Public Policy & Aging E-Newsletter

Volume 6, Number 2, March 2012

This bimonthly e-newsletter highlights key developments and viewpoints in the field of aging policy from a wide variety of sources, including articles and reports circulating in the media, academy, think tanks, private sector, government and nonprofit organizations.

The goal of this email publication is to reach teachers, students, and citizens interested in policy-relevant issues, especially those who may not have easy access to policy information disseminated both in Washington and around the country.

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I. WHAT’S HAPPENING IN WASHINGTON?

A. Raising the Ages of Eligibility for Medicare and Social Security: This Congressional Budget Office issue brief reviews how ages of eligibility affect beneficiaries under current law and how delaying eligibility would affect beneficiaries, the federal budget, and the economy. Raising the ages at which people can collect Medicare and Social Security would reduce federal spending and increase federal revenues by inducing some people to work longer. However, raising the eligibility ages for those programs also would reduce people's lifetime Social Security benefits and cause many of the people who would otherwise have enrolled in Medicare to face higher premiums for health insurance, higher out-of-pocket costs for health care, or both.

B. Health Insurance Coverage for 50 to 64 Year Olds: This AARP Public Policy Institute report examines issues confronting those not covered through an employer-based health-insurance plan, characteristics of the uninsured, shifts in coverage with retirement, market trends, health care spending, and the impact of the Affordable Care Act. As the implementation of the Affordable Care Act proceeds and debates about how to improve the health care system continue, it will be important to look at how well the system serves people who are most at risk in our current system, including adults age 50 to 64.

C. Black and Latino Retirement (In)security: This UC Berkeley Center for Labor Research and Education research brief explores financial security among retired Black and Latino seniors. Findings include that these minority groups rely more heavily on Social Security and have less access to other types of retirement income than white retirees. The brief also reports that less than half of employed Blacks and less than a third of employed Latinos in full-time jobs are covered by an employer sponsored retirement plan, a critical resource in ensuring adequate retirement income.


II. WHAT’S HAPPENING AROUND THE COUNTRY?

A. On the Verge: The Transformation of Long-Term Services and Supports (LTSS): This AARP, National Association of States United for Aging and Disabilities, and Health Management Associates report takes a comprehensive look at Medicaid and non-Medicaid financing of LTSS in each state and provides a snapshot of the status of LTSS for older Americans and adults with disabilities. The lagging economy and increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs and another 11 with plans for implementation.

B. Social Security State Quick Fact Sheets: 2011: This set of AARP fact sheets provides a one-page overview of quick facts on Social Security for each of the 50 states and the District of Columbia. Information is provided about each state's older population, average personal income, Social Security beneficiaries, Social Security benefits, and Social Security's income percentages among older residents' income. Comparing the use of Social Security benefits across states provides important insights into the program’s role in lifting retirees out of poverty.

C. Annual 50-State Survey of Eligibility, Enrollment, Renewal, Cost-sharing Policies in Medicaid & SCHIP: Amid state fiscal challenges, the requirement in the Affordable Care Act (ACA) that states maintain their eligibility levels and enrollment and renewal procedures was central in preserving coverage during 2011. In this annual report, the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families identify changes implemented during 2011 and explain how enhanced federal funding spurred many states to launch Medicaid systems improvements that will help states modernize their programs and prepare for the 2014 ACA coverage expansions.


III. THIS ISSUE'S MAJOR POLICY STORY: Global Aging

A paradox envelops this e-Newsletter’s major policy section on “Global Aging.” On the one hand, cross-national comparisons usually seem to be an afterthought in the discourse and research priorities of American gerontologists. Our Federal government, unlike other nations (such as Japan, Commonwealth nations, and countries in western Europe) only occasionally highlights long term trends associated with societal aging. U.S. investigators rarely issue policy manifestos that indicate how the Longevity Revolution will differentially affect younger, middle-aged, and older cohorts in our population in terms of allocating educational opportunities, employment trajectories, as well as access to health care and social services. On the other hand, as the articles in this section indicate, major institutions (the World Economic Forum, the Stanford Longevity Center, the World Health Organization, the National Institute on Aging, Metropolitan Life Insurance Company, AARP, and the Institute for Research on Public Policy) underwrite important research on population aging here and abroad. To this list surely should be added other policy think tanks, such as the International Federation of Ageing and Bob Butler’s International Longevity Center, which has found a new home in his alma mater, Columbia University.

