GBO NEWS: PBS Alzheimer’s Docu Slammed; HHS Leaks; Medicare Age Boost Would Add Uninsured; Fellowship Deadlines at Columbia, Roslyn Carter Center; & MORE
GENERATIONS BEAT ONLINE NEWS
E-News of the Journalists Network on Generations — Beginning Our 24th Year.
February 9, 2017 — Volume 17, Number 2
Editor’s Note: GBO News, e-news of the Journalists Network on Generation publishes alerts for journalists, producers and authors covering generational issues. Send your news of important stories or books (by you and others), fellowships, awards or pertinent kvetches to GBO News Editor Paul Kleyman. You can subscribe to GBONews.org at no charge simply by sending a request to Paul with your name, address, phone number and editorial affiliation or note that you freelance. You’ll receive the table of contents as e-mail, just click through to the full issue at www.gbonews.org.
In This Issue: Real Valentines–Not Alternative Ones (“Love You, But–You’re Fired!”).
1. THE STORYBOARD: *** “Leaked HHS Draft Order to Fix Insurance Market Draws Mixed Reviews,” by Harris Meyer, Modern Healthcare; *** “Social Security Waits Anxiously for Trump to Nominate Commissioner,” by John Fritze, Baltimore Sun; *** “Nursing Home Residents Gain New Protections,” by Paula Span, New York Times “New Old Age” column;
2. GOOD SOURCES: ***Huge Increase in Uninsured if Medicare’s Eligibility Age Raised: Study from the National Committee to Preserve Social Security & Medicare Foundation; ***National Foundation to End Senior Hunger; ***Encore.org’s “Generation to Generation” Campaign.
3. EYES ON THE PRIZE: ***Columbia University’s Age Boom Reporting Fellowship Deadline March 3; *** Rosalyn Carter Journalism Fellowship in Mental Health Application Deadline, April 12.
4. ON SCREEN: PBS Alzheimer’s Special Slammed—“A Devastating Hour … and Simmering Controversy.”
5. TONI MORRISON’S WISDOM FOR WRITERS ON ‘BARING WITNESS’
1. THE STORYBOARD
*** “Leaked HHS Draft Order to Fix Insurance Market Draws Mixed Reviews,” by Harris Meyer, Modern Healthcare, (Feb. 7): “A leaked draft rule from HHS intended to help stabilize the individual insurance market highlights the narrow limits of what the Trump administration can do on healthcare reform without action by a deeply polarized Congress. [The Department of Health and Human Services (HHS)] reportedly has submitted a proposed rule to the Office of Management and Budget, but no details of the rule have been disclosed by either agency. Politico, however, obtained two different draft versions of the rule.
“’The small nature of these changes shows that real reform has to come through legislation, because none of this will fundamentally change the market,’ said Craig Garthwaite, a health insurance expert at Northwestern University. ‘And it’s not even legally clear they can do this.’”
Meyer also noted, “Time is another challenge for the Trump administration in trying to stabilize the market through rulemaking.” That’s because insurers must file their 2018 plan offerings and rates for 2018 with the feds by April and May, but if HHS floats the rule now, they still require 2-3 months for public comment.
“Meanwhile,” Meyer goes on, “consumer advocates say the proposed provisions would make insurance less affordable and accessible for older and sicker people and those who face unexpected life changes, financial problems, or illnesses.” The leaked drafts say HHS “is proposing to let insurers charge older enrollees premiums 3.49 times as much as they charge younger enrollees, up from the Affordable Care Act’s maximum permitted age-rating band of 3 to 1.” That would especially affect individuals 50-64, not yet eligible for Medicare.
Meyer explains, “Insurers argue they need more flexibility to set lower premiums for younger, healthier people to lure them into the insurance market and offset the cost of older, sicker people.”
GBO’s editor recalls that insurers lobbied heavily for at least a 5 to 1 “age-rating band,” while progressive advocates during the ACA debates in 2009 countered that any age-based increase amounted to discrimination and argued that risk would be more reasonably spread across the population with rates being generally equal.
But he also reports that the Trump administration may not be able to increase the age-rated multiple through simple rule making because Congress explicitly set it at “no more than 3 to 1 for adults.” Huffington Posts’ Jonathan Cohn noted (Feb. 6), “According to sources privy to HHS discussions with insurers, officials would argue that since 3.49 ‘rounds down’ to three, the change would still comply with the statute.” (Attention, Trump-Mart shoppers, there’s a $3.49 special on aisle HHS. But just consider it rounded down to $3.)
