over which is this: it's great to be old as long as you don't exhibit any of the typical problems of of old age. and old age, also, has been very much redefined in the terms of young old age which sociologists and doctors call people in their 60s and 70s who are basically pretty healthy even if they've had all kinds of diseases like cancer and heart disease and old old age in the late 80s and 90s. the typical problems of people in old old age are down played as if 90, well, i decided to write this book when i went to a panel at the world science festival a few years ago titled "90 is the new 50th." and i thought, does anybody really believe that? and the answer is there are a lot of people in their 40s, 50s and 60s who do believe

that. it's a new kind of more subtle form of ageism in that it's great to be old, as long as you don't have any of the typical problems of people who are really old. .. >> guest: they are deluded. >> host: use it to overwhelming problems of old, old age our health and working overtime which is inevitable and

the tendency for most people to get more. you suggest there's collective action that we should take in response to that. what are those points. >> guest: health there's not much we can do about it. there are people whose health doesn't constantly worsen over time. but i think those of us who have parents who have survived into the '90s and grandparents as i have, know that the typical person has to deal with many more health problems over time. and this by the way, the province of the oldest old have to be looked at as not entirely but they are huge women's issues because right now the vast majority of people over 85 are women there and everybody gets for overtime except people like warren buffett. i'm sure he's going to be well fixed at 92. but women in particular get poor because there are lots of things that happen to total income with

the death of a husband. this is true of women today, most of them didn't work outside the home. but it's also going to be true of older women because women have more interrupted work patterns than men do, which reduces the total amount of either pension or social security income over a lifetime or so people get poorer as they get older and moreover, this is also connected with worse health because people need many more services as they get older that cost money. most of which none of our social service programs, which the republicans are now subject to cut income and certain democrats as well, paid for already. so people's needs in terms of the assistance they need if you like to go on living independently become greater at a time when their income becomes less. >> host: in fact you mention in the book you had a friend who, when you told are you writing a book about aging and

old age, she said you're writing a book about women. for the exact reason you say, statistically women live longer and have a more problematic older aged. >> guest: and people in this age group among women in the '90s, social security makes up about 90% of their income. there's not a lot of money left around by then. >> host: i would like to say something also that often forget in interviews. >> guest: i think that's one of the problems here is, thinking about this rationally, is we do live in a society in which the idea that people ought to be able to save enough, to finance a 30 year retirement, that there is something wrong with you if you can't do that. and this is ridiculous. the social security act was signed in 1935. the average life expectancy was 62. people were not able to save enough for their old age and. that's why social security was enacted.

but no one foresaw a time when right now all of the baby boomers are turning 65, in 20 years they will be 85, there will be 8.5 million of them. save enough money to finance a 10 year retirement and a 30 retirement if you have an average income. if you're not rich, are two different things. it is not a matter of moral turpitude. if the average family in this country cannot say enough to finance 30 retirement. furthermore, there's a real question, a 45 or 50 euro parent says to the kid in college, i can't help you, i'm putting aside money for long-term care. is that a healthy society? i don't think so. >> host: some of the consequences press of growing up, as i did, as you did in an age of medical miracles, i was just a little girl when the polio vaccine came along. there's always been anti-alex.

we have fake hips, fake knees, organ transplants. that's the medical norm now. people who have taken advantage or not been disadvantaged because they have had access to this kind of care, what i think, that is a good thing. but you paint sort of an overall picture in your book that these two have consequences because they prolong life beyond what our social network, our social safety network was able to provide art was created to provide. >> guest: that's true. but i think they have other consequences, too. antibiotics, yes, people who would have died of pneumonia at 65 or if they got a bad case of pneumonia don't anymore because there are anti-alex. talking about in the older age group. but i think there's something else about medical miracles that

really create thinking realistically about old age, things like my first medical memory. i am just old enough to remember life in the summer before the sulfadoxine in the early 50s when your parents would never let you go out to go swimming before they were so terrified of polio. that was eradicated overnight. i think because we've grown up amid these medical miracles, we don't realize that some of the things that kill people in old age inevitably, alzheimer's disease, for example, or forms of cancer that if they don't hit in old age your immune system becomes too weak to overcome them. but these things are far more complicated. they require, will require if there ever to be emulated, they require research at the basic biomedical level which is now going on. and they are very connected.

