It is often said that the United States doesn’t have a health care system—it has a sick care system. It is clear this system is at its breaking point. Despite advancements in medical knowledge and technology, more Americans than ever suffer from chronic illnesses—heart disease, diabetes, dementia, and cancer—and that number will only grow if left unaddressed. Rising rates of chronic disease are driving unsustainable health care spending, robbing our paychecks, and fueling the federal debt crisis.
The Trump administration’s goal to “make America healthy again” is encouraging because it suggests Washington may finally be focusing on the right question: How do we harness the extraordinary talents of our doctors and scientists and the vast resources of our system to focus on truly extending the healthy lifespan of Americans?
In fact, many scientists and doctors are already tackling this problem through the emerging field of geroscience. It studies how the biological processes of aging drive the onset of chronic diseases. The research shows that interventions targeting these processes can prevent or treat multiple age-related conditions. This could extend our healthy, active years and dramatically reduce projected health care spending.
The implications of this research are profound and would drive a paradigm shift in American medicine. It could transform our reactive, single-disease-focused model of health care to one focused on the prevention of diseases and the optimization of health. As the United States and the rest of the world enter an aged demographic structure, successful translation of geroscience into everyday medicine is essential.
That’s where bold policy comes into play.
First, we need investment in aging biology science commensurate with its enormous potential. Aging is by far the No. 1 risk factor for developing disease. However, less than 1 percent of the National Institutes of Health (NIH) budget is currently dedicated to understanding aging biology. More profoundly, NIH is structured in a siloed manner that studies diseases in isolation rather than what connects them. Contrary to its name, NIH spends most of its budget studying disease, rather than health.
To help address this, Congress should establish a dedicated National Institute of Healthy Longevity and Aging Research (NIHLAR). This institute could focus on developing interventions that prevent multiple chronic age-related diseases and increase the healthy lifespan of the American people. Congress should allocate a budget to this newly developed agency that is on par with other age-related disease institutes, such as the National Cancer Institute. Congress’s acknowledgment of and support for research and development in the biology of aging would drive more transformative and effective science at NIH while insisting on accountability for real-world results. A move like this would also encourage and stimulate private investment into the space.
We also need to modernize our regulatory frameworks to reward therapies that can address multiple diseases at once. Today’s Food and Drug Administration (FDA) approval process focuses on single-disease treatments. This inadvertently discourages research into interventions that would simultaneously prevent or treat several chronic conditions. This is a glaring oversight. If we can develop drugs that address multiple ailments by targeting their shared biological processes, why wouldn’t we incentivize that? By encouraging developers to pursue these broader-impact therapies, we would significantly improve patient outcomes, reduce overall costs, and get far more value from our scientific talent and resources.
An Accelerated Approval Pathway for Longevity Medicines (AAPLM) at the FDA would fast-track and incentivize breakthroughs that target multiple conditions of aging through a single intervention. The provisions in place for accepted biotech companies would give them the resources to prove that their therapies are effective in treating multiple chronic diseases. This pathway wouldn’t cut corners. Rather, it would recognize that a fundamentally new type of medicine requires fundamentally new guidelines and incentivization strategies.
These proposals should resonate across party lines. The development of preventative medicine would reduce health disparities in the United States. It would also rein in runaway health spending and free up resources for other priorities such as debt and deficit reduction. A healthier population would also be more productive and make us better able to compete economically and militarily with rivals such as Russia and China (who are themselves investing heavily in geroscience).
The time to act is now. Our current, reactive, treatment-focused sick care system is failing. It is leading to worsening health outcomes and bankrupting our country. Bipartisan leadership should align behind a prevention-first health care strategy. The private sector should be spurred to take bolder risks. If successful, we can chart a future in which Americans spend more years in good health—and worsening health and skyrocketing medical costs no longer threaten our nation’s fiscal stability.
The stakes are high, but the opportunity is immense.