Meyer goes on that AARP “strongly opposes changing the law to let insurers charge older consumers higher rates, calling it ‘a bad deal for Americans’ that will lead to higher costs and reduced coverage.” They would sue if HHS moves ahead with the proposal. Another source told Meyer that “it’s nearly certain the courts would block this change,” adding more uncertainty to the “roiling” individual insurance market.
***And, check out Robert Pear’s “Issues Facing Republicans in Replacing Affordable Care Act,” New York Times (Feb. 7), his analysis of last week’s audio leak of GOP lawmakers’ consternation over what to do–or not–about replacing ACA.
*** “Social Security waits anxiously for Trump to nominate commissioner,” by John Fritze, Baltimore Sun (Feb. 8): “President Donald Trump has offered little indication about who he will nominate as the next commissioner of the Social Security Administration [SSA]—an agency that has gone four years without a permanent leader . . . . The agency has now been without a Senate-confirmed leader since 2013, when the term of Bush appointee Michael J. Astrue ended. Then-President Barack Obama took more than a year to nominate Carolyn W. Colvin to be commissioner. Her confirmation stalled in the Senate in 2014, and Obama did not propose a new nominee. It has been an unusually long wait for an agency that affects so many Americans.”
Fritze goes on, “The agency is likely to be at the center of upcoming fights over entitlement programs, such as whether to raise the retirement age for
Social Security benefits or make changes to disability insurance. Trump has muddied the debate by promising repeatedly not to cut Medicare or Social
Security — pledges that broke with GOP orthodoxy.” SSA’s current acting director is Nancy A. Berryhill.
*** “Nursing Home Residents Gain New Protections,” by Paula Span, New York Times “New Old Age” column (Jan. 27): “The Centers for Medicare and Medicaid Services last fall issued a broad revision of nursing home regulations; the first batch took effect in late November, with the rest to be phased in this year and in 2019.” The article is a smart summary of key provisions, which health and long-term care writers should know about and keep an eye on for further coverage. The new rules, for instance, “allow people to receive any visitor they choose (not just relatives) whenever they choose, without restricted hours, as long as visitors don’t disturb other residents.”
Span continues, “For the first time, nursing homes must take ‘reasonable care’ of residents’ personal belongings and can’t shrug off responsibility for theft or loss by requiring residents to sign waivers.” In addition, “The regulations call for expanded staff training in preventing elder abuse and in caring for patients with dementia.” Furthermore, nursing homes are prohibited by the law from “dumping” difficult or costly patients, such as by refusing to take them back after they’ve been transferred to a hospital and are recuperating.
But, Span explains that the American Health Care Association, which represents most for-profit nursing homes—70 percent of nursing homes in the United States are for-profit—“filed suit to stop the change. In November, a federal court in Mississippi granted a preliminary injunction.” The provision would ban facilities from requiring residents to sign a binding arbitration agreement.
“Giving residents and families the right to take nursing homes to court could bring far-reaching results, said [Robyn Grant, public policy director at the National Consumer Voice for Quality Long-Term Care, a leading advocacy group] . . . . It’s all behind closed doors. When you have a public lawsuit, that’s an amount of money that gets attention from owners and operators and serves as a deterrent” to substandard care. Medicare has appealed, but a final court disposition could be months or years away.”
Span continues, “The government also declined to incorporate specific staff ratios or minimum hours of care in the new regulations, or to require nursing homes to have registered nurses on site around the clock. (Current rules require R.N.s only for eight hours.)”
2. GOOD SOURCES
*** Study: Huge Increase in Uninsured if Medicare’s Eligibility Age Raised: A new report from the National Committee to Preserve Social Security & Medicare Foundation says that raising the Medicare eligibility age from 65 to 67, long a goal of Republican leaders.
According to the study, “If Medicare eligibility is raised to age 67 and the ACA remains in effect, by 2019 the percent uninsured among those aged 65 and 66 will increase more than nine-fold, from less than 2 percent to 18.7 percent (1.9 million people). If the ACA is repealed the uninsured rate will increase to 37%, more than one-third of those 65 and 66, affecting 3.8 million seniors.” The research was conducted by the Actuarial Research Corporation (ARC) and funded by the Retirement Research Foundation.
According to Marilyn Moon, who chaired the National Committee task force that produced the study, “After reviewing the ARC data, it’s clear that raising the Medicare age will undermine the health security of millions of older Americans. Those who become uninsured will have greater difficulty accessing health care, and as a result these individuals are likely to experience worsening health status.”