Few comparative analyses of social insurance remain as timely and provocative four decades after publication as Hugh Heclo’s Modern Social Politics in Britain and Sweden (1972). It is a daunting challenge, for authors and readers alike, to compare apples and oranges, to analyze similarities and differences in norms and values, politics and processes, impacts and institutional adaptations. Yet leaders and citizens in virtually every polity on earth must address the choices and consequences of global aging in an age of globalization. I invite you to read this section with an eye to points of convergence and divergence in how nations grapple with inexorable changes wrought by shifts in fertility rates, migration patterns and the Longevity Revolution. At the grassroots, state, and Federal levels, we may be able to adapt ideas that took root elsewhere.

--Andy Achenbaum

A. Global Population Ageing: Peril or Promise?: Global ageing, in developed and developing countries alike, will dramatically alter the way that societies and economies work. This World Economic Forum and Stanford Longevity Center report addresses the following issues: How individuals find fulfillment, at what age they retire and their quality of life once they do retire; how governments devise social contracts to provide financial security; how the older and younger generations interact as they divide up the economic pie; how businesses staff their jobs to compensate in many countries for shrinking workforces; and how health systems respond to the altered needs of those living longer.

B. Global Health and Aging: This report, jointly issued by the World Health Organization’s Department of Ageing and the Life Course and the National Institute on Aging, attempts to address whether population aging will be accompanied by a longer period of good health and well-being, or associated with more illness, disability, and dependency. Emphasizing the central role that health will play in the coming years, the report compares population aging across different countries, focusing particularly on how aging will impact health care and social costs.

C. Global Trends: The Impact of a Changing Age Structure: This Metlife Mature Market Institute brief discusses the demographics and policy implications of the aging global population. The world’s two largest countries are projected to experience very different rates of growth. China is projected to add less than 5% to its population by 2030, while India is projected to add as much a 25% to its already very large population. There is a similarity, however, in that both countries are predicted to have an exponential increase in the percentage of older people to younger. A major concern is how to meet the health care needs of the rapidly growing population of older adults given the shrinking number of younger workers.

D. Many Degrees of Policy Freedom: The Federal Government’s Role in Care for Seniors: Although researchers have been warning of the aging of Canada’s population for decades, governments do not yet have an overarching policy strategy to deal with the profound, long-term socio-economic implications of this demographic shift, let alone its more immediate impact on seniors’ care. This Institute for Research on Public Policy study examines the federal government’s present role in care for seniors and its policy options for the future.

E. The Journal: AARP International: AARP publishes an International Journal focusing on dimensions of global aging and covering trends, innovations, and research that impact the lives of people age 50 and over. The 2012 edition features articles from the most respected voices in global aging and covers active aging, social security, intergenerational solidarity, and women as economic drivers. Click here to sign-up for a complimentary print copy.


IV. WORTH NOTING

A. American FactFinder: The new American FactFinder, the U.S. Census Bureau’s statistics and information search engine introduced one year ago, has been updated with files formerly found in its “legacy” version. Users now have access to more than 60 important data sets in the new FactFinder English interface and 14 data sets in the Spanish interface. The search engine provides users with one-stop access to results from the decennial census (2010 and 2000), the economic census (2002 and 2007), American Community Survey, population estimates, and key annual economic surveys.

B. Annual Report of National Health Expenditures: 2010: The National Health Expenditure Accounts (NHEA) contains the official estimates of total health care spending in the United States. The Center for Medicare and Medicaid Services highlights include a breakdown of home health care spending compared to spending on nursing care facilities and continuing care retirement communities. Additionally, the report separates health spending by the major sources, including Medicare, Medicaid, and private health insurance. In 2010, the total health expenditures reached $2.6 trillion, which translates to $8,402 per person or 17.9 percent of the nation's Gross Domestic Product.

