GBO NEWS: News Links Besides Impeachment and Primaries (Cuts & Claims Below the Fold); Columbia U’s Age Boom Reporting Fellowships; GAO Says Health Guidelines Fail Older Americans; 2020 Candidates on Disability, Long-Term Care; & MORE
GENERATIONS BEAT ONLINE NEWS
E-News of the Journalists Network on Generations – Our 27th Year.
February 7, 2020 — Volume 27, Number 2
EDITOR’S NOTE: GBONews, e-news of the Journalists Network on Generations (JNG), 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. To subscribe to GBONews.org at no charge, simply sending a request to Paul with your name, address, phone number and editorial affiliation or note that you freelance. For each issue, you’ll receive the table of contents in an e-mail, so just click through to the full issue at www.gbonews.org. GBONews does not provide its list to other entities.
In This Issue: Recanvass Iowa Votes—the Senate’s, too. (Got an app for that, Shadow, Inc.?)
1. BELOW THE FOLD: Reporting Buried Under 1A Headlines—on Social Security, Medicare, Home Health and More.
2. EYES ON THE PRIZE: Reporting Fellowship Deadline March 6 for Columbia U’s 2020 “Age Boom Academy.”
3. LEADS FROM LIZ by Liz Seegert: GAO Finds U.S. Health Guidelines Don’t Reflect Older Americans.
4. THE STORYBOARD:
*** “The U.S. Economy Would Be Better Off If More Senior Citizens Had Jobs,” by Alessandra Malito, and “Why Aging Americans Will Be a Boon for the Economy,” by Chris Farrell, both at MarketWatch;
*** “UC Davis professor helps with Alzheimer’s care. Why her work goes beyond the office,” by Theodora Yu, Sacramento Bee;
*** “Socioeconomic Inequalities in Disability-Free Life Expectancy in Older People from England and the United States: A Cross-National Population-Based Study,” by Paola Zaninotto, PhD, George David Batty, PhD, Journals of Gerontology;
*** “Third Time’s the Charm for Reestablishing the House Aging Committee,” by Herb Weiss, Woonsocket (RI) Call.
5. 2020 PLANS FOR THAT: *** Presidential Candidates’ Proposals on Disability Rights and Long-Term Care; *** LATE-BREAKING ADDITION – “Social Security: Where Do the 2020 Candidates Stand?” by Mark Miller, New York Times;*** “EVERBODY COVERED,” 5-Part Series by Dylan Scott, Ezra Klein and Tara Golshan, Vox on lessons for the U.S. from health systems in Taiwan, Australia, The Netherlands, Maryland and the UK.
1. BELOW THE FOLD
WHAT A WEEK—the Iowa white out, the State of the Unremoved address, the Unremoving vote under God and the GOP’s Mitt fit, and the national hand-wringing (preferably with anti-bacterial) as the coronavirus spreads.
Meanwhile, the gen beat goes on with substantial public impacts reported often back around page A19 or in the business news, usually below the fold or buried online with hardly a sniff from the algorithms that push too many consequential stories way, way out of sight for lack of popular clicks. Not to worry, GBONews readers. Your editor grabbed his Minnesota snow shovel to dig out some of what’s actually happening (not merely app-ening).
Major media and late-night comedians have already fed the president’s third annual address through their analytical shredders (the “Nancy2020” model), for instance, pitting his pledge to reduced prescription drug prices against the stalled status of, as Democrats shouted during the speech, “H.R.3! H.R.3! H.R.3!” That’s the House of Representatives bill, now in Senate Majority Leader Mitch McConnell’s hearing-free limbo, to allow Medicare to negotiate drug prices.
On the 45th president’s claim, “I’ve also made an ironclad pledge to American families. We will also protect patients with pre-existing conditions,” CNN’s fact check countered, “… His administration has consistently taken steps to undermine the Affordable Care Act — including joining a lawsuit aimed at striking down the law — without presenting alternative plans that would offer similar benefits.”
The New York Times dryly parried, “This is misleading,” to his assertion, “We will always protect your Medicare and your Social Security always.” Wrote the paper’s Linda Qiu, “Not only has President Trump failed to strengthen Medicare and Social Security, but the financial outlook for both trusts has not improved or worsened. That is at least partly the result of Mr. Trump’s tax law, which has left the Treasury Department to collect fewer taxes from Americans and, in turn, invest less money into each program. Last April, the government projected that Medicare funds would be depleted by 2026, three years earlier than estimated in 2017. The report noted that less money will flow into the fund because of low wages and lower taxes.” Ah, yes, all of those meagerly paid gig-economy jobs accounting for the nation’s lowest unemployment rate in, as the POTUS stated, “over half a century.”
*** “Battle over Social Security Spills into 2020 Campaign …”: In case you missed it, as the Washington Post’s Jeff Stein reported on Jan. 22, “President Trump appeared to express a new openness to revamping entitlement programs, such as Social Security and Medicare, . . . if he is elected to a second term.” Stein quoted the interview by CNBC’s Joe Kernen with the president at the World Economic Forum in Davos, Switzerland last week. The president called taking on entitlement spending is “the easiest of all things.” WaPo’s Stein reported that the U.S. leader “seemed to suggest higher economic growth would make it easier to reduce spending on those programs. It was unclear exactly what changes the president was envisioning and the White House did not immediately respond to a request to clarify.”