the more alzheimer's research is being done, they assumed when they started this, a disease that is, and your half of all people over 85 have it, someone else nobody likes to hear, don't shoot the messenger. >> host: i have no gun. >> guest: right. but these things are not as easy to find an answer to, not that anything like polio seems easy before they found a vaccine either, but they are far more complex. most of the scientists i've talked to them far from the '90s company 50 crowd, feel that the solution to these things are even let's say something that would delay alzheimer's, which will be a wonderful thing. that much more likely to be there for our children or even our grandchildren, for people who are now in the '50s and early '60s, to count on us to give them a new old age is really not being realistic. i like to quote my dear friend, dr. robert butler whom i'm sure

you knew who died at 82 last year of leukemia. and he basically invented the field of gerontology and was the first direct on the national institute of aging. you is the only voice on the '90s to 50 spam. i asked him a few months before he died. i interviewed him for the book, and i said what do you think about the prospects for, say, i cure for alzheimer's? and he said honestly, i'm a scientist and nobody believes in science more than a scientist. i'd like to wake up tomorrow morning as he there is a cure for alzheimer's. he said realistically i think the reason we need to invest more research now is it still a long way away. and furthermore you can always hope for something like that, but you can't base strategy for dealing with old age on the assumption that this is going to happen for you. i think that's my view. we can always hope for a medical

miracle, but hope isn't a plan of action. hope is just help. >> host: i felt that your chapter on alzheimer's was the most passionate in the book, or maybe i was bringing my own experience to that. but talk to us a little bit about how you develop that chapter and the personal experiences that you had that maybe she'd that chapter. >> guest: alzheimer's, not in my family. my mother and my grandmother lived -- my grandmother lived to be 99 with a sound mind. and i never personally had experience with alzheimer's until my partner, who was 15 years older than i did, got it. and mercifully he died three years of cancer before the last remnants of his mind went. and one thing this experience is

helping to care for some, someone with alzheimer's changed my thinking about one thing. first of all, it changed my magical thinking about it, and i realize although i know better, i've written about science, i know that intelligent, educated people get alzheimer's also. but i had sort of magic thought my way out of it thinking well, if you're really, if you're smart and you're engaged with life and you work hard and you do intellectual work, if you exercise and you eat your vegetables, you're not going to get alzheimer's. well, this of course is nonsense as the national institutes of health found out in a major review of this in august. and all these people who believe that exercise and greens are going to protect them from alzheimer's, those are good things in themselves, the exercise and greens and intellectual work. they are not a magic pill that's going to make you not get alzheimer's. but one of the things about it that is so tragic, and when you think that the risk of it

doubles in every five year period of over 65, and half of people who are over 85 have dementia, which alzheimer's is the leading cause. my partner, i can remember when he was sort of in the middle stages of it, when he could still do some things but not others, i can remember him saying i feel it somewhere inside me, as a person i really am. the person i was before. but he said i can't find him. i can talk to him. if there's ever a definition of what happens in the dying brain of a person with alzheimer's, that is it. and you understand what this means and you also understand how tragic all of this false hope is. and while i have to say one of

the things that particularly enrages me are these ads for the so-called memory pills. i won't mention the brand names, but, you know, what they are. helping dad be more like himself, which by the way we were also found to be basically have no effect at all in the national institute of health review your 1 dollar terms to the other and says helps dad do himself? what it doesn't show is that taking the pill, walking out of the house, getting lost and not being found for seven hours. and i would disclose with one or personal thing. my partner took them but i know when he was still able to think things through he had no faith in them. i can remember him taking the memory pill one day and saying, in yiddish, basically nothing will help your this is the punchline of a lot of old jewish jokes he used to tell in the days when he would tell jokes. and i think this false idea that there are all sorts of ways

right now that we can armor ourselves against this. this is not good for people. it's great to hope that you will never get it but not to think that you're living right things will turn out right for you. >> host: do you think baby boomers are particularly susceptible to that kind of wishful thinking, or illusionary thinking? and if so, which comes first, the products that you mentioned that are advertised in the leaky pipes, the viagra, all these sorts of things, or -- drinking viagra works. viagra is different than the memory pill. drama but these products that are aimed at the baby boomers to make us think that if we take them or use them, you know, i will change as i become 80 or 85. >> guest: i think there's a lot in our history come in our social history that makes us have a lot of faith in the idea

of self transformation, that you are the master of your faith, the captain of your soul. and i don't for one minute want to denigrate the value of good health habits. these habits, things like exercise and so on have been shown to make you healthier while you're healthy. they may make you healthier in old age than you would have been otherwise. they probably will. there are good things in themselves because they make your life better. they are not in antiaging pill. they are something that is good for their own sake, but they are not anymore of the transcendental meditation was over -- or, we can our member all of the self-help movement of the '70s. some of them are good and some of them or not. but they don't armor you against something which is inevitable, which is getting older and the realities of disease and

