Easy lies the head

Is the health of European royalty expensive?

.. that wears the crown.

The brave few commenters who struggled to the end of my post blaming admired medical researchers for the long-term crisis in health costs  didn’t like it much. We would all much rather blame parasitical insurance companies and greedy plastic surgeons; but how do they account for the same trends in Britain, Switzerland and Japan? Or Big Pharma: which does operate everywhere, but whose marketing excesses are only allowed to flower in the USA? The slowing down of Pharma’s innovation into incremental plodding does drive costs higher everywhere – but that also is basically a failure of research.

I’m not required to offer solutions, but here goes. Suppose, in the flames and chaos of the collapsing Bachmann Administration, an act of spite by the fleeing President makes me by accident head of the luckless NIH. What would I do in the interval before the Mounties and the UN peacekeepers restore order and the Committee of Public Safety gets round to replacing me?

A successful conservative institution is bound to resist my ideas. So I’ll quickly set up an in-house MARPA – Medical Advanced Research Projects Agency. Like its Pentagon model, it would operate on a venture-capital rather than peer-review paradigm. accepting high failure rates, backing people and ideas rather than neatly packaged proposals, and exploiting unorthodox mechanisms like open prizes and competitions. The mandate will include cost reduction as well as innovation.

As an example let’s look at the apparently glowing health of European royalty.

The evidence for health and longevity is anecdotal but strong.

 

Queen Elizabeth of the UK – age 85, working. Photo 2010. Keyhole surgery on both knees.

Queen Beatrix of the Netherlands – age 73, working. Photo 2011. Operation for cataracts.

 


King Harald V
of Norway – age 74, working. Heart and cancer surgery.

 

King Carl Gustav of Sweden – age 65, working, Photo 2011. Only publicly known health problem is dyslexia.

 

Queen Margrethe of Denmark – age 71, working. Photo 2011. Arthritis; both knees replaced.

and two consorts:


Prince Philip – age 90, semi-retired.  Photo 2011. Heart condition.

 

Queen Elizabeth the Queen Mother – died age 101, working into her 80s. Photo at age 100. Appendectomy, two operations for colon cancer, cataracts, hip replacement.

The Queen Mum’s alcohol consumption, 70 units of alcohol a week, was about ten times the recommended level. It was apparently outweighed by regular physical exercise (walks and dancing) and mental (party games, waspish conversation, horse racing), as well as a rugged Scottish constitution.

The sample is of course biased. These are the survivors. How many royal Johnnies  died young, or Katherines and Nerissas spent their lives in institutions?

The project aims are (a) to confirm this anecdotal picture of rosy health and (b) to find out how much it costs.

The first is straightforward and, if true, easily explained. Royalty have nice jobs, so they keep working into their 80s; healthy lifestyles, with sport, sociability, and a requirement to look presentable; and lifelong access to state-of-the art medicine. The advanced millinery is probably irrelevant. They are also, conveniently, a near-random genetic sample, unlike selective cohorts like university professors and international civil servants. (European royalty used to be inbred, but for two generations now they’ve been mating with commoners.) It’s a reasonable stretch to assume that under universal health care they represent the future of the whole population. Which makes question (b) important. Does this health depend on greater health care resources?

My guess is no. Royals don’t have to wait and their physicians spend more time with them at each consultation. But they don’t have access to mythical super-doctors, just reliably good ones. Queen Elizabeth II was advised to breast-feed her children in the 1950s, no doubt as an example to the poor.  To get a fair comparison with the average patient, I think you would want to convert the royals’ actual out-of-pocket costs for private doctors (a luxury good in these countries) to standard costs.

Batty you say? More so than DARPA’s synaptic chips? Find a better idea that actually addresses the health costs trend, the only real external driver of the US deficit, unlike rubbish like cutting Social Security.

Author: James Wimberley

James Wimberley (b. 1946, an Englishman raised in the Channel Islands. three adult children) is a former career international bureaucrat with the Council of Europe in Strasbourg. His main achievements there were the Lisbon Convention on recognition of qualifications and the Kosovo law on school education. He retired in 2006 to a little white house in Andalucia, His first wife Patricia Morris died in 2009 after a long illness. He remarried in 2011. to the former Brazilian TV actress Lu Mendonça. The cat overlords are now three. I suppose I've been invited to join real scholars on the list because my skills, acquired in a decade of technical assistance work in eastern Europe, include being able to ask faux-naïf questions like the exotic Persians and Chinese of eighteenth-century philosophical fiction. So I'm quite comfortable in the role of country-cousin blogger with a European perspective. The other specialised skill I learnt was making toasts with a moral in the course of drunken Caucasian banquets. I'm open to expenses-paid offers to retell Noah the great Armenian and Columbus, the orange, and university reform in Georgia. James Wimberley's occasional publications on the web

2 thoughts on “Easy lies the head”

  1. “The advanced millinery is probably irrelevant.” Never. I am quite confident that the joy of wearing, and observing, a really great hat lowers blood pressure. And if it makes people go so far as to laugh, so much the better.

    I don’t find your question particularly batty, but I suspect that a huge chunk of this royal health comes from being greeted lovingly everywhere they go. Being royal means, or seems to mean, that life is like a box of chocolates that was specially packed for you, like at See’s. The downside would be if one of them were born shy or something. Those ones probably die youngish.

  2. “….if one of them were born shy or something”. George VI had a stammer from childhood, see the movie The King’s Speech. He died at 57 from lung cancer brought on by smoking, reasonably related to the stammer. The job is a pretty good one, but it’s not all being greeted by adulatory crowds. You have to deal with the tabloid press and oily Prime Ministers, and make unfailingly polite conversation at state dinners to diplomatic bores and war criminals. We Need More Research, like I said.

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