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The Wall Street Journal had a long read titled America's Seniors Are Over Medicated. The following snippet is a pretty good TLDR.

In 2022, 7.6 million seniors were simultaneously prescribed eight or more medications for at least 90 days. Of those, 3.9 million took 10 or more drugs at once. Mixing medications that affect the central nervous system can magnify their side effects, leading to falls. 

Yikes! An anecdote from a brother-in-law's family member who takes a GLP-1 for Type 2 Diabetes. They lost a lot of weight, of course, but then they started to have kind of serious problems because their dosing was for someone much heavier, and it took some time to figure that out. 

In terms of side effects and interactions between multiple prescriptions, the conversation we have here is incomplete. We talk frequently about the potential expense involved with taking 8-10 prescriptions, but interactions and side effects pose more of a danger to our actual well-being. I've been on a few medical calls with the fire department where drug interaction was an element. Part of the assessment process is to ask about what they take, they are taking as prescribed, and any new meds they are taking. 

The story of Barbara Schmidt in the article (gift link) wasn't catastrophic, but it was not good. She fell multiple times and had some cognitive issues caused by the interaction of the medication. A very common drug is Gabapentin, which came up in the WSJ article, and it is very problematic. A couple of days after the above article, WSJ came out with another one just about Gabapentin. Again, yikes!

I blog because it is a lot of fun, and all the better if anyone gets anything out of our conversation, but this is serious stuff, and no one is going to solve it for us. Something of a conspiracy theory, but there's a lot of truth, is that drug companies aren't trying to cure chronic conditions. It is in their interests for people to manage their chronic conditions forever, and then add in different drugs to help with side effects. The sad thing is that it is acceptable to many people to do just that, start taking meds, and then add more. "It's a normal part of aging," they might tell themselves.

It doesn't have to be. 

I'm no saint here; clients own a couple of drug stocks based on that exact premise, people are more likely to take a pill than change their habits. In 2022, Copilot says there were 58 million people age 65 or older. The 7.6 million and 3.9 million quoted above are very high percentages of 58 million. Copilot went on to say that 1/3 of those people took 5 or more prescriptions. 

A story I've told before, my first run-in with the idea of not needing prescriptions came on a medical call 14 or 15 years ago, the patient hurt himself working outside, he was 64 and very proud of the fact that he wasn't taking any prescriptions. Study after study says what to do to have this same outcome as the 64-year-old patient: eat less sugar, cut down processed foods, and lift weights. Other forms of vigorous exercise are, of course, beneficial, but building muscle mass is vital for avoiding frailty. A ground-level fall for someone who is frail (brittle bones) can be life-changing in a bad way. Strong bones and strength from building muscle mass can turn a ground-level fall into merely being embarrassing. 

A related pivot, Barron's looked at whether AI will hurt Social Security, and will the loss of some jobs to AI would result in less money going in, potentially hastening the time frame of when benefits would have to be reduced? With no changes or action in Congress, benefits are slated to be reduced by 23% starting in 2034, but both of those numbers are moving targets. 

There's no reasonable probability of this being resolved in a manner that is "fair" to everyone. Maybe the income cap is lifted. Currently, only the first $186,000 of income pays into Social Security. If they raised the cap to $500,000, people between $186,000 and $500,000 who are self-employed will be paying a lot more in taxes. 

If they mean test to a benefit cut, anyone getting a cut will certainly not be happy. What about raising the eligibility age? What if taking it at 62 got taken off the table entirely, and they moved that up to 65? How about just taxing the rich (however that might be defined)? Maybe ideas will be "unfair" to a smaller segment or to everyone, but it will be problematic. If I am wrong and they figure it out, all the better, but as I've been saying, there is absolutely no reason to get caught off guard by this.

Things come up that could adversely impact an income stream that would come from an investment portfolio. So now, something might come up that adversely impacts the income stream we are expecting from Social Security. I'm not optimistic that anything I could personally do or say will have an impact on whatever happens to Social Security, but I am optimistic about being able to prevent/solve any problem that might be coming my way in case our benefit gets cut by more than the 23% being kicked around now. 

Anyone who can stay lean and strong has a good chance of avoiding prescriptions and the costs and side effects associated with prescriptions. Anyone who can figure out how to monetize something or maybe a couple of things has a good chance of enduring a harsh cut to Social Security. Anyone who can do both has a good chance of having a long and able-bodied retirement, or put differently, a successful retirement. 

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