Giving Family Caregivers A Seat At The Policy Table

When Congress and the White House develop health or long-term care policy, they hear plenty from providers, drug or medical device makers, and scores of other lobbyists and advocates for various interests. But they rarely hear from family caregivers—those people in the trenches who struggle every day to assist their loved ones. On Monday night, Congress passed a bipartisan bill that may give family caregivers a seat at the table.

What Do We Call Aging Baby Boomers?

Are you ready for a new debate over what to call old people? This happens every few years:  We’ve tried senior citizens, seniors, the elderly, elders, retirees, and even gerontos. Lately, “older adults” seemed to be catching on. That’s the phrase I mostly use though it is not entirely satisfying either. Older than who?

Then there are the euphemisms for old age itself: Three decades ago, the British historian Peter Laslett created the phrase “Third Age.” Later, the marketer Ken Dychtwald spun it into the age wave. Actress Jane Fonda (who is 80) has a Ted Talk called “life’s third act.”  

In The Coming Debate Over Medicare, Remember How Much Seniors Pay

House Speaker Paul Ryan (R-WI) promises that 2018 will be the year Congress attempts to reduce spending on big federal programs like Medicare. As that debate unfolds, keep this in mind: A 65-year old woman will need to have put aside $95,000 to have a just a 50/50 chance of paying her Medicare premiums and prescription drug costs over her remaining lifetime. If she wants to 90 percent chance of paying her Medicare bills, she’d need $147,000. The estimates are from the Employee Benefit Research Institute.

What the GOP Tax Cut Will Mean For Older Adults

Congress is nearing passage of a $1.5 trillion tax cut that would mostly benefit businesses and high-income households. For older adults, the effects are complicated. Some will receive large tax cuts. Some will be no better off and a few will be worse off. But beyond the immediate tax changes in the bill, the measure sets the stage for what promises to become a major battle in 2018 over critical programs such as Medicare and Medicaid, and over the way future Social Security benefits are calculated.

Health Care Measures Everything, Except What Really Matters To Seniors

As board chair of a community hospital, I am often confronted with the dozens of quality and safety measures that state and federal regulators use to score and pay us, and private organizations use to rate us. And as someone who works to improve the quality of care for older adults, I am struck by how much all these measures miss when it comes to what really matters for seniors.

Here’s an example: Imagine an 85-year-old widow with mild dementia who lives alone at home. She comes to the emergency department of her local hospital with severe hip pain. She is treated quickly and efficiently in the ED. The orthopedic surgeon finds that she has severe arthritis and determines the best treatment is hip replacement surgery.

The Risks Of Social Isolation For Older Adults

Socially-isolated older adults are likely to be sicker and die sooner, and have higher health care expenses, than seniors who retain their social connections. A new study by researchers from the AARP Public Policy Institute, Stanford University, and Harvard finds that Medicare spends an estimated $6.7 billion more each year on seniors who have little social contact with others.

An Easy Way To Reduce Health Costs…And Patient Stress

Health experts often focus on the needs of a relatively small number of people who are the heaviest users of medical treatment. You know: that five percent of Medicare beneficiaries who account for half the program’s costs.

But a new study published in the October volume of the journal Health Affairs (paywall) looks at another cost-driver in our health care system. This one will be familiar to many seniors and their adult children: Needless high-volume but relatively inexpensive tests and procedures such as cardiac screenings for low-risk patients, PSA prostate cancer tests for men aged 75 and older, and imaging for common low-back pain.

Two Proposed Tax Changes That Will Hurt Frail Older Adults

Two of the many major changes House Republicans would make to the federal tax code could make it harder for fail older adults, younger people with disabilities, and their families to receive badly-needed services.

Repeal of the medical expense deduction would severely hurt those who face major uninsured expenses for medical treatment or long-term supports and services, including care at home or in facilities. At the same time, other proposals that would cut the tax benefits for charitable giving would hurt community-based non-profits that often provide direct services to seniors and younger people with disabilities.

Medical expense deduction

Medicare Spends Far More On Older Adults Who Need Personal Assistance

Want to know if an older adult is likely to use lots of medical care? Just ask if she needs help with living activities such as bathing, dressing, or getting out of bed.

In a new study with important implications for both caregivers and policymakers, researchers at the Long-Term Quality Alliance (LTQA) found that Medicare spends an average of three times as much on an older adult who has these functional limitations than on a senior who does not. Even after adjusting for age, the number of chronic conditions, or Medicaid eligibility, the pattern is the same: If you have severe functional limitations or cognitive impairments such as dementia, Medicare will spend far more on your medical care than if you do not. Earlier studies, including one in 2011 by Judy Feder and Harriet Komisar reached similar conclusions.

A Simple Solution To Medicare’s Enrollment Mess

Enrolling in Medicare Part B should be simple. But for years the government has been making enrollment nearly impossible for millions of seniors, especially those who are still working or who have delayed taking their Social Security benefits. They are never told that are eligible for Medicare, they don’t know that they face still penalties if they don’t enroll by a deadline, and they can’t figure out how Medicare fits with other health insurance they may have.