Through the mechanism of the Trust Fund, Congress can put off having to act on the fundamental demographic problem that they can’t do much about. They hope they can run the Magic Money Machine to cover all the goodies they want, and in 2034, the Boomers will mostly be over age 80. Maybe another pandemic will deal with them….
(and nobody cares about us Gen Xers. In 2034, I won’t even be eligible for Social Security old age benefits.)
Nobody expects the Social Security benefits to be cut in 2034, or whatever other magic date when the Trust Fund runs out. The only thing the current Trust Fund mechanism requires is cuts… only if Congress doesn’t actually pass legislation to “fix” the issue.
They have been doing ad hoc “fixes” to Medicare and other parts for years so as to avoid massive cuts.
My late wife spent the last two and half years of her life in a nursing home with a form of early onset dementia. While she was in her fifties, almost everyone else there was elderly. In each of the three winters she was in the home, the place was closed to visitors at some point because of flu. This added heartbreak to heartbreak, but it was entirely reasonable. Nearly three in four flu deaths in the last pre-pandemic season occurred among seniors. Someone aged 65 or more who contracted the flu had a chance of dying of it of about one in 120. (By contrast, while more than 85% of the breakthrough deaths are among those over 65, the COVID death rate for fully vaccinated seniors is one in about 25,000.)
That is to say that the risk of death from flu in a nursing home was almost a thousand times as large as the risk of death from COVID to the overall vaccinated population, and the risk of dying from the flu if you caught it as a senior was more than 200 times greater than the risk from COVID if you are currently disease-free, similarly aged and fully vaccinated.
Pundits, observers, and investors believe the 1920s will be a slow growth decade. High taxes, heavy regulations, wage pressures are the main culprits. (Author note: the consensus in 1921 was incredibly bearish and incorrectly predicted a slow growth decade; the polar opposite consensus circulates today) This editorial cartoon sums up the mood in 1921:
This region has been the tough one. It looks like we’re on the other side of the case surge in the worst hit states (LA, MS, FL, AL). Daily cases went up much higher than I would have expected, even higher than the winter surge. What has been truly surprising is that Florida is substantially more vaccinated than those other states, about 15-20% higher in adult vaccination and up at 95% vaccinated for seniors. That should shrink their pool of COVID-vulnerable individuals massively and reduce their death rate substantially.
And, while Florida’s death rate is lower than LA and MS, it’s not nearly at the levels we would have hoped or expected. I’m at a loss to explain this. Certain proposals have been tossed around: Florida is an older state, so more of their population is vulnerable. But their vaccination rates (nearly universal coverage among the elderly!) really should suppress this enormously. If a particular age group had +90% vaccination rates, I would expect that group’s COVID deaths to be reduced by at least 70%. Instead, the elderly are still making up the vast majority of COVID deaths in Florida.
Author(s): PoliMath, aka Matt Shapiro
Publication Date: 31 August 2021
Publication Site: Marginally Compelling at substack
There you have it — for this slice of time, the beginning of August 2021, Israel shows that the vaccines reduced risk 80%+, for all age groups.
Yes, if you just do an aggregation at the whole population level, it looks like a 67% reduction. That’s the “magic” of Simpson’s Paradox. For any given age group, the percentage reduction is much larger. But due to the relative risks by age, even with such high reductions, the overall population result shows a smaller improvement.
Takeaway: COVID vaccines greatly reduce risk
This is the main takeaway: the COVID vaccines greatly reduce the risk of adverse outcomes.
By the way, this is also true of the annual flu vaccines, which range in efficacy based on how well the vaccine that year matches up with the strains circulating, and which strains are circulating (some strains, even if you formulated the vaccine perfectly, still infect.) I could give you flu/pneumonia death rates by age groups, and you would see that flu/pneumonia is a big killer of the elderly. Get your flu vaccines, please.
But, we should also expect a lot of people hospitalized with COVID to be vaccinated old folks. Just because of the huge risk slope by age, which will still exist after vaccination.
In 1989, only 12.4% of the population was age 65 or older. In 2019, we had 16.5% of the population in that age bucket.
The changing age structure means that one can have mortality rates trending down for all ages, but the crude death rate climbs because the population is getting older. It’s definitely driven by people living longer (due to those lower mortality rates), but also driven by fewer babies being born.
As with heart disease, we see improvement at all ages, but the percentage improvement is not as high with cancer as it was with heart disease.
One of the biggest things, though, is how death rates go up by age group. I will use 2020Q1 cause of death rates to make comparisons, as these are in the SOA report, and the COVID impact didn’t come fully until 2020Q2.
Heart disease death rate for those aged 85+ was 3766 per 100K, and those aged 75-84 was 986. That’s a ratio of 3.8.
Cancer deaths for those aged 85+ was 1562 per 100K, and those aged 75-84 was 1004. That’s a ratio of 1.6.
Two things to note:
Cancer death rate for those age 75-84 was higher than the heart disease death rate for the same group
Heart disease death rates climb much more rapidly than cancer death rates by age
when you’ve got really steep differences between subpopulations and the subpopulations are of very different sizes, the overall population average will be very different from simply looking at the average of the two populations.
– The base risk rates for each group are extremely different (3.9 per 100K for young, and 91.9 per 100K for old) – The percentage each subpopulation makes up in the larger population is very different (67% young, 33% old) – The vaccination rates are very different by population (76% young, 92% old)
The long-term trend has been improvement for this cause of death, with it most obvious for the oldest age groups. This trend has been driven by improvement in medical treatment for the condition, but also due to the decrease in smoking rates… decades ago. Some causes of death have behavior that precedes the death by decades, which can get tricky to track for our top two causes of death: heart disease and cancer. Even so, smoking cigarettes has been a huge driver for both these causes, and made a large differentiator by sex and smoking status for a long time.
So the goal of tax policy should be taking as much revenue as you can while trying to minimize distortions. Some kinds of taxes are more distortionary than others. In order of least to most harmful, it goes
1. Consumption taxes
2. Income taxes
3. Wealth taxes
Cut to our current tax debate, where these concerns get no attention. The goal seems less about minimizing distortions/maximizing revenue and more about punishment, i.e., rich people for making too much in a zero-sum world and corporations for being greedy. Now, I think our tax system should be more progressive, too. But there are good and bad ways to achieve that goal.