It has long been among the foundational observations of my inquiry into the nature and causes of the wealth of nations that the labour of the human body is, of all commodities, the most immediately useful to its possessor. It follows, by a logic I confess grows more bewildering the longer one contemplates the present arrangements of the American republic, that the maintenance of that body in its declining years should have become among the most expensive transactions a private person can undertake — not in the repair of some great manufactory, not in the provisioning of a fleet, but in the mere continuation of existence.
Fidelity Investments, a counting-house of considerable reputation, has lately published its estimate for the year 2026: that a couple retiring at the age of sixty-five may expect to expend $185,000 across the remaining course of their natural lives upon healthcare alone. This figure, let it be noted, represents an advance of 7.5 percent upon the corresponding estimate of the prior year. The labouring poor, who have contributed the better portion of their productive years to the aggregate wealth of this nation, are invited to set aside a sum exceeding what many among them will have earned in three years of honest toil, against the certainty of illness and the probability of prolonged physical dependence.
In The Wealth of Nations I observed that the price of any commodity must in the long run resolve itself into the wages of labour, the profits of stock, and the rent of land from which it is produced. The commodity here in question is, broadly, the physician’s art, the apothecary’s preparation, and the attendance of those who care for the infirm. That its price should rise at a rate seven times the growth one might hope to observe in the income of a pensioner is a circumstance that invites, at minimum, a patient examination of who, along the chain from affliction to remedy, is presently extracting the surplus.
The Theory of Moral Sentiments holds that our sense of justice is sharpened by the capacity to place ourselves, in imagination, in the condition of another. I would commend this exercise to any member of the sovereign legislature who has occasion to review these numbers and find in them nothing remarkable.
One hundred and eighty-five thousand dollars. The figure requires no elaboration. It has only to be set down in a sentence and allowed to stand there, as a fact stands, without apology or ornament, for the reader to form whatever judgment the impartial spectator within permits.