Republicans charge that Democratic health care reform would, in Sen. Charles Grassley's words, "pull the plug on Grandma." According to Sen. Jon Kyl, the bills before Congress would ration medical treatment by age. Rep. John Boehner says they promote euthanasia. Alaskan abdicate Sarah Palin has raised the specter of "death panels." Such fears are understandable. It's not preposterous to imagine laws that would try to save money by encouraging the inconvenient elderly to make a timely exit. After all, that's been Republican policy for years.
It was Sen. Grassley himself who rammed the GOP's most astonishing pro-death policy through the Senate in 2001. The estate-tax revision he championed reduces the estate tax to zero next year. But when the law expires at year's end, the tax will jump back up to its previous level of 55 percent. Grassley's exploding offer has an entirely foreseen if unintended consequence: It's going to encourage those whose parents and grandparents are worth anything more than a million bucks to get them dead by midnight on Dec. 31, 2010. This would be a great plot for a P.D. James novel if it weren't an actual piece of legislation.
As economists will tell you, when you tax something less, you get more of it. Various studies have shown that this logic applies to life and death as well as to more modest behavioral choices. In a 2001 paper titled "Dying To Save Taxes," Wojciech Kopczuk andJoel Slemrod examined 13 tax changes since 1917 and concluded that "for individuals dying within two weeks of a tax reform, a $10,000 potential tax savings … increases the probability of dying in the lower-tax regime by 1.6 percent." A 2006 study done in Australia, which abolished its inheritance tax in 1979, reached the same conclusion: "a statistically significant effect of the abolition of inheritance taxes on the number of deaths." More than half the people who, according to statistics, ordinarily would have paid the Aussie inheritance tax in its final week managed to evade it by living a bit longer. Here, Congress has created an incentive for Grandma to stick around through Jan. 1, 2010, then snuff it before the end of next year.
Other GOP policies promote death for senior citizens with more modest incomes. Take the conservative push to privatize Social Security, which George W. Bush proposed and failed to get Congress to pass in 2005. Social Security has driven life expectancy up and death rates down since it was instituted. It has an especially pronounced impact on suicide rates for the elderly, which have declined 56 percent since 1930. Had Bush prevailed, we would now be undoing income security for the elderly. Those who gambled on the stock market and lost would be less able to afford medicine, food, and heating for their homes. In aggregate, they'd presumably die younger and commit suicide more often.
Republicans continue working to shorten and sadden the lives of the elderly in more oblique ways, too. One of President Obama's first official acts was to reverse Bush's executive order limiting government funding for stem-cell research, which remains the most promising avenue for new treatments of diseases that afflict the aged, including Parkinson's and Alzheimer's. Clean-air legislation, which the Republicans defeated in 2002, has the potential to save 23,000 lives per year, according to the Environmental Protection Agency. Many of those victims are elderly people, who suffer disproportionately from cardiovascular and respiratory illnesses exacerbated by air pollution. Because emissions of carbon monoxide and such are merely a contributing factor, you can't name the individuals who have died because of this policy choice. But there are tens of thousands of people who would still be elderly today if Republicans didn't value the rights and campaign contributions of polluters more highly than their lives.
Why are Republicans trying to kill America's old people? After all, senior citizens are more likely to vote for the GOP than for Democrats. They were the only substantial demographic segment John McCain won in 2008. You'd think Republicans would want them to hang on as long as possible. The problem is that because of the Democratic programs Social Security and Medicare, the aged are expensive for government to keep around. Some years ago, my former colleague Jodie T. Allen suggested a reason for what she called the GOP's "pro-death" policies: Faced with an unpalatable choice between cutting benefits and raising taxes to pay for the growing costs of entitlement programs, Republicans gravitated toward a third alternative—restraining growth in life expectancy. If you want lower taxes and aren't willing to risk cutting spending, you need fewer beneficiaries.
I do not wish to alarm older, wealthier readers, but you may find family gatherings becoming increasingly tense over the next year. Do not be surprised if your heirs and assigns try to sit you down for a "conversation." You may want to have a witness or security guard present. And do not be surprised if you experience something like the following nightmare: You're in a hospital bed, hovering in a state of partial consciousness. Beneath the mask, that surgeon fiddling with the IV line has a familiar face … wait, isn't that … Dr. Grassley? And coming at you with a hypodermic syringe—Nurse Palin? At which point, if you are lucky, you will wake up in a cold sweat.