economic problems that now a company getting older. there's some things that are not within our control's. we can make the best of what life hands us, and part of that is the genetic and we are down. but we are all capable of aging successfully until we are not. >> host: what you mean by that, aging successfully? ethnic aging successfully, what i mean by it is making the best of your help at any given point. but what i think society means by it is not getting old at all. now, my mother is now 90. if you asked me, she would've been a prime example of successful aging four years ago. she did 25 hours of volunteer work in the critical care unit of her local hospital, a huge job. if anybody come if you ask anybody about her, you know that she was really on top of her game. but she is had, again, like my grandmother, she has a full functioning brain and body that

has let her down and is now mostly confined to her room in an assisted living facility. so she was capable of aging successfully until some diseases she had had, because as you get older your immune system's ability to fight off things that, when you're 60 and 70, you can live with a lot more easily, goes. and so what i mean by aging successfully is doing everything you can at that moment, but there comes a point unless there is this fairytale we all have, going to drop dead at the age of 95 in the middle of making love our paragliding or skydiving. but, in fact, with no pain, no display, nothing leading up to a. and back who wouldn't want -- but you don't get to choose the manner of your own death in that way. my mother who is very frank and has had a living will and health care proxy for use them her children don't need to wonder what she wants done.

my mother says frankly that she doesn't, that the life she is living out, she does not consider likely she would have liked to drop dead of a heart attack while she was doing her volunteer work, but that's not what happened for her. >> host: what did she think of your book? >> guest: she likes my book. and by the way, it's very interesting. i've a huge number of e-mails in response to various articles i wrote in various places. the older people say they like my book. i have had a lot of responses from computer savvy people in their 80s, you know, saying you said what i'd like to say, but i don't dare say. and i find these things interesting. you ask about successful aging. what they mean by they don't dare say that is one of the ways in which you get used as a hip older person by younger people is this, you never complain about your health, because nobody who is in good health wants to hear. and i don't think anybody who is

in good health really understands what it is to get every morning, up every morning and got to deal with various paint and things like that, that you don't feel the way a 30 year-old or a 50 year-old does when you're 85 but even a relatively healthy 85 year old person. so you don't talk about bad health. you don't talk about losses. if you're grieving for a partner, a longtime partner who died, yes, you're allowed a month or two of tears, but i saw this ridiculous piece in the new times a few days ago, an op-ed piece about some social scientist has done a study, that basically, most people are supposed to get with it after about six months. and yes, they may still grieve for the partner, but tears are thinking about the partner all the time, or constant feelings of sadness, maybe a sign of depression or something more.

and that is another thing. so you have to project a positive attitude. frankly, i don't understand anybody who, six-month after the death of a partner of 30 years feels okay and doesn't think about them all of the time. but i think that is one of the positive thinking business, is something our society poses on everybody. but with no group is more cores by that any old. if you express sorrow our dissatisfaction when you're 85, something that a 45 year old which is considered a normal gripe, at 85 is a well, he's just a cranky old geezer. she's just a mean old crow. what people express when they're older is put down to old age rather than a legitimate response to a loss which anybody would have if they had at any age, except all people have more of them. >> host: i suspect that old people are reluctant to express

those genuine emotion because of another point you make in the book which is loneliness factor, that when people get old, maybe the partner has died and they don't have a private person and is not a child in the picture, and the social circle has shrunk. and so i think what you're saying is that society coerces people not to be that bg grow, not to be that grumpy man because that pushes people even farther away. talk about about that loneliness factor. >> guest: that in particular in the oldest old, i mean, one of the reasons that it has and it may well be true is that women do better as widows and india as widowers is women have more women friends. and this is true. women relate to other women more closely throughout their lives. at least now. that may not be true in a generation from now, but still,

than men do. but when a woman lives to be really old into her 90s, then because she is the oldest of the old survivors, she begins to lose her female friends also. my grandmother, i did -- she did live to be 99, i talked to her a lot about this. one of the things she said to me was, she was a person who always made younger friends throughout her life. if anybody had as good and old age as you could into you can't, she did. but she said one of the hardest things about being in her 90s is she outlived everyone who didn't see her as this old woman, but who remembered her as the young and vibrant girl and woman that those people were all gone. and, of course, you can have friends of all ages and good friends. there's a special things to friends of your own generation. and for the people who live the longest a have to cope not just with the won loss of a primary

