development.

A cigarette or cigar has not touched my lips since.

Had I not jumped, I don’t believe I would be writing this today, at 80, having just completed a brisk 30-minute walk and a touch of strength training in my office with my adjustable kettlebell and exercise bands.

Between 6/6/79 and today, I watched my father and an uncle die of COPD. I am now witnessing its devastation play out with my sister.

All were multi-decade smokers.

Slow, creeping, irreversible suffocation is at the absolute bottom of the list of the ways I want to leave this planet.

We didn’t know better.

My formative years were in rural southeast Wyoming. In the 1940s and 1950s, smoking was not only accepted but it was also touted as healthy by doctors, dentists, actors.

I remember an ad for Lucky Strikes showing wounded veterans from the Korean War in a hospital ward smoking with the message that Luckies were an important part of their recovery.

Demonstrating a heavy dose of hypocrisy and naivete during high school, I would only smoke during the summer and not during school because of athletics. Deep down, I knew it wasn’t good.

But it was cool back then. And cool, as an adolescent, was important – just as it is today.

We didn’t know better, I guess. It was 1964 before the Surgeon General issued a general report citing health risks associated with smoking and 34 more years of denial and stonewalling by the tobacco industry before they admitted culpability and ponied up a $264 billion “settlement.”

It was hard, hard, hard!

If you’ve been a smoker, you know how hard it is to quit.

It took enrollment in an 8-week program called SmokeEnders (now offered online) for me to quit – along with the ever-present and openly expressed concern from my wife and two elementary school-aged children.

I remember that nearly half the SmokeEnders class of 40 had some level of emphysema and were there on doctor’s orders. Very few of these extreme cases were able to quit and most dropped out.

But, I was ready. I had already started running and knew that this had to happen. The class was the catalyst for me. And helped launch me into a four-decade Continuous Personal Development (CPD) process.

CPD is a big bucket.

6/6/1979 kickstarted an evolutionary process of personal development that continues today. What started as smoking cessation and an increase in physical activity has evolved into a deep commitment to continuous mental, physical, social, and spiritual growth.

I’ll offer up a few things I’ve learned on this non-stop journey:

Takeaway #1:

It’s never too late to start to improve; it’s always too early to quit.

CPD is age-independent. I push myself at each workout. I’m striving to get better every day at my writing. I still read a book a week and have for over 15 years. I’m learning that not knowing is more important than whatever I do know and that I’ll always be behind.

Takeaway #2:

With very few exceptions, we are born with a birthright of health and bodies and minds with amazing resilience and recuperative powers.

Just as my lungs returned to normal after 15 years, nearly all of the parts of this magnificent collection of cells will recuperate from mistreatment or accident when given the right tools. Collectively, we’re not very good at knowing what those tools are, or, if we do, we fail to use them.

Takeaway #3:

Culture is not our friend.

We’re persuaded to compare and seek comfort, convenience, and quick fixes. We choose a Snapchat/Instagram world where comparison sneaks in to rob us of joy. We are drawn away from our natural selves and give up our individuality in order to conform.

Takeway #4

We’re on our own to protect our birthright of physical and mental health.

A healthcare system that can’t/won’t spell prevention. A food industry that delights in our naivete and in destroying our livers and pancreases. A pharmaceutical industry that rides profitably on the backs of both. An entertainment industry that dulls our brains and steals 5+ hours of our time daily with mountains of drivel. All foes of CPD.

CPD is hard too.

CPD isn’t convenient. It’s often uncomfortable. It’s easy to abandon.

I had trouble giving up the Marlboro’s because there was a strong physical addiction as well as deeply ingrained habit patterns.

My goal is to strive to entrench my CPD in the same way while I give thanks that it stepped in for the COPD.

Do you have a 6/6/1979 in your story? Tell us about it. Leave a comment below for others to see. We’d love to hear from you on this topic.

We’re Approaching a Tipping Point – Start Saving Yourself Now!

