"I ain't as good as I once was
But I'm as good once as I ever was.”

-Toby Keith

Toby Keith and I are roughly the same age and both feeling the effects of our lost youth.

I am overweight and have the knees of an 80-year-old, but in the back of my mind, I think I can dunk a basketball or run a 5-minute mile.

Since I never could do either, I am really as good as I ever was.

Baby boomers like Toby and I are settling into middle age begrudgingly.   Bionic knees and medicines that help us eat, sleep, and have sex are becoming more important.

A lot of these medical saviors are paid for by health insurance.

As people get older, live longer, and medical costs get more expensive, the country will soon have an angry and contentious debate.

We will have to decide whether to limit health insurance to things that will save our lives or to allow it to keep paying for things that make us feel young.

If I want to be as good once as I ever was, should my health insurer have to pay for it?

In my youth,  I was a real money maker for my health insurance company. I went years without going to the doctor, and if I did, it was for a checkup.  Now my doctor and I have regular visits. The same is true for most people my age.

I’ve never had surgery, but when I hear my knees creak, I would love to have a fix that would allow me to run or shoot some hoops.

Since there are  plenty of people wanting to recapture past glory, it is a hot and quickly growing market.  The question is who is going to pay for it.  

Many companies have gotten into the business  of making “spare parts” for guys like me.  A  New York Times article calls it, “the fight for the bionic baby boomer.”

There will  soon be people with as many bionic  body parts as Lee Majors had when he was the “Six Million Dollar Man.”

Unlike Lee, they won’t have a television series, and the six million dollars could be coming from insurance premiums or taxpayers.

The Baby boomers’ quest for eternal youth has made a lot of money for drug companies and medical device manufacturers.    

The New York Times article talked about the potential profitability of these “spare parts” companies. Unlike drug companies, who are supposed to be regulated carefully, “spare parts” are easy to get approved by the Food and Drug Administration and can be quickly developed.

Although it may be a great time to be an investor in a medical spare parts company, I keep wondering who is going to be paying for it.

At some point, major decisions are going to have to be made. 

They are literally life-and-death decisions. 

Does the insurer or the government restrict health insurance to life threatening diseases and illnesses?  If so, which one? On the other end of that question, when do you cut off treatments for people who are terminally ill?  Do you stop or reduce health care or health insurance for people past a certain age?  Do we cut off people with bad habits like drinking, smoking or overeating?

When we reach the point where hard decisions need to be made, it is going to get ugly. It could pit older people versus younger people or those with terminal illnesses versus those who just want to keep up their looks.

They are questions that no one wants to talk about now. They will only be debated when our backs are against the financial wall.

Our leaders have been able to duck giving hard answers, but it is time for them to think about it.

Especially when Toby and I keep using our health insurance to be as good as we once was.

Don McNay is Chairman of the Board for McNay Settlement Group, where they are as good or better than they ever have been.  His award-winning column is syndicated on the CNHI News Service.  You can write to him at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or read other things he has written at www.donmcnay.com   He is on the Board of Directors of the National Society of Newspaper Columnists.