Moon, director of the American Institute for Research’s Center on Aging and a former public trustee of the Social Security and Medicare Trust Fund, continued, “This will also impact the Medicare system because when they do qualify for Medicare at 67, their poorer health will generate increased financial demands on the program.”
The study determined that repealing ACA “would also eliminate the special protections that currently allow access to insurance without discrimination (pre-existing conditions clauses). Consequently, people with the most severe health problems would have the most difficulty in obtaining coverage and will generate significant costs for hospitals, providers and private insurers who experience ‘cost-shifting’ as a hidden subsidy for care of the uninsured.”
The full report, titled “Impact of Raising Eligibility Age for Medicare” (January 2017) and headed by principal investigator Peter S. Arno, PhD, runs 19 pages.
*** The National Foundation to End Senior Hunger says, “In 2005 nearly 1 in 9 — or 5 million older citizens — were threatened by hunger then. By 2014 those ranks had increased to an intolerable 15.8 percent, or more than 10.2 million people.” In June 2016, they released their report, “State of Senior Hunger in America 2014.” The organization, based in Alexandria, Va., is headed by founder and CEO Enid Borden, who can be reached at 571-312-2675; e-mail: nfesh@nfesh.org. (Thanks to GBONews reader Marsha Weiner for this tip.)
*** Encore.org’s “Generation to Generation” Campaign To Mobilize 1 Million Older Adults to Help Youth Thrive.” The nonprofit launched its new Generation to Generation Campaign last fall “to mobilize 1 million adults over 50 to help young people thrive.” Encore.org, creator of the Experience Corps, Purpose Prize and other entities promoting volunteerism and other approaches to civic engagement for older adults, has initiated the new program with nonprofit partners in 25 communities to improve opportunities for youth.
The program aims to “bring together communities, employers and member associations, youth-serving organizations, funders and public agencies to collaborate and connect,” in helping people of different ages, backgrounds and social classes to “fight inequality in the next generation.”
According to the Encore.org release, “One-in-five children in the U.S. grows up in poverty. Half of all children in our public schools are part of low-income families, typically starting kindergarten far behind their more affluent peers. And more than 5 million young people, ages 16-24, are on society’s margins, disconnected from school or work. Additional research shows that 32 million adults 50-plus are eager to dedicate their time and energy to well-run initiatives that bring the generations together for mutual benefit.”
Encore.org founder and CEO Marc Freedman emphasized in the web release that intergenerational programs “are emerging all over the country — oftentimes, hidden in plain sight.” The Encore staff can assist reporters in connecting with many of the program’s local partner organizations for their stories.” Among groups working with Generation to Generation are AARP, Big Brothers Big Sisters of America, Boys & Girls Club of America, Corporation for National and Community Service, Generations United, Girls Inc., National Head Start Association and No Kid Hungry.
They also note that efforts to develop “intergenerational impact zones” have begun in Los Angeles, San Jose, Boston, Seattle and elsewhere. For more information and interview requests, contact the program’s communications director, Sarah McKinney, (smckinney@encore.org), or Marci Alboher of Encore.org (malboher@encore.org).
3. EYES ON THE PRIZE
***Columbia’s Age Boom Fellowships for Reporters: Columbia University’s Age Boom Academy is accepting applications from journalists to attend its two-and-a-half-day fellowship training program in New York City. The application deadline is March 3. To be held at Columbia’s Graduate School of Journalism during the second week of June, the program will have the theme, “Exploring Inequities in Health, Work and Retirement.” The Age Boom Academy is cohosted by the Robert N. Butler Columbia Aging Center. The funder is the Alfred P. Sloan Foundation.
Selected fellows for this program, which began in 2000, “will have the latest research concerning aging, health and working longer. Some of the questions that will be answered are: Is there a relationship between health and how long you work? How does this relationship change for people with different backgrounds or different jobs? How does retirement affect cognitive and physical health? Does this relationship change based on education, socioeconomic status, and civic engagement? What is the relationship between the kind of work you do, health, and how long you work?”
For more information please contact Caitie Adams at ca2700@columbia.edu; phone: (212) 342-0441.
*** The Rosalyn Carter Journalism Fellowship in Mental Health Application Deadline will be April 12. Eight fellows are chosen annually. The one-year fellowship comes with a $10,000 stipend. No relocation is necessary, such as to Atlanta, where the Carter Center is located, although fellows will meet at the center at the beginning (Sept. 11-13) and end of the program’s year. Applicants must have at least three years of professional experience in journalism, and they welcome both staffers and freelancers.
