In Craig Bowron’s Washington Post article “At the end of a loved one’s life, why is it so hard to let go?” (reprinted in The Japan Times on Feb. 22), certain impressions about life expectancy need to be further interpreted with examples from advanced societies other than the United States.
Bowron’s point that a high mortality rate among infants tends to distort the general picture is pertinent, but it offers only a partial view of the life expectations for adults, particularly among the industrial working class before World War I.
Germany and the United Kingdom made the first steps toward what would become a welfare system, including a national pension plan. It is easy to be cynical, but the bald actuarial fact is that British Finance Minister Lloyd George’s national pension (1908) could be realized only at the age of 70. This did not involve much of a fiscal outlay because the average working class person never lived that long (life expectancy in the U.K. was about 50 before 1914). Air pollution, poor living conditions and inadequate medical treatment were among the debilitating factors affecting the health of the industrial working class even until 1945.
Bowron’s point is not simply historical. If very elderly people are receiving unnecessarily invasive treatment, this is a function of private medicine and should not be confused with the sort of quasi-social insurance system that finances public medicine in Japan.
Japan’s medical system cannot easily be criticized for being inadequate in its treatment of the elderly. But it is not excessive either; it cannot afford to be. Besides, the human body is not biologically designed to live much beyond 80. This is a philosophical reality that those of us over 60 must face up to.
The opinions expressed in this letter to the editor are the writer’s own and do not necessarily reflect the policies of The Japan Times.