November 15, 2022

Image by Michal Jarmoluk from Pixabay

Should this headline concern you?

Kaiser Permanente reports $1.5B Q3 loss

How ’bout these reports?

Chicago-based CommonSpirit Health (the largest Catholic health system, and the second-largest nonprofit hospital chain in the United States) reported a $1.3 billion operating loss for the 12-months end on June 30.

Ascension, based in St. Louis (a private healthcare system ranking second in the United States by number of hospitals) also reported a $1.8 billion loss for the fiscal year’s end in June.

Or this:

Third-quarter payer (insurance) profits:

UnitedHealth Group: $5.3 billion, up over 28 percent
Cigna: $2.8 billion, up over 70 percent

Third-quarter provider profits:

HCA Healthcare: $1.13 billion, down over 50 percent
Trinity Health: $1.4 billion in 2022 losses, down over 135 percent

These have come in the last couple of weeks from a leading healthcare newsletter, Becker’s Healthcare.

I don’t expect you’d have much reason to tune into Becker’s. I do because I’ve been swimming in the shallow end of the hospital pool for over 18 years, as a (former) executive healthcare recruiter, career coach, and, currently, as a coach, resume writer, and online presence (LinkedIn) expert for healthcare executives.

So, what’s the big deal?

Many big businesses suffer swings in profitability. Most recover, some fade away.

How might this scenario be different?

Look, my crystal ball has resulted in me eating a lot of broken glass, so consider the source for what follows. I’m going to suggest that we, of evolving “modern elder” status, be alert.

Alert to what?

It seems COVID-19 may be forcing us to be honest by exposing many of the inherent weaknesses in our healthcare system – a money-driven, often counter-productive sick-care system built on cure and a model more and more experts – even those running it – are saying can’t sustain.

It’s also a model that isn’t addressing the mind-blowing deterioration of the health of the U.S. population.

It’s a system that won’t dare utter words “prevention” or “upstream”, both antonyms and anathemas to a model built on “cure” and “downstream.”

You’re on your own. Save yourself!!

I’ve been camped on that theme for the last five years but now I’m more than a little hyped up about the importance of knowledge-based self-care.

Operating on the fringes of the U.S. healthcare system for nearly twenty years has connected me with some of the brightest, most driven, selfless, dedicated, overworked, and under-appreciated people on the planet.

Healthcare professionals are some of the hardest-working and most committed people you will ever encounter. Hundreds of conversations with C-level hospital and medical practice executives over the last several years have informed me of the incredibly complex and daunting challenges they face.

I was once told that a hospital is the most complex organism on the planet to manage – perhaps as complicated as trying to run the military.

It’s herding cats at its best.

Yet, faced with incredible challenges, these execs show up every day, problem-solve, herd the cats, and help save lives.

They don’t complain.

They forge on –

-even aware they are steering a ship that is starting to sink, rapidly.

Are we finally going to be honest-

-about how busted our ~~healthcare~~ sick-care system is? If Harvard Health says it busted, it must be busted.

Here are some additional insights published recently by Becker’s Healthcare Review. Please note the portions I’ve bolded.

“Healthcare systems in the U.S. have had a challenging year, and they are on track for their worst financial year in decades, according to an Oct. 25 report from Health Affairs.

Dramatic margin fluctuations have characterized 2022, and U.S. hospitals are still operating substantially below pre-pandemic levels. Most metrics improved month-over-month in August as revenues and expenses climbed compared to July. However, most organizations are in poor shape with a negative operating margin, according to the report.

Several factors suggest hospital margins will continue to face challenges in the coming years. The labor shortage is noted as the primary driver for rising hospital costs. Nursing labor is a critical point as the report indicates hospitals have lost about 105,000 employees, and nursing vacancies have more than doubled. In response, hospitals have relied on expensive contract nurses and extended overtime hours, which caused labor costs to surge. The national nursing shortage is a continuing problem as a substantial segment of the labor force is approaching retirement, and the shortage of new nurses is projected to reach 450,000 by 2025.