person in your life, but a succession of losses as a people who are not as hard as they are die off before them host that my father is 86 lives right in the area. his high school class still has a reunion once a year. and it's such a highlight of his year to go to this and see people that he probably doesn't see from year to year, but i think the element of having children together. it reminds him of himself gets back even not necessary somebody you knew when you were young adults. all of the people that my grandmother and my grandfather used to do things with and so on, she outlived them all. and even a loving child cannot make up for the absence of your contemporaries. >> host: you mentioned aarp a few times in your book, and say

that the organization has only helped the americans aside have a full picture of the realities of the old, old. what you that organization do? >> guest: i do believe that, and i should say, i'm not just criticizing aarp. i wrote for aarp publications for years. so who i am criticizing is myself. but by thinking about aarp has changed since i was writing for the bulletin and the magazine. i think that one of the things that aarp needs to do is it needs to, first of all, stop concentrating, which i think it does obligations, on the 50 and 60 and early '70s some things, and start presenting a full picture of older people as well. if you look at any of the aarp features on people we love, almost all of them will be in the '50s and '60s. i know, that's where the business is. that's what the boomers are.

but there will be one person in the '80s, and this was always the case in aarp publications because articles about people who are really sick and how they cope with it, i think they are to be doing more of that. but there are also down or articles. the story i told on myself and this book was, this is many years ago, none of the editors are there now with editors have been. i was asked to do a story about people who, after a serious illness, had made the changes in their health habits and have greatly improved their lives. and the first person i thought of was the high school classmate who had a form of cancer in her 50s and she was supposed to die from, and she didn't. and when it became clear she was going to die, she responded by giving up smoking and losing 50 pounds. they ran a picture of her, she was 56 been. i swear she was so gorgeous, she

looked not really, anybody would've recognized as a high school cheerleader she was. i didn't do anything -- i didn't have anybody over 64 because i couldn't find his triumphant stories in people who are in their late '70s and '80s. they exist but i think simply by featuring younger people in these publications so constantly and not older people, they are suggesting that people like in the '80s can expect the same results and the fight aging in the same way that people in the '50s can. and by the way, i think that it's fine people over 50, i've been a member of the aarp since i was over 50, but people in their 50s comparing him to people in their 80s is also, is also ridiculous. but i think mostly the aarp publications present in the personal examples the sunny side of old age always. and i don't think, given that aarp represents all seniors and

it has a huge battle on his hands and it's going to for the next 10 years to maintain medicare and social security, in ways that all people need, that the aarp needs to start featuring more of the worst problems as well as the best case outcomes. >> host: is there any aspect of popular culture that does come in your mind, presents the accurate view of route old age? do we have any tv shows? do we have any top your culture? >> guest: of course, you know how few television shows there are that feature all the characters. but when they do, the fact that we see coming back to betty white, a show you how few of them there are because when anybody asked you about that, the own personal that you can think of is betty white. you know, the most wanted talk

show guest and so on. by the way, this was about people who are old. really, they were the young all. even the old series, the golden girls, i thought was completely unrealistic about life for women in their 50s and '60s. and all these golden girls were concerned about was getting another man. i don't think he was in any way realistic about the real problems that real women in the '50s and '60s faced. so no, i don't think that there is anything in popular culture because popular culture doesn't bash at what it likes to at is a person like betty white who doesn't seem old. forgetting, i couldn't move my hips and dance like betty white when i was 30. betty white is one of those unusual people. but i don't think there's anything in popular culture that actually reflects the lives of all people because it's a down. and even not in popular culture,

the hbo production alzheimer's project, which was the first real tv series to really examine alzheimer's and produced by british art for of course his father recently died of it. there was a lot wrong with that series. and one of the things wrong with it was, is it presented only nice long-term care facilities, or people -- it was horrifying enough. it didn't actually show what the people in the last stages of all timers are like, but there was always a caretaker, a home, a woman. there was nothing in that about the people who have no caretakers in the late stages of alzheimer's. people who are not in a nice nursing home whose life savings have run out and are in nursing homes on medicaid. and i've done articles on nursing homes when i was younger, and they are not nice places. and so that it did not in a way,

issue the worst-case individual scenario. you lose your own, but there is always a caretaker. it was always a woman. there was a woman but given up her job in minneapolis to care for her mother. who's going to care for that woman of the years she's lost her taking? that is a very, very serious issue, which is -- >> host: you mean for earning power? >> guest: right. let's say a woman is when to quit her job and her 50s who take care of her mother. well, if that woman is going to need to be taken care of in one or another when she's older. and the fact she quit her job, we don't have anything really that provides for long-term care in homes, even for people in the middle stage of alzheimer's who can do a lot. when my partner was in the middle stages of alzheimer's, and i emphasize he did not reach -- cancer mercifully took in before that, but there were a lot of people involved in his care. and he had something i thought was stupid and he voted children

