GBO NEWS: JAMA’s “Critical Issues”; Fed Health’s Other Digital Mess; Elders Denied Social Security


E-News of the Journalists Network on Generations

 Nov. 14, 2013 — Volume 13, Number 16

 Editor’s Note: The new “GBO News” marks the 20th year of the Journalists Network on Generations. Click through this table of contents to the full issue at

IN THIS ISSUE: The Truth about JFK—50 Years and the U.S. Is Still Reeling.

1. HEALTH CARE REFORM SCHOOL: ***JAMA’s “Critical Issues in U.S. Health Care” Features Comprehensive Care for Frail Elders


3. FISCAL REFORM SCHOOL: Millions of Ethnic Elders Struggling With Little or No Social Security

4. GEN BEATLES NEWS: SPJ NorCal Names Mercury News’ Krieger Journalist of the Year for “Cost of Dying” Series; Rhode Island’s Herb Weiss Posts 505th Article; GBO News Heads to Aging Conference in New Orleans



The Future of Care for Frail Elders is a key theme in this week’s special edition of the Journal of the American Medical Association (JAMA) on “Critical Issues in U.S. Health Care,” also the subject of Tuesday’s JAMA Media Briefing at the National Press Club in Washington, D.C.

In a JAMA commentary titled, “Reliable and Sustainable Comprehensive Care for Frail Elderly People” (Nov. 13), Joanne Lynn, MD, states, “Without significant structural changes in service delivery, an aging nation faces a future of substantial costs and needless pain and distress among those who are old.”

Lynn, who currently leads the Center on Elder Care and Advanced Illness at the Altarum Institute, stresses in the article, “Many believe that the challenges of the frail years should be a family responsibility, and families do provide more than half of the personal care and paid services. However, relying on family will be insufficient. The number of frail elderly individuals will double as the children born after World War II, the ‘boomers,’ age into their years of frailty, starting in about 2025. Many simply have no family; almost half of women older than 75 years live alone.”

Lynn, who coauthored The Handbook for Mortals 2nd Edition (Oxford, 2011), among many books and publications, has long been among the leading voices for compassionate care for seniors with serious or terminal illness. Her JAMA op-ed says the United States “needs arrangements that allow elderly people to live with confidence, comfort, and meaningfulness at a cost that families can afford and the nation can sustain. Failing to meet this predictable demographic change would force frail elderly people to live without critical services, effectively abandoned.”

Noting that the U.S. lags behind other countries, Lynn calls for such “essential reforms” as requiring development and use of comprehensive care plans; modifying medical care to ensure continuity, comprehensiveness, and honesty about treatment goals and comfort; and combining health care with long-term services and support “into stable funding and management arrangements.” One key to doing so, she emphasizes, is “enabling some degree of local monitoring and control.”

To request this brief but incisive commentary, contact JAMA Network Media Relations at 312-464-JAMA (5262) or e-mail For video and written material on Lynn’s presentation are posted on the Altarum Institute’s site.



The Fed’s Other Looming Digital Health Disaster: Poor computer planning leaving millions of Americans vulnerable, congressional Republicans glaring at the Administration—sound familiar? However, this health care scandal isn’t about Obamacare’s health insurance website, but another mandate of the Patient Protection and Affordable Care Act (ACA). In September, Congress’ nonpartisan watchdog, the Government Accountability Office (GAO), released its report showing that even though the Centers for Medicare and Medicaid Services (CMS) is moving ahead with ACA’s mandate to modernize its IT system, the agency has neglected to include a relatively simple change that would protect 50 million Medicare beneficiaries from identity theft and other kinds of fraud, replacing Medicare numbers–which are also Social Security Numbers (SSN).

GAO states, “The visual display of the SSN introduces risks to the security of beneficiaries’ personal information, as the number may, among other things, be obtained and used by criminals to conduct identity theft.”

GBO News’ editor first noted this potential problem after registering for Medicare and tucking the card into my billfold. Only after a year or two did I happen to look carefully that the card, a government document that instructs its holders to have it in their possession at all times. Not only can a senior’s lost or stolen wallet yield trouble, but telephone scammers typically con seniors with a call, say, to “update” their information and ask to verify one’s Medicare number. I mentioned this in GBO some time ago and advise older friends not to carry their cards—admittedly a conflicting message for those wishing to make sure a doctor or hospital can access their information.