Payment rates will eventually adjust to rising costs, which are likely to occur slowly and unevenly, according to the report. Medicare rates, adjusted annually based on inflation, are projected to undershoot hospital costs and are expected to widen the gap between costs and payments.

Economic uncertainty and the threat of recession are expected to create continued disruptions in patient volumes. While healthcare has been referred to as “recession-proof,” high-deductible healthcare plans and more aggressive cost-sharing mechanisms have exposed patients to costs, making them more likely to weigh them against other household expenditures.

Combined, these factors suggest that the current financial pressures are unlikely to resolve in the short term.”

Consider these comments from Scott Galloway, Clinical Professor at NYU Stern School of Business, in a recent blog post:

“The U.S. Healthcare industry is a wounded 7-ton seal, drifting aimlessly, bleeding into the sea. Predators are circling. The blood in the water is an unearned margin: price increases, relative to inflation, without a concomitant improvement in quality. Amazon is the lurking megalodon, its 11-foot jaws and 7-inch teeth the largest in history. With the acquisition of One Medical, Amazon is no longer circling…but attacking.”

Professor Galloway allows facts to speak for themselves (you may want to read his full blog here):

Per capita, U.S. healthcare spending went from $2,968 in 1980 to $12,531 in 2020 (both in 2020 dollars), resulting in an industry with 13% of the nation’s workers and total spending accounting for a fifth of U.S. GDP.

Two-thirds of personal bankruptcies in the U.S. result from sick-care issues (medical expenses and time off work).

Forty percent of adults in the U.S. have delayed or gone without needed sick care because it’s too expensive.

The U.S. has one of the highest infant mortality rates among developed nations.

Professor Galloway concludes with this summary opinion;

“No industry has better demonstrated the dis-economies of scale. If we received the same return on our healthcare spending as other countries, we’d all live to 100 without getting sick … U.S. healthcare is the worst value in modern history.”

U.S. healthcare is the worst value in modern history precisely because it is not healthcare – it is overburdened sick care.

Regardless of age, now is the time to start elevating our self-care knowledge, take charge of our health, put better habits in place, and jettison the mindset that says there is always someone that can come and save us from our poor lifestyle habits.

Nobody’s coming.

They’ll just wait in their inefficient hospital or medical office buildings for you to wade through all the paperwork and languish in the waiting room to get 15 minutes to be told which drug or surgery is appropriate to treat your “downstream” issue.

But, wait – what about Amazon, CVS, Walgreens, Walmart?

They all are getting into the healthcare business to provide primary care services. Doesn’t that change things?

Don’t be deceived. Follow the money. Do these companies do anything that doesn’t appease shareholders?

They are the sharks in the water circulating this bleeding hulk and see the opportunity to take their vast technology experience and put it to work to streamline an inefficient system.

It doesn’t change the brokenness because it remains a sick-care system. These companies see the opportunity to get you in and out of that 15-minute cure-based system faster and tap that government/insurance cash cow quicker.

More people in and out quickly and directed to the drug counter twenty steps away. Aside from Amazon, is it a coincidence that the other three are dominant players in the retail pharmacy world?

Pills – the other, and incredibly profitable, side of this mess – riding on the backs of its brokenness.

Costs are going to continue to go up, service and availability will decline.

Physicians are burning out and retiring out. Medical school enrollments are down.

So are the nurses. Fewer young people are made of the stuff that it takes to be a nurse and fewer are showing interest in the profession.

We’ve built monoliths (see picture at the top) that can’t sustain in the long run.

You and I are suckers if we don’t get smarter about our lifestyles.

The mission? Simple – stay out of the doctor’s office. Be proactive about your health, not reactive. Avoid this broken system.

Let your 24×7, 35 trillion-cell immune system do its thing. Give it what it needs to keep you out of this busted system. Our bodies and minds are incredibly resilient with amazing recuperative powers, but they need our help to provide the raw materials.