come and people who subbed for each other. he had a big network, and for when there could be somebody there, because he did reach a point where he couldn't really not be left unsupervised, even though he could still do things like enjoyed old movies and things like that, but he couldn't be trusted not to turn the stove on and burn the house down. when he retired, he took a lot of a lot of medical benefits that provide for some home care. we needed that. most people can't afford that, and we are now talking about cutting down when interest to provide home benefits for families who are willing and able and eager to help care for a person cost so much less than to let people's life savings run out put them in a nursing home. >> host: you make a number of criticisms of the medicare program, particularly that assistance for the home caregiver isn't covered. why don't you talk more about

that? >> guest: and this is a hard to talk about because nobody is talking about it expanding services. all people are talking is medicare is ways to cut them. and fact i think there are a number of things we're going to have to deal to reduce in of life care which only prolongs death. i'll talk about that and a bit, but it is a great criticism of medicare that you cannot -- let's say you have a husband at home in the middle stages of alzheimer's, but you cannot care for him 24 hours a day. you have a job yourself, and it can be very much needed. medicare will not pay for people to come in for eight hours a day, the eight hours you need to work, which would be so much cheaper in the long run. but we are a country that doesn't too long run thinking. but having people lose their assets and having to put somebody into a nursing home when they're someone who is willing and eager to provide

care at home, if only they have some help. >> host: nursing home costs maybe three times as much as assisted home care. >> guest: and there are people who need nursing homes. make the mistake about it. but there are people who could stay at home longer. there aren't healthy old people who could live independently longer if they could have nursing homes. if they could have some kind of home care, not necessarily medicare, which our society doesn't pay for unless you have completely exhausted all other assets. this is going to be an urgent issue as more boomers live to be over 85. and, of course, now there certainly isn't going to be a discussion of it right now because all they are talking about is about how to cut the cost of medicare. now i will talk about that. i can tell you, i can tell you one thing, one thing that would cut the cost of end-of-life care. and it's not death fails.

it is the thing that out of political cowardice has recruit from which is paid for voluntary consultations between older people, when they are healthy, it doesn't have to be when they are sick. in fact, it's much better if it isn't. talking with her doctors about what are their feelings about end-of-life care, would they like, for instance, there are two things do everything. which means as long as the heart is beating, whether you're in a coma or not, and that is what we spend a huge proportion of the medicare budget on in the last month of life, i think that if people were encouraged to discuss this with their doctors, and by the way, doctors who are scared of death and dying as a but else needs to discuss this as much as their patients, would encourage them to go home, talk to the people they love, investigate the legal issues. only a third of americans have living wills. even if you have what you also need, which is somewhat legally appointed to make decisions for

you if you can't take care of yourself. if only half of the 70% of americans who don't have any end-of-life care instructions would make those decisions for themselves, it is incalculable how much since we spend so much the last month of care, and this is not death panels, it's people being encouraged to think about what 90% of americans say they would like to die at home. only 20% do. now, i will definitely use my mother as an example. she made out her living will and appointed my brother and me as her legal representatives 30 years ago. and we are in no doubt about what she wants. and, in fact, she has rejected all kinds of care already. we don't have to make decisions for her now because she is of sound mind. if she ever is not then we will do exactly what she said. we would be afraid not to. but the point is she's taken care. my mother is not going to cause

a third of the medicare budget in the last year of her life. she understands and expects differences between care that can only prolong her dying, and care that could return her to a good quality of life. there isn't much of that for her anymore. and she made these decisions when she was healthy. and i'm not saying everybody is a strong-minded as my mother, but a lot of people are if they are encouraged to do it. that is a way without having death panels, or even talking about assisted suicide. we can encourage people who want to make plans for their own end-of-life care to do it, instead of encoding passion avoiding the subject. >> host: if someone wants to have a living will, tell us what that means, what steps some have to go through. what questions they have to ask themselves and answer. >> guest: first of all, not every statewide will recognizes living wills. first of all yankee find that what you're state law is about this. and this is something, aarp is

full of information. if you can't use the internet, you can call up the appropriate office at aarp and they will tell you exactly what you're state law is about this. and even those people who can't use the internet, which i think more boomers will be able to use the internet, but even if you can't you can call up aarp, you could call up your local citizens council and they will tell you what the state of the law is. it is a myth if you are not rich, there are financial issues involved with your regular will. you need to have a lawyer for that. i understand there are people who want to do-it-yourself wills, but there's all kinds of centers that offer aid at a fairly moderate rate. but for a living will, a living will sort of states your wish, a living will states for example, in new york state that if there is no chance of my returning, recovering, like being able to