4. ON SCREEN
PBS Alzheimer’s Special Slammed
*** “A Devastating Hour … and Simmering Controversy,” by Matt Perry, Aging With Dignity (Jan. 31): He leads, “If you want to spend a devastating hour in front of the TV, watch the excellent PBS documentary on Alzheimer’s disease Every Minute Counts.” The film aired nationally on Jan. 25, and is still available online. “It’s all there,” Perry writes, “The devastating impact Alzheimer’s has on families and finances. The shocking discovery that neither private health insurance nor Medicare covers housing costs for long-term care. And the sordid reality that exhausted caregivers often get sick themselves.” The production stresses that today’s 5 million or so cases are expected to grow “to a whopping 14 million by 2050.” One filmed expert says the treatment budget for Alzheimer’s alone will equal the defense budget.
But, Perry cautions, the hourlong documentary “tells only part of the story. What’s not revealed are the very real controversies surrounding Alzheimer’s – scientific and cultural – that could dramatically change the trajectory of the disease and its care.”
More than a film review, Perry’s piece provides an overview of concerns not covered in Every Minute Counts. For instance, although Congress increased needed funding in 2015, “the most dominant strain of Alzheimer’s research focuses on beta amyloid ‘plaque’ buildup on the brain, shortchanging “the second major theory about Alzheimer’s disease . . . that there are ‘tau tangles’ in the brain.”
Pharmaceutical companies, he writes, are “drooling over a magic pill that could be worth billions of dollars – cheaper and simpler preventive solutions are largely ignored. Pills over prevention. Sound familiar?” Being ignored, Perry writes, is evidence linking nutrition and Alzheimer’s. “Some have even called it Type 3 diabetes, linking it to sugar consumption.”
Perry also reviews a video from the Buck Institute for Research on Aging pairs with Grain Brain author David Perlmutter.
In addition, he discusses a second controversy around how Alzheimer’s: Every Minute Counts caters to the stigma attached to how the disease is treated. He sights several sources, such as the late Richard Taylor, PhD, a founding member of Dementia Alliance International (DAI) and a leading proponent of humanizing dementia patients. Perry recalls that Taylor “fought tirelessly after his [Alzheimer’s] diagnosis during an uphill fight to see patients not as the ‘disease’ but as simply human.” Among other sources, Perry also quotes Karen Love, who heads the Dementia Action Alliance, who has stated, “I need you to enable me, not disable me.”
GBONews also received a sharply critical commentary on the film by Bill Thomas, MD, founder of ChangingAging, regarding the film as an unfortunate example of the “tragedy narrative.” In another posting, Thomas and colleague Kavan Peterson wrote that the film ignored “the many ways people living with dementia lead rich and rewarding lives as active members of their communities.”
This editor, while acknowledging worthwhile information in the film, would add that I’ve seen this all too often over the years, fear mongering often by well-meaning advocates and lobbyists–and make no mistake that this kind of “documentary” has a federal-funding agenda–while contributing to the frightening public image of Alzheimer’s.
There’s no arguing that dementia is a debilitating and draining condition. But this film utterly fails to present more than a token glimpse of the many well-developed ways for people to live well with the disease, minimizing and diffusing crises and learning techniques for easing ongoing problems. The lack of caregiver support in the U.S. goes unnoted in the film. The huge, depressing cost of long-term care is depicted with no discussion of that being America’s political choice–one needing to be challenged and one not adapted by most other advanced economies. The film decries the overuse of emergency rooms by families, but it doesn’t mention that paucity of resources for things like respite programs and adult day health care.
The cure-it-or-else and budgetary-tsunami narrative of this film misses the underlying realities of a nation misguided in its obsessions with government research budgets and the heroic quest for scientific breakthroughs at the expense of supports for affected people in both personal and policy contexts. None of this is new to people in aging, and the filmmakers, PBS and funders should have known better.
5. TONI MORRISON’S WISDOM FOR WRITERS ON ‘BARING WITNESS’
“You have to be willing to look at it really cold and not angry, not sad. You have to be intelligent about it. It’s an intellectual project; my emotions are of no use in the writing. That’s a waste of time, of energy–and of smarts, even. It’ll sink you. But if you’re clear and eager and take it seriously, you bare witness–that’s my job: to bare witness.”
— Toni Morrison in 2008 interview on West Coast Live, on how she approached tragic circumstances for her characters, such as in “Beloved.” (Rebroadcast Feb. 2017)
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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 2017, JNG. For more information contact GBO Editor Paul Kleyman.
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