Eliminate UPFs (ultra-processed foods) and sugar.
Increase fiber intake.
Increase weekly exercise to 300 minutes, including some rigorous strength training.
Challenge your brain – learn to dance, learn another language, join a chess club, take up the guitar
Expand your social network, including hanging out with younger people.
Infuse your longevity bonus with something purposeful.

Set your sails to take advantage of the emerging longevity revolution and design a longevity lifestyle that keeps you out of this system.

Take charge – be the CEO of your health.

Are You a “Modern Elder?” Take This Test and Find Out.

November 8, 2022

By now, you know I’m a big fan of Chip Conley, author, entrepreneur, and founder of the Modern Elder Academy.

His book “Wisdom @ Work: The Making of a Modern Elder” was a top read for me in 2019 and led me to write about the Modern Elder concept a few times:

Chip has a daily newsletter that I follow. He recently sent out a “quiz” to test how we stack up against the Modern Elder criteria. I’m sharing it here so you can take it and test yourself to see where you fall.

Straight from his weekly newsletter:

Here are 10 affirmative statements. Rate yourself as a 0 if the statement doesn’t resonate with you. Give yourself a half-point if it feels right to you, but it’s not an enthusiastic “yes.” And give yourself 1 point per statement if you feel a full-body yes.

Outside of my family, I am often in environments where I am the oldest or one of the oldest, and I don’t hide my age.

I am both a lifelong learner and a “long-life learner,” someone who wants to live a life that’s as deep and meaningful as it is long.

I enjoy growing older, and I believe my best work and life are ahead of me.

I feel like my ego is no longer my primary operating system, and I have a growing stirring in my soul.

I have developed an active practice of cultivating and harvesting wisdom based on metabolizing my life experiences, and I can teach others to do the same.

I love becoming a new beginner at something and am endlessly curious.

I believe my emotional intelligence has grown, and I’m less reactive than I was ten years ago.

I have moved from the accumulation stage of my life to the editing stage. I am good at ending projects, relationships, mindsets, and distractions that don’t feel nourishing or allow me to serve others effectively.

People tell me that I’m a great mentor and a conduit for wisdom. I would be honored to be called a “wisdom worker” instead of a “knowledge worker.”

I no longer define myself based on my achievements, image, status, or power, as I’m more focused on my purpose and legacy. The sentence “I am what survives me” defines my life today.

Of course, depending on the day, your answers may differ. Your tabulated score will run from 0 to 10.

If you scored from 0 to 5, you’re probably not a modern elder yet, so you might focus on those statements in which you scored yourself a 0 and ask, “How might I develop habits or practices that allow me to feel more affirmative about this characteristic?”

If you scored above a 5 and below an 8, you’re a budding modern elder, and you might find MEA’s programming perfectly timed for where you are in your life as a prep school for modern elderhood.

If you scored an 8 or above, who knows, you might be teaching at MEA someday. If you haven’t experienced our in-person or online programs, start with that and begin documenting the ways you’re developing your curiosity and wisdom.

I gave myself a 9. Not sure my roommate would agree, but I felt pretty good with it.

How did you rate yourself? What areas do you feel strongest about? Where do you need the most work? Let us know with a comment below.

Does Age Matter? Yeah, But We’re Overplaying It!

October 11, 2022

The inevitable seems to be consuming us!

Maybe it’s just me. Have you noticed how massive the parade has become of folks commenting on, conjecturing about, agonizing over, second-guessing, fixing, denying, snake-oiling, and profiteering from the concept of aging?

We “modern elders” are kicking up quite a fuss about this irreversible phenomenon.

It’s understandable. The youngest baby boomer hits 58 this year and the oldest is looking a ninth decade in the eye. And that’s a group that has never been known for being all that quiet and complacent.

What’s it all about, Alfie?