speak again, i do not want to be hooked up to ventilators. i do not want to be force-fed by tubes. it spells it out quite explicitly. and he needs legal, any lawyer will draw up one of those. but a living will is not all you need. you must discuss this with whoever and appoint a legal representative to act for you if you cannot act for yourself. because as many people by the time these issues arrived can't act for themselves. your children, your spouse or your friend if you are not married this is going to be a bigger issue for boomers because many more boomers are divorced. boomers have smaller families. the assumption that there's going to be someone -- and by the way, the person you appoint may not necessarily be your child. it will be if you don't appoint anyone, it may be a child that doesn't agree with your ideas about that at all. people need to appoint legally a

representative. and you actually do need a lawyer and another to do it. this doesn't cost a great deal in most places. if you call to aid our senior organization, they will tell you have defined legal help for not very much money. but you have to have the will that spells out what you don't want done to you if you can't recover. and somebody to sign the papers for your if you cannot sign them for yourself. the people who criticize this and talk about these and death panels, as far as i'm concerned are idiots. leon, a famous man and chairman of president bush's council on bioethics, president bush the younger, he is opposed to living wills because he writes that no one can possibly imagine what they would do and all future contingencies and there's no substitute for a loving partner. good for him. he's got a loving partner, a

wife but there a lot of people, particularly women who want to have a loving partner even if they had a loving partner for most of their lives. and what it is certainly true that you cannot know what you do in every circumstance, i can't know, you know, whether if my knee gets worse, i'm really willing to go through and the replacement of whether i would rather hobble along the knee i tore up 20 years ago. i don't know the answer to that. but i do know that if my brain, my higher brain functioning are done, that i do not want to be force-fed to keep my body alive, that a do not want to be hooked up to an artificial than the later if i'm 85 years old and cannot breathe on my own. but i don't know, i can and do what i would do in every situation, doesn't mean that i can't know what i would do in the most common situation. and i think whatever anyone does

about this, i do think the objections to the are of a particular kind of highly conservative religious -- i was raised a catholic. i'm an atheist but i was raised a catholic and i know that the catholic church has no objection to saying you don't want to be on a ventilator if you can't get better. that is not considered suicide. it's considered you don't have an obligation to have everything to keep your body alive as long as possible. but there's a particular kind of -- i was a -- very anti-individualistic religion, which says that everything is in content we'll have the right to make any decisions for ourselves. and i think that is where the opposition on the far right is coming to the whole idea of living wills. mainstream religions do not object to these things at all. any mainstream religions do object to suicide but that is a different thing. assisted suicide is a very

different thing from saying i don't want extreme things done just to keep my heart artificially pumping when i'm never going to be meet again. >> host: you to say that suicide or assisted suicide can be a rational choice. you go on to make the point that in medicine, at least how it is practiced in this country, tends to give anybody reaches that decision that that's the option they want to take is either off their marbles or is depressed and can be cured by pills. >> guest: the fact that suicide is rare under any circumstances is borne out by states like oregon who is at assisted suicide laws for 10 years. very few people use them. the number of people have used them are people who are terminal within six months and who number in the hundreds. many who went through the process of applying for this didn't do it. most people are not going to commit suicide under any circumstances.

but i believe that for people who are in unbearable pain, it is a rational choice. and i don't agree at all that everybody who wants to commit suicide is a rational or depressed. and i think this is part of patronizing. i don't deny for a minute that there are some people who are depressed. for example, i will give you an example of people who are depressed. there are people, people in the '60s and '70s who, when you receive a diagnosis of something like multiple sclerosis, or parkinson's, which you're eventually going to die of but unlike alzheimer's or some forms of cancer, they are manageable and treatable and you could have a meaningful life for a long time. they are not a death sentence, but there are people who treat that kind of a diagnosis as if it were an immediate death sentence. those are people whose thinking is distorted. and many of them might not only

need to be on antidepressants that have therapy and have their disease explain to the better. a lot of a lot of people agree something that is not a death sentence as a death sentence are depressed and irrational in their thinking about what is always able. like being told they have ms or parkinson's. but as we can cite huge numbers of examples of people who have lived meaningful lives long years, decades after these diagnoses, you can live with it unlike some of the worst diseases of old, old age. but to say that everybody can even people who are not terminal, everybody who said i've had a good life and i've had enough is depressed, one example i use in my book is this 102 year-old man in st. louis. very well-known in st. louis. i'm sure the shrink would have loved to have gotten their hands on them. he was a leader in the jewish community, still have the st. louis. in the 1940s with st. louis was still very much a southern town and its racial attitudes,

