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.
Want the most up-to-date access to aging policy resources?
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I. WHATS 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. WHATS 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
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.
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 email@example.com .
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
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
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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.