The new GAO report, titled, “Centers for Medicare and Medicaid Services Needs to Pursue a Solution for Removing Social Security Numbers from Cards” (GAO-13-761) shows that CMS has until now failed to include established solutions to the problem.

An Oct. 10 press release from the House Ways and Means Committee states, “Nearly a decade ago, the Bush Administration issued an order to remove all SSNs from public documents and create identity safe documents.”

While CMS has dragged its feet, “In 2011, the Pentagon finished replacing nearly 10 million military ID cards, translating the SSN into a bar code that made it more difficult to read,” according to Washington Times reporter Phillip Swarts. His news story adds that the VA replaced 8 million numbers in 2004. But CMS officials told him the agency still needs to coordinate with the Social Security Administration and other agencies.

Dallas Morning News business columnist Pamela Yip noted last May  that CMS seemed to be making progress with replacing the numbers after having balked at the cost. “At one point [CMS] said it would cost as much as $845 million to make the changes,” she wrote. Under pressure from GAO, she reported, CMS slashed its estimates for either of two solutions: $317 million to replace SSNs, or $255 million to obscuring the first five digits.

Yip noted that, according to the Justice Department, in 2008, about 1 million people 65-plus were among the 8.6 million Americans victimized by ID theft. Other than that, there hasn’t been much media attention to the issue. Seems like a national story that gen beat reporters could even localize.

Requesting GAO’s new study were Texas GOP representatives Sam Johnson, Chairman of the Ways and Means Subcommittee on Social Security, and Kevin Brady, who chairs the Subcommittee on Health. News hounds on the generations beat might want to follow up with their staffs and also contact GAO staffer Valerie C. Melvin at (202) 512-6304 or .



Millions of Ethnic Elders Struggling With Little or No Social Security

An October poll by the conservative National Journal/United Technologies piles on the consistent findings that Americans remain fiercely opposed Social Security benefit cuts to reduce the federal deficit—including a majority of those identifying as Tea Party supporters–in spite of growing support for government spending cuts and against raising taxes.

In fact, two-thirds of seniors receiving Social Security’s retirement benefits rely on it for at least half of their income. And for ethnic elders, says a recent report from AARP’s Public Policy Institute, about a third of older African Americans and Hispanics
receiving benefits depend on Social Security for more than 90 percent of their family income.

Further, a significantly larger proportion of non-white seniors reach old age with little or no Social Security income at all?

About one in 10 white older adults do not receive Social Security benefits of the 42 million seniors in the United States. Of that 4-plus million people, a disproportionate one-third are ethnic elders. In fact, according to the U.S. Census, one in six African American, one-of-five Latino—and a whopping 28 percent of Asian American and Pacific Islanders (AAPI) 65-plus don’t benefit from the national retirement pension.

As I reported this week on New America Media, many lower-income seniors not qualifying for Social Security “have lived under the radar,” as Karyne Jones, president and CEO of the National Caucus and Center on Black Aging (NCBA) put it. They have worked in low-wage jobs, often paid cash with no contributions going to Social Security. They’ve endured high unemployment levels or years of child rearing and caregiving leaving them short of enough credits (40 quarters of work) to get much or anything from Social Security.” Many finding themselves up America’s aging creek without an economic paddle are immigrants, who arrived here at age 50 or older, often to help their families.

Making ends meet is especially difficult for Asian retirees in the United States, although the wide income gap between Asian subgroups underscores the need for reporters and policy makers to diversify their analysis. For instance, Census Bureau figures from the 2009-2011 American Community Survey show that although average Social Security income for Japanese American seniors was $10,867 per year (close to the U.S. average), Korean seniors here averaged $7,170, Chinese elders received $6,301 a year, older Hmongs received $4,789—and elderly Bengladeshis averaged just $2,659–$221 per month–the lowest benefit among the 19 Asian or South Asian ethnic groups tracked by the census.