he insisted that unions on his construction projects admit african-americans. he was a huge civic figure, philanthropist and builder in st. louis. and he was just fine until he was about 99 when he fell and broke his hip. anyway, again, a great example of someone who can age successfully into you can't. then he had to have a companion, which for a man like this, he hated. there was nothing wrong with his mind. two weeks before he committed suicide he had given a long from memory speech at a synagogue about his life, about what a great life he had. he outlived two eyes. he outlived some of his children. and his grandchildren. what he did one morning, and he hated living with a companion. well, i'm sure there are a lot of the people, people commit suicide are all crazy. thank god that helping professions didn't get their hands on a. he one morning stole the keys to his companions car. he had been a champion swimmer in high school and college that

he drove it from his lifelong home. he had all the money in the world. he would have died at home but he did not want to have his every move monitored by another person, august. he drove his car to the missouri river. got up on the bridge and dove off it and committed suicide. now, i am not advocating that people do this. i think i don't think this man was crazy. and the letters he left for his grandchildren, please don't agree for the are think i was out of my mind. he said i don't want to live until i have no control over my own death. i can't do any of the things really that have given my life meaning. and i'm not -- i think this is a phase of a man who said enough. i've had a great life, it's downhill from here. and again, i don't advocate this, but i don't think he was crazy. and i'm glad that some psychiatrist with antidepressants and xanax didn't get him in his hands before he took his own. >> host: i don't want to get

away from his before i ask you what the two or three or four public policy decisions over retrofits need to be done in order to start addressing the issues that you raise in your book. just vacuuming everything that we're being taught against in washington right now? one, one, we need social security is not desperate straits now. but we need not reduce social security benefits. actually, i think we can increase the retirement age. i think we can increase it a few years. but it has to be with an understanding that's not an absolute requirement. i hate the idea of retirement. until the army i'm not retiring. it happens, as long as i have my mind i tend to be working. but there are people have spent

a whole lifetime of physical labor. and i don't just mean working in coal mines. i also mean that i consider physically on the body having stood behind a retail counter on my feet for 40 years is far more physically taxing that having been a writer. there are people who need to retire before age 70. firefighters. but not just that. there are a lot of low income jobs that are relentless physical work. and i think that to say, for instance, that everyone who made their living as a health care aide in a hospital can't retire until they're 70 is wrong. so i think there has to be a lot of exceptions, raise the retirement age yes, but also built a lot of physical exceptions into that law. the hardest thing in the world to do. we do have to raise the retire age for a lot of people retirement age could be raised to 70. for a lot of people it can't.

there's no one size fits all. i don't think we need to cut social security benefits at all. i think we must not because they are not that generous now. three quarters of people over 75 live on $34,000 a year or less, including social security. does that sound like ridge greedy geezers to you? first of all, we need to raise social security taxes apply to everyone. >> hosthost that even the rich people? >> guest: even people, right now i think this unit is $109,000. and there aren't too many people who make more than $109,000 but everybody should pay social security withholding on every bit they make, whether they make $109,000 or a million dollars. that said, you can do that. we will still probably have to have increases in attacks as

well. cutting the retirement age and taxing all income will be part of it, but there will have to be probably a higher tax. i don't think that higher taxes, and i'm not in that fortunate millionaire category, higher taxes i understand are a dirty word. and what we have right now is politicians who are encouraging the public about this, polls show the majority of people are totally opposed to cutting medicare or social security benefits but they're also totally opposed to paying more taxes. that cannot be. right now with no politicians in either party who had the courage to tell people a, we cannot cut social security benefits. old people need that your i think also yes, you could also have a means test in the people who make a million dollars a year who are 80 years old don't need social security. but that is such a small percentage of it. inevitably, referring to social

security would mean raising the retirement age in a sensible way, taxing everybody on all other income for social security. and probably raise. if we don't do that we will undo the most stellar achievement of the american 20th century, which is the reduction of old age poverty. medicare is harder. that medicare system, again, i'm talking high in the sky because nobody is talking right. every morning on "morning joe" i hear they talk constantly about the need to cut entitlements. medicare, medicaid. medicare really does need fixed, but it's the kind of takes that has to come the way -- the equivalent of old age of medical care does not cost european countries a proportion of the gross national product as it does us. why? first of all, there are real