C. HHS seeks comment on draft National Plan to fight Alzheimer’s Disease: The U.S. Department of Health and Human Services (HHS) released an ambitious draft National Plan to overcome Alzheimer’s disease and related dementias. The plan offers specific action steps to accelerate research on treatment and prevention, as well as proposals for improving care, services, and support for patients, families, and caregivers. HHS is seeking comments on its penultimate draft to fully engage the Alzheimer’s disease community, the public, states, local governments, community based service organizations, the private sector and others in its development. Public comment will be accepted through March 30, 2012 and should be e-mailed to napa@hhs.gov .


V. WHAT'S HAPPENING ABROAD?

A. Creating Excellence in Dementia Care: A Research Review for Ireland's National Dementia Strategy: An estimated 41,000 Irish people have dementia, a figure which is expected to triple by 2041. This Irish Centre for Social Gerontology report estimates the cost of caring for people with dementia at £1.7 billion a year. In order to prepare for these costs, the report suggests involving people with dementia and their caregivers in crafting the public policy strategy, as well as a greater emphasis on prevention and early diagnosis.

B. Attitudes to age in Britain 2010/2011: This Department for Work and Pensions (DWP) report compares attitudes between people in their 20’s and people aged 70 and over, showing that age-related discrimination and stereotyping remain rooted in British society. In order to gain a fuller understanding of attitudes to age, the report also looks at the socio-demographic variables associated with attitudes and uses this information to suggest policy strategies that will ensure social inclusion of older people.

C. Supporting Caregivers and Caregiving in an Aging Canada: Providing alternatives to hospital and institutional care for the nation’s expanding older population is one of the greatest social policy challenges Canadian governments are facing. This Institute for Research on Public Policy study is an overview of caregiving in Canada today, including the costs incurred by caregivers and the type and extent of public support they receive. The report presents projections of future care needs and examines potential improvements in policy for income security programs, labour market regulation, and human resource management in health and home care.


VI. PERSPECTIVES ON POLICY: ROB HUDSON, EDITOR, PP&AR

The most recent issue of Public Policy & Aging Report (Volume 22, Number 1) documents longstanding failures to adequately address the topic of elder abuse and neglect by providing multiple perspectives on what is currently underway to improve the situation – including passage of the Elder Justice Act. The lead article by XinQi Dong and Melissa Simon introduces the problem of safety issues for older adults and presents an overview of major federal legislation addressing it. Marie-Therese Connolly follows with an extensive analysis of the numerous agencies with responsibilities for addressing elder abuse but whose efforts continue to lack adequate coordination and direction. Robert Blancato provides an insightful legislative history leading to passage of the Elder Justice Act in 2010 as part of the Affordable Care Act. Long-term care represents the arena in which some of the most egregious patterns and instances of elder abuse have existed, and Alison Hirschel and Georgia Anetzberger detail the scope of the problem and the great risks facing potential abuse victims. Kathleen Quinn and Paula Mixson turn attention to adult protective service needs in the community and explore the history and workings of APS programs at the state level. Pamela Teaster and colleagues highlight the growing problem of financial abuse, i.e., the illegal taking of funds or property from older people. In addition, the issue includes an overview of the Archstone Foundation’s Elder Abuse and Neglect Initiative. The concluding article by XinQi Dong sets forth an agenda for future research, education, training, and advocacy for the elder abuse and neglect field.

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Newsletter Editors: Dani Kaiserman and Greg O'Neill, National Academy on an Aging Society; Andy Achenbaum, University of Houston.

The Public Policy and Aging E-Newsletter is supported in part by a grant from the AARP Office of Academic Affairs. The views expressed are those of the authors and not necessarily those of The Gerontological Society of America, the National Academy on an Aging Society, or the AARP Office of Academic Affairs.

© Copyright 2012; all rights reserved.