Aging, Longevity, Abortion and Taxes

Philip Kotler
5 min readApr 21, 2024

April 19, 2024

Philip Kotler

I see some interesting relationships between aging, longevity, abortion, and taxes.

Bear me out.

Aging wasn’t much of a problem in the year 1900. The average American died at age 47. There were few headline news stories about aging.

Today, most people are living to much older ages in many countries. Life expectancy is highest in Hong Kong, Japan, Switzerland, Singapore, Italy, South Korea and Spain where life expectancy is 84 or more years. The U.S. ranks 47th with an average life expectancy of 79.74 (women 82.23 and men 77.27).

As more people get older in a society, aging becomes a major topic. Several things happen:

1. The economy becomes more dependent on fewer people. Today 17% of the population is over 65; by 2040, that proportion is projected to grow to 22%. This means that the working population has to support a growing number of retired or unemployed persons.

2. The population grows more conservative, less progressive. Older persons who have more assets are concerned about higher taxes and how to maintain their life style after retiring.

3. Older persons get afflicted with more physical and mental problems and more medical bills. They have more accidents, need more knee and hip replacements, may need walking assistance, and may experience dementia. Many oldsters feel the pain of loneliness as some of their cohorts pass away. A nation’s health system has normally not kept up with the rising life expectancy of the population.

4. Older retired persons often run out of money to meet their needs. The rich have no money problem but most Americans have insufficient savings upon retirement. The average person needs $1.5 million upon retiring. Yet the average saver has only $88,400 in savings. Many poor Americans don’t even have the cash to pay for a $400 emergency bill.

Doctors and the Rise of Longevity Specialists

Most retired people turn to their physicians for help with their physical problems. Doctors tend to focus on one problem of the patient rather than helping their patients lead a more healthy life. True, doctors do warn their patients about smoking, alcoholism and drug abuse. Doctors may urge their patients to eat better, get more sleep and get some interests and human relationships. Some doctors may recommend that their patients turn to vegetarianism or change their diet to more Asian type menus.

The New Yorker magazine recently described the rise of longevity specialists to help patients live a longer life. The specialists include celebrity doctors, scientists and futurists who might run longevity clinics. One prominent longevity specialist is Peter Attia, author of the best-selling book, Outlive: The Science and Art of Longevity. He offers health advice, diagnostic tests, exercise protocols, stem cell therapy, mind therapies, and supplements to a wealthy clientele, sometimes charging a six-figure annual fee. The longevity field also has some quacks who promote pills, potions, and promises.[i]

The obsession on longevity has produced some skepticism and opposition.[ii] The writer, Ezekiel J. Emanuel, recently published a provocative article “Why I Hope to Die at 75.” Ezekiel is a 57 years old oncologist and a health-policy professor at the University of Pennsylvania. He argues that living too long is also a loss.

“It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.”

Aging and the Birth Problem

Potential mothers are hearing more about the problems of bringing children into the world. There is the question of a mother’s right to abortion in case she has doubts about having the resources to raise a child, or is pregnant as a result of rape or incest. Potential parents worry about whether they will have enough income to raise the child, hire baby and child services, and send their kids to college.

The need grows to let women have the right to determine whether they want an abortion. Why force the poor mother who was raped or had a one night stand to give birth to a baby. If forced to bear children, there is a good chance that she won’t like the child and often be too poor to raise the child to be a good citizen. She is raising a child who might be a cost to society. Some studies show that societies where women have the right to an abortion end up with less crime taking place in those societies.[iii]

In addition, marriage rates are declining in many countries or taking place at older ages. For these and other reasons, birthrates have been falling, meaning that fewer children are being born to supply the necessary labor. Companies increasingly are favoring more open immigration to get the number of employees they need and an affordable wage.

What Role Do Taxes Play in Affecting the Health of a Society

Societies with a more even spread of income usually have a better health system. The Nordic countries (Sweden, Norway, Finland, Denmark and Iceland) practice democratic socialism. They charge a higher income tax especially on the rich and use the money to improve the health, education and wages of average citizens. They provide more child care services, parent care services, and longer vacations. As a result, citizens of Nordic countries usually rank high on their educational level, citizenship level, health level, and their happiness and well-being.

The implication is that in countries with high income inequality, persons often are paid less than a livable wage and experience a substandard educational and health system. The rich do their best to protect their high incomes and resist high taxes. Their argument is that they earned their high wealth and it will trickle down to the citizens as their wealth is spent and creates jobs. It is true that as the rich build their mansions and buy expensive cars, boats and airplanes, jobs are created. But they are not helping average citizens who need a living wage and sufficient health care.


The good news is that more people are living longer lives. Their quality of life depends on whether their needs for income, education, and medical services are adequate at all stages of their life.

The bad news is that as more people live a longer life, their income and services tend to be inadequate to meet their needs for a happy old age. They have more expensive physical and mental health problems. They experience more pain and loneliness. Their savings are typically inadequate to meet their needs and problems. Their pain would lessen if there was better performing Capitalism that would provide more adequate incomes to its citizens. An observer could ask why someone who earns multiple millions each year is only taxed 37% at the current top bracket tax rate.

[i] “How to Die in Good Health,” The New Yorker, April 22, 2024.

[ii] “Why I Want to Die at 75,” The Atlantic, October 10, 2014.




Philip Kotler

Philip Kotler is the S.C. Johnson and Son Distinguished Professor of International Marketing, Kellogg School of Management, Northwestern University (emeritus)