Is all this commotion about aging an anxiety-based “gnashing of teeth and ripping of robes?” Or is it an objective view of the inevitable with a touch of positivity?

It’s kinda my space so I read a lot of this stuff and consider it a bit of both i.e. mostly anxiety-based objectivity.

We’re smart enough to appreciate the inevitable nature of it i.e. objectivity. But we can tend to be a bit naive about the extent to which we can alter the course of it.

OK – I know. I’m a poster child for altering the course of it with my goal of reaching 112 1/2.

But, I get a bit riled up with all the anti-aging and age-reversal stuff flying around the net – magic creams, untested supplements, tantalizing and unfounded hints by microbiologists that we are on the verge of finding the magic to reverse aging. Especially considering that there is a better than even chance that those most desirous of an anti-aging or reversal formula spend an inordinate amount of their income at fast-food restaurants and much of their time being one with a voice-activated remote.

Ashton nailed it!

That’s why I appreciated a recent article by Ashton Applewhite published on Medium.com and on the Neo.life website. (Here’s a link to the Medium post).

Gotta love the headline:

I Hope I Get Old Before I Die

You may already know Ashton. She’s a prolific writer, author of the best-selling book “This Chair Rocks: A Manifesto Against Ageism” and a leading spokesperson for the emerging movement to raise awareness of ageism and to dismantle it.

I encourage you to read the article as she puts a balanced spin on aging with more of a positive flavor than most of what you will read.

I’ll entice you with this excerpt (the bolding is mine):

Goal #1: longer lives

“Aging isn’t something debilitating that bushwhacks us somewhere north of mid-life. Aging is living and living means aging. Nor is aging a disease; otherwise life, too, would be a disease. As British journalist Anne Karpf put it to NPR’s Brian Lehrer, “You can no more be anti-aging than anti-breathing.” Part of the distinction is semantic: make the target “age-related functional decline,” not “aging.” The “root cause of aging” is the passage of time, not cell senescence. At the end of all that living, we die. If the goal is to prevent death, whether by freezing ourselves in cryonic vats or by achieving what scientist Aubrey de Grey calls “longevity escape velocity,” let’s describe it accurately: not anti-aging but anti-dying.”

Can’t we all relate to “age-related functional decline?”

I like that better than saying I’m getting old.

What Is a Middle-age Crisis? Had Yours Yet?

October 4, 2022

The concept of a “crisis” at mid-life is talked about a lot.

IMHO, it’s highly overplayed. Few of us experience a true crisis. It’s really more of a catharsis that we go through, usually starting at that point where the ego begins to move aside and the need to continue to accumulate, strive for title or prestige, and meet artificial cultural expectations begins to fade.

It can be a point in which the individual comes to grips with the fact that earlier life decisions have placed them into something outside of their true nature or essence.

Often, it’s the realization that continuing on the ego-dominated track seems pointless, or certainly not fulfilling, in the long run.

The caricature of the red convertible, trophy wife, and bling is rarely the true manifestation of a middle-age crisis. It will tend to be more of a phase of deep and often uncomfortable internal turmoil and reflection, with questions like:

Is this all there is?
Does anyone know I’m here or really care? (P.S. – they don’t.)
Am I doing anything that will succeed me? How do I leave a footprint when I’m gone? Do I still have time?
Why do I feel so empty in what I do?

The classic for me, as I finally acknowledged a catharsis in my mid-50s, was this:

Is it true that the number of people who will attend my funeral will be largely determined by the weather?

OUCH!

For many, this midlife catharsis represents a significant turning point that leads to a life that is more fulfilling and purposeful. For others, the potential for this turning point is missed, the cathartic questions ignored, the ego kept in control, and an opportunity wasted.

The career is where the catharsis and the tough questions are most likely to emerge. Most career decisions are made to satisfy the ego and the need to accumulate, compare favorably, and meet cultural expectations.

It’s a fortunate soul who comes to the realization that their career choice is misaligned with their deepest talents and true essence and then able to emerge from this catharsis doing something that aligns with that essence.

