Life & Death & Policy Modeling Paul Fischbeck Social and Decision Sciences Engineering and Public Policy Center for the Study and Improvement of Regulation Carnegie Mellon University Demo/Pop Model 1

Population Is Critical Clinton Connects Overpopulation to Climate Change       During a visit to India, Secretary of State Hillary Clinton revealed not only the administration’s commitment to tackle “global climate change,” but also her willingness to link it to overpopulation. Al Gore's newest book Gore stresses that governments should start to enact policies to slow the population growth that leads to higher energy demands. While past studies suggest that industrialization is what brings about smaller birth rates, current research demonstrates this is not the case. “Go forth and multiply less,” the Economist 11/9/2009 Sometime in the next few years, the world will reach a milestone: half of humanity will be having only enough children to replace itself Demo/Pop Model

Trade-offs Birth rates Death rates Quality of life Natural reduction as in Europe Forced reduction as in China Death rates Advances in healthcare Significant improvement over time (life expectancy) Dramatic changes possible for developing countries Quality of life Can there be better quality of life without improved health care? Productivity improvement What combination will work at controlling population? For these metrics, what should the world’s values be? Minimum, average, median, average, maximum?

Total Fertility Rates

Life Expectancy and Fertility Rates

Transition?

Gapminder World www.Gapminder.org Graphical interface into dynamic data Web-based Downloadable world database Includes social, economic, environmental data over time Easy to add new variables

Population Model Excel-based Downloadable at www.epp.cmu.edu/csir Spin-off from Spring’s project course Interactive Downloadable at www.epp.cmu.edu/csir Expanding capability Consumption Environmental Dial-in a country

Inputs

Improving Healthcare Will it continue? What if does?

Business as Usual

Stop Improving Healthcare

Stop Immigration

Stop Immigration and Improving Healthcare

European Birth Rates

Effects of Different Healthcare & Birth Rates on 2110 Population

Effects of Different Healthcare & Birth Rates on Worker/Retiree Ratio

Annual Per Capita Healthcare Costs

Benefit for Spending More? US is spending more but has lower risk for older population But what happens when healthcare costs are allocated by age?

Costs by Age Categories US is spending much more for older ages

What If … US Had European Healthcare Costs?

Retired and Dying before 85 (Male)

US-Norwegian Comparison Norway was just cited by the UN as having the highest quality of life in the world US was ranked 13th Worried about dying before retirement age … Much more likely in US Approximately 25% more likely for both men and women Given a retiree, dying before 85 … all Scandinavian countries relative to the US, Norway is generally better for women and worse for men US women are more likely to die except for the oldest group

Dying before 65

Dying before 85

Conclusions How tightly connected are quality of life and healthcare issues? What happens if the world evolves to developed-country levels of quality of life and healthcare? Difficult policy issues must be faced if population reduction or stabilization is to occur Population stabilization can be achieved but does it include demographic imbalance? Difficult societal planning problems arise (workers/retiree ratio and healthcare improvement) 26