Death is normal; we are genetically programmed to disintegrate and perish, even under ideal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded by third-party payers from the cost of our care, we demand everything that can possibly be done for us, even if it's useless. The most obvious example is late-stage cancer care. Physicians-frustrated by their inability to cure the disease and fearing loss of hope in the patient-too often offer aggressive treatment far beyond what is scientifically justified.

　　In1950, the U.S. spent .7 billion on health care. In 2002, the cost will be billion. Anyone can see this trend is unsustainable. Yet few seem willing to try to reverse it. Some scholars conclude that a government with finite resources should simply stop paying for medical care that sustains life beyond a certain age-----say 83 or so. Former Colorado governor Richard Lamm has been quoted as saying that the old and infirm “have a duty todie and get out of the way”, so that younger, healthier people can realize their potential.

　　I would not go that far. Energetic people now routinely work through their 60s and beyond, and remain dazzlingly productive. At 78, Viacom chairman Sumner Redstone jokingly claims to be 53.Supreme Court Justice Sandra Day O'Connor is in her 70s, and former Surgeon General C.Everett Koop chairs an Internet start-up in his 80s.These leaders are living proof that prevention works and that we can manage the health problems that come naturally with age. As a mere 68-year-old, I wish to age as productively as they have.