Should anyone be surprised that the census survey also shows high reliance on public assistance for elders in many of these groups, such as Supplemental Security Income or the Supplemental Nutrition Assistance Program (SNAP, or food stamps)—the one Congress has cut? More than one-third of Hmong seniors (many of whom fought for the United States in the Vietnam War) need food stamps to get by. Also needing food stamps are one-in-five older Tongans and Samoans, as well as African American and Latino seniors.

Crucial Nonprofit Connections

Crucial links for immigrant elders to Social Security and other programs to help them make ends meet are trusted community based organizations, says a 2011 report from the Insight Center.

For example, Christine Takada, president and CEO of the National Asian Pacific Center on Aging (NAPCA) described a Vietnamese couple the organization is aiding at its Seattle program through the group’s job training and placement project for low-income seniors.

One immigrant couple NAPCA is working with, Takada said, came to the United States in 2004. The man, age 71, and his wife, 61, both had low-skilled jobs, but lost them during the recession.

The pair, who lives with their two young-adult children, were previously only able to receive food stamps and “were at risk of being homeless,” said Takada. “They are limited in their English proficiency and have minimal prospects for employment.”

The couple, who did not wish to be named for this article, learned at a local community center about NAPCA’s jobs for low-income workers 55 or older.

Takada said that a year after enrolling in the program, the man found full time employment in a factory job earning minimum wage. He is also among many older immigrants in the program who attend English-language classes at a local library or community center.

Meanwhile, the man’s wife remains in the program, where she earns about $600 a month for on-the-job training (17 hours per week) in food preparation at a low-income housing facility.

NAPCA, which serves 1,150 Asian American and Pacific Islander seniors (and many non-AAPI elders as well) in nine cities, is one of about a dozen national nonprofits, such as NCBA, running jobs programs for older workers through the federally funded Senior Community Service Employment Program (SCSEP).

Nationally, the SCSEP program has seen severe funding reductions, in spite of the country’s high unemployment levels, and currently reaches fewer than 50,000 low-income older workers—less than half the number of three years ago–who could be contributing to their communities while supporting themselves.

Echoing directors of SCSEP programs across the nation, Takada lamented, “Our reach is still only meeting a fraction of the need.”

Comprehensive Reforms

While most national debate over Social Security in recent years has been over proposals to cut the program’s benefits, advocates for elders have recommended ways to strengthen it to meet the needs of the country’s increasingly diverse older population.

For people receiving very low support, for example, the 2011 report, “Plan for a New Future: The Impact of Social Security Reform on People of Color,” called for program reforms. Among these measures are raising Social Security’s Special Minimum Benefit to 125 percent of the federal poverty line “for those who have spent their adult lives in low-paying jobs and who are unlikely to have private pensions or other savings to fall back on,” says the report.

As difficult as Social Security reform may be politically, many seniors ineligible for its life-supporting assistance may also have to wait for immigration reform. Last spring the National Hispanic Council on Aging and National Council on Aging (NHCOA) released a report urging Washington to meet key immigration challenges facing older adults and people with disabilities.

For instance, the report called for reforming Medicare and Medicaid rules that now keep lawfully present elders and immigrants with disabilities from gaining access to medical care through the programs for as much as 10 years or more. NHCOA and NCOA also recommended major reforms in the meager Supplemental Security Income (SSI) program, as well as a path to citizenship for direct care workers—those most needed to care for America’s aging population.

NHCOA and NCOA concluded its report by urging policy makers to take a comprehensive approach that “addresses needs of older immigrants and immigrants with disabilities, and enhances health care and economic security [to] benefit us all.”

This editor will also note that I’m managing a new webpage at New America Media, “Growing Older, Getting Poorer,” thanks to a grant from The Atlantic Philanthropies.  We’ll also be holding reporters’ roundtables and journalism mini fellowships around the country, with a special focus on income security for ethnic elders.



***The Cost of Dying Well Explained: San Jose Mercury News health and science reporter Lisa M. Krieger will be honored as the Journalist of the Year by the Society of Professional Journalists (SPJ), Northern California Chapter, for her yearlong coverage of the cost of dying. Beyond publishing the articles, according to the chapter’s board of directors, she’s being recognized for her “dedication to helping the public understand critical decisions about end-of-life care.”