I’m a poster child –

-for mishandling a catharsis.

I acknowledged, by my mid-50s, that corporate life had been a mismatch for me all along, although I was almost three decades into it.

I decided to disengage and do my own thing at age 60, a time when many are choosing which pasture they want to head for.

My own thing didn’t flourish. It was done for the wrong reasons – to make more money and gain control of my time.

Ego driven.

It failed to consider the misalignment with the way my creator wired me up, with the things that were natural, comfortable, and easy for me.

I was continuing to try to fit the proverbial square peg in the round hole.

A second catharsis.

It took me until my 70s to fully unfold the earlier catharsis and realize and act on my true essence and innate talents.

I was a teacher, a learner, a deep introvert, an iconoclast with a “terrifying longing” to write or speak to the unordinary.

Although quite late, I consider myself fortunate to know where I should be and what I should be doing by honoring my essence. And that I have something that I can finish out with and perhaps even leave a faint footprint.

I’ve adopted a mantra from one of my heroes, Dr. Ken Dychtwald, author and expert on aging and founder of the AgeWave organization, who lives by this simple phrase:

Breathe – Learn – Teach – Repeat

It’s a fit and the result of catharses, not a crisis.

Did you have one? Having one now? If you did, how did your middle age crisis/catharsis play out? Love to hear from you on this one. Leave a comment or email me at gary@makeagingwork.com.

P.S. I apologize for my two-week absence (the first time in 5 years). My hosting service chose to do maintenance on my site on 9/19 and proceeded to take down the site along with access to my WordPress. It took them until last week to sort it out.

In your assessment, do you think you are aging gracefully?

September 6, 2022

Or is there some work to be done?

I had to stop and think about this question.

What does “gracefully” mean? My dictionary doesn’t have it except as an adverb of grace.

Under grace, we find words like charm, attractiveness, beauty, and ease of movement.

I’ve been on the planet longer than most, having just entered my 9th decade (P.S. – for you Las Vegas Raiders fans, that means I just turned 80 ).

Candidly, there isn’t much about aging that I would consider graceful.

Charming? I can’t think of a single person in my circle of family, friends, and acquaintances that would herald me as charming. I think Webster’s antonym would apply better: inelegant, stiff, unchangeable, nondisposable, gaseous.

Attractiveness? Yes – to my daughter’s two standard poodles. Beyond that, the ranks dwindle to, well, zero.

Beauty? Exit from the shower tells it all – it ain’t a pretty picture.

Ease of movement? Not bad for an octogenarian, but only because I take my physical health very seriously, and do serious weight training and balance exercises. Thankfully, the grandkids don’t need me on the floor with them anymore. Half of that playtime went to getting up.

Trying to match graceful and aging is too much work. I’ve decided not to try to be graceful but rather to move to the antonym side.

There’s an argument for being inelegant at this age. Most of us octogenarians have something to say that’s important. Unfortunately, it requires being inelegant to get anyone’s attention since most have sort of written us off as irrelevant based on the number.

Yeah, I’m largely unchangeable. At 80, we have all the answers, hoping that, any day now, somebody will start asking the questions.

So, I’m not going to pursue graceful. I’m choosing “audacious” as my adjective of choice and the style that I will finish out with.

I don’t think you will find much graceful in the definition of audacious:

Extremely bold or daring
Recklessly brave
Fearless
Extremely original
Without restriction to prior ideas
Highly inventive
Recklessly bold in defiance of convention, propriety
Insolent
Brazen
Lively
Unrestrained
Uninhibited

OK, I’m not all of any of those. I like to think I’m a bit of all of them. Some of the above come naturally and were built in when the universe assembled my parts.

Some are coming along nicely.

Most still need a lot of work.

“Do not go gentle into that good night.” Dylan Thomas

I’m not into poetry, but I’m all in with Dylan.

Better to make a ruckus on the way out than to go silently into the night.