| Will the elderly really bankrupt us? Catastrophic projections of the burden to society of an increasing aging population abound. The prevailing belief is that an increasing aging population inevitably means increasing demands on the resources of society, including health care resources, in the face of competing interests and diminishing, or at best finite, resources. According to this scenario, it is not just the increase in the numbers of people over 65 which is the problem; more importantly, it is that as more people live to older ages, there will be significant increases in the morbidity in the older population. The greater morbidity of older people, so the argument goes, will drive up health care costs. This "bankruptcy hypothesis of aging," in which "oncoming hordes of elderly" deplete national health care budgets, constitutes "apocalyptic demography.".;It is argued that in the context of the modern welfare state, as a "therapeutic state," there has been a commodification and resultant depoliticization of need. This is discussed in terms of the concepts of dependency, reciprocity and community. Finally, a case is made for a repoliticized language of need in terms of a moral economy of interdependence.;This dissertation represents a challenge to the apocalyptic demography position, arguing that it is, in part, the response of the health care system itself to the increasing numbers of older people which, by generating needs, is responsible for the increasing health care utilization rates attributable to the over 65 population. Biomedicine in general is examined as a practice which tends to create new "medical spaces," and the social construction of Alzheimer's disease--as the most paradigmatic "disease" of old age--is considered as a case example. The creation of new medical spaces is linked to the "structured dependency" of the elderly which is then located in the broader discussion of the politics of need. |