Krieger began the series with the deeply personal story of her father’s final days in an intensive care unit at Stanford University Hospital. At that time she had to make agonizing choices as she struggled with the emotional and financial cost of his death. Despite her father’s carefully prepared advance directive for end-of-life care, his hospital bill added up to $323,000 in just 10 days. The public response was so powerful, she continued filing stories on end-of-life care throughout 2012, garnering many awards, including last year’s Explanatory Journalism Award, one of SPJ NorCal’s competitive honors.

This time the SPJ NorCal board decided to recognize her as Journalists of the Year, stating, “Through a body of work in 2013 that includes print stories, interactive graphics, videos, online chats and community forums, Krieger has continued to help the public understand the complex and emotionally fraught choices dying individuals and their caretakers must often make.”

Krieger will collect her kudos next week at SPJ’s annual Excellence in Journalism Awards dinner in San Francisco. Her ICU ordeal with her Dad is also told in Katy Butler’s new bestseller, Knocking on Heaven’s Door: The Path to a Better Way of Death.

***New England Columnist Herbert Weiss Posted the 505th Article of his career last month, “Aging Groups Gear Up to Oppose Cuts in Social Security” (Oct. 18). A well-seasoned gerontologist, Weiss has covered the generations beat for 34 years for both consumer and professional media at the local and national levels. His weekly columns now appear in two Rhode Island newspapers, the Pawtucket Times and Woonsocket
Call. He also posts the columns at His administrative work in aging over the years took a different turn some time ago, and Weiss’ current position is as Economic and Cultural Affairs Officer for the City of Pawtucket, R.I., where he’s been a key player in developing the city’s Arts and Entertainment District.

*** GBO News Heads to New Orleans next week for the Gerontological Society of America 66th Annual Scientific Meeting, Nov. 20-24, so GSA is now old enough to collect Social Security. (Why not, aren’t corporations “people” now?)

Previously, GBO News listed this year’s reporters selected for the MetLife Foundation Journalists in Aging Fellowships. (The program is GSA’s collaboration with New America Media (NAM), in cooperation with the Journalists Network on Generations, which puts out GBO News.)

But wait, there are more reporters. In addition, the GSA-NAM program is providing travel grants to previous MetLife Fellows to continue their work on the age beat. The encore Fellows taking a bow include: Sally Abrahms, freelance, Boston; Azadeh Ansari, CNN, Atlanta; Eileen Beal, senior health freelancer, Cleveland; April Dembosky, Financial Times, San Francisco; Tommy Goldsmith, News & Observer, Raleigh, N.C.; Yolanda Gonzalez Gomez, Huffington Post Voces, Plano, Texas; Kerry Hannon, business blogger, Forbes, AARP, Washington, D.C.’; Janice Lloyd, USA Today and others, Washington, D.C.; Araceli Martinez, La Opinion, Los Angeles; Peter McDermott, Irish Echo, New York; Andrea Parrott, freelance, Twin Cities; Barbara Peters-Smith, Sarasota Herald Tribune; Xiaoqing Rong, Sing Tao Daily, New York; Rochelle Sharpe, investigative freelancer, Boston; Paula Spencer Scott, senior health freelancer, Kensington, Calif.; Rita Watson, Providence Journal, Psychology Today, Boston; Warren Wolfe, freelance age-beat reporter, Minneapolis. Huff

***Call for Gen Beatles News: GBO News welcomes tips on recent major articles, awards, books, websites, blogs or other developments or kudos that have come the way of reporters or authors on the generations beat—either you honors (don’t be shy!) or others you know of. Just drop a note with details to

GBO News will return in December. Have a swell Thanksgiving.



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The Journalists Network on Generations (JNG), founded in 1993, publishes Generations Beat Online with in-kind support from New America Media (NAM). JNG provides information and networking opportunities for journalists covering generational issues, but not those representing services, products or lobbying agendas. NAM is an online, nonprofit news service reaching 3,000 ethnic media outlets in the United States. GBO News readers are invited to visit the NAM website, and click on the Ethnic Elders section logo on the right side. Opinions expressed in GBO do not represent those of NAM. Copyright 2013, JNG. For more information contact GBO Editor Paul Kleyman.

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