tight government feelings on certain procedures. and if you have government cost controls, for instance, the bush prescription drug plan which passed a prescription drug plan but without passing cost controls in which the government demand certain concessions for big pharma which can still make money, charging a lot less for those drugs. if the government is going to be its biggest customer it has the right to demand a ceiling on drugs which cause, the same drugs cost so much less in every other country in the developed world. there is no solution to providing universal health care for the old. without more government cost controls. but i believe also there really is no solution to the problem of medicare for the old. the financial one without a solution to the rising cost of health care and health insurance for the young. i write in my book when i

started working at the "washington post" in 1965, social security seems a lot bigger on $105 a week salary that it did later. i didn't resent it. that was for my grandparents. however, if i had good health insurance in the "washington post" and health care did not cost that much been. now for the last 20 years i have been spending 15% of after-tax income for a bad private health insurance plan. the next generation below the boomers of whom there are fewer than us is not going to so easily accept those taxes for medicare and social security if the cost of their own bad health insurance keep rising.

which whatever you think of that bill, was the first attempt to address this issue. the majority of people over 65 were opposed to universal health care for anybody but themselves. sorry. bad things. a lot of people reside because the aarp supported that health care bill. there is no solution. the young are not going to support the old if the old don't recognize the financial stress of the young as well. >> host: one reviewer called your book, our culture every hour the instructor and set it's not a cheerful book. are people buying its? >> guest: i don't know actually. i meant book tour's land where you hardly know. but i will take that people either love or they hate this book. the people who hate it, hate it because they say it's too pessimistic. i call it realistic. the older people are, the floods of e-mails i've had in my website from people in the

'70s and '80s, this is what i wanted to say but didn't you i could say it. people either love this book and consider it saying something that they wanted to say, or they consider it an absolute diatribe. >> host: you said your friends and fellow writers encouraged to in the book on a happy note. >> guest: i tried. do you think it comes off happy? >> host: know. i tried to -- they wanted to end ththe book of what good advice i have for people to solve these problems. >> guest: and one of the things i'm saying in his book is old age itself is not ultimately be viable. the practical pieces of advice i have, first of all, i think people need to stop thinking about retirement and less their whole purpose in life is living in a sunny climate which i admit after this winter seems more attractive.

but the best place to be older in cities with public transportation systems. there are not a lot of them but there are some. because one of the things that is so bad about a lot of this country is the minute you can no longer drive, you can no longer have a life. people can be in excellent mental shape wanted to go to the theater, wanting to go out, wanting to go shopping, wanting to do all these things that they're perfectly capable of doing but not, for reasons of vision or something like that, unable to drive safely. in new york i see it every day. i see old people pushing their walkers on to the left of the buses and go into all kinds of places. i see people with a little more money getting taxes, but you do not need a car to live in only a few cities in this country. so we have a country without public transportation. it is a mini train, people moving back to seize when they reach retirement age.

i do think that whether it's paid or unpaid work, people who have their minds need to keep engaged in working and in the community as long as they can't. not because it's going to guarantee they will never get alzheimer's or die and they can defy old age for ever. but because it makes for a meaningful life now. but apart from that i don't know if -- in other words, those are things that are controllable. you don't leave the life of eventual winner not one. you make the best of your physical situation. new york is an assisted living community. i don't understand why more places like lansing, michigan, where my mother lives don't deliver food at home for people and they don't. there are cities that have a culture of delivery and people who don't. for old people on days when whatever you've got is acting up, being able to get your drugs delivered. in new york as part of the cost of doing business your they don't charge extra for it.

if you don't like the food that you have in your refrigerator or you're a assisted living community of serving, being able to order in some chinese. this is the great thing. new york is an assisted living community in the ways a lot of cities are not. i would think we are carefully about retiring to one of those retirement communities what even though they have services, if you don't have a car you just can't get around that i was talking to a whole bunch of people in florida about that, and they said the car thing, they were people who were young. they say they're very worried about the driving issue. and i think it's too late. we have had social policies which encourage this kind of dispersal so that a lot of people are stuck. but i think very carefully if i was a younger boomer in my late '40s about wanting to retire to sun city. i did, my grandmother, one of the worst things, there are practical reforms with long-term care facilities.

they should segregate people with dementia from people without. one of the worst things about the last few years of my grandmother's life, she was one of the very few people in the place where she was who didn't have dementia. she couldn't sit down to dinner with someone and have a normal conversation with them. that is a terrible thing. i remember the last time i saw her, she said to me, i took her out to a riverbank in nearby and she was so happy. she said it's good to be among the living. but the last thing she said, the last time i saw her was, as you look at the water and she said, it's good to know that the beauty of the world will go on without me. drama and that's a lovely thought of which we will end. thanks so much. the book is "never say die." >> guest: thank you. >> visit booktv.org and click podcast on the upper left side of the