The president referred to the “unprecedented growth” of the U.S. economy, apparently suggestion that the presumed prosperity might justify lower spending on social insurance programs. Stein noted though that the American economy “is growing but not as fast as it has in the past, though the stock market is at record levels.”
Also reporting on the president’s Davos comments, Alan Rapaport and Maggie Haberman of the New York Times wrote, (Jan. 22), “The president has already proposed cuts for some safety-net programs. His last budget proposal called for a total of $1.9 trillion in cost savings from mandatory safety-net programs, like Medicaid and Medicare. It also called for spending $26 billion less on Social Security programs, the federal retirement program, including a $10 billion cut to the Social Security Disability Insurance program, which provides benefits to disabled workers.”
The piece goes on, “Republicans have largely avoided talking about rolling back entitlement programs since Mr. Trump became president, assuming that doing so would be a non-starter. Following the $1.5 trillion tax cut that Republicans passed in 2017, some suggested that they would quickly turn to reduce the cost of Social Security, Medicare and Medicaid.”
(A separate story in the same issue of the Times reports, “Trump Removes Pollution Controls on Streams and Wetlands.”)
The State of the Union address also included the president’s appeal to the old right white vote. He derided more than 130 House members for having “endorsed legislation that would bankrupt our nation by providing free taxpayer-funded health care to millions of illegal aliens, forcing taxpayers to subsidize free care for anyone in the world who unlawfully crosses our borders. These proposals would raid the Medicare benefits of our seniors and that our seniors depend on, while acting as a powerful lure for illegal immigration.” Those alienated by the blatant and, sadly, effective racist divisiveness can find fact-based outrage in the Daily Beast piece, “Trump’s Speech Was a Nationalist, Anti-Immigrant, Socialism-Hating Game Show.
As a card-carrying Medicare member, this editor, also an old white guy, this editor will only add another rip at the president’s ageism for presuming that most older voters are too ignorant to know that the vitality of the USA has always depended on immigrants. They need to be healthy, whether they are caring for elders, providing childcare (including for their own grandchildren), or staring new businesses. That’s how we boost taxes and community value in the longevity economy.
*** Meanwhile, there’s more than one way to skin a public benefit program, such as Medicare. Judith Graham of Kaiser Health News, posted, “Why Home Health Care Is Suddenly Harder To Come By For Medicare Patients,” (Feb. 3, 2020): “ The decision came out of the blue. ‘Your husband isn’t going to get any better, so we can’t continue services,’ an occupational therapist told Deloise “Del” Holloway in early November. ‘Medicare isn’t going to pay for it.’” Graham explains that in 2017, Anthony Holloway, 57, was diagnosed with ALS (amyotrophic lateral sclerosis): “He can’t use the toilet, bathe or dress himself. Therapists had been helping Anthony maintain his strength, to the extent possible, for two years.”
Of the Maryland man, she wrote, “Before retiring in 2016 because of ill health, Anthony was chief of police for the U.S. Bureau of Engraving and Printing. ‘It seems to me nobody cares about what’s happening to me,’ he told me. ‘It makes me feel terrible — awful, less than human.’”
Nationally, Graham continued, home health agencies “are grappling with a significant change as of Jan. 1, in how Medicare pays for services. (Managed-care-style Medicare Advantage plans have their own rules and are not affected.) Agencies are . . . cutting physical, occupational and speech therapy for patients. They are firing therapists. And they are suggesting that Medicare no longer covers certain services and terminating services altogether for some longtime, severely ill patients.”
2. EYES ON THE PRIZE
Graham added that under the administration’s new rules “agencies now have a stronger financial incentive to serve patients who need short-term therapy after a stay in the hospital or a rehabilitation facility, said Kathleen Holt, associate director of the Center for Medicare Advocacy.” She noted there are about 12,000 home care agencies (most of them for-profit), which provided care to 3.4 million Medicare beneficiaries in 2017.
*** The Reporting Fellowship Application Deadline is March 6 for the 2020 “Age Boom Academy” at Columbia University in New York City. The program, jointly sponsored by Columbia’s School of Journalism and its Robert N. Butler Columbia Aging Center, will select 20 journalists (staff or freelance) from all media types around the nation. Chosen reporters will attend the training session on June 4-6, with travel and hotel expenses paid.
This year’s theme is “Combatting Loneliness in Aging: Toward a 21st Century Blueprint for Societal Connectedness.” The focus will be on “how to effectively translate science into accessible reporting on the complex issues of the effects of loneliness and social isolation on health and in aging,” says their announcement.
According to the program’s site, “There is evidence that loneliness has been escalating substantially and has emerged as a distinctly 21st century issue because for much of the latter part of the 20th century, we designed loneliness into our society. In the U.S. in the 1970s, 11-17% of Americans of middle age and older reported being lonely; in 2010 that had risen to 40%. And today? A majority, or three in five Americans, reported feeling lonely in 2019.”
Among scheduled experts will be major experts in gerontology from Columbia, Yale and other universities. The program will also include speakers and story clinics with Columbia J-School head, Bruce Shapiro, as well as trainers from the Solutions Journalism Network plus veteran generations beat writers Rich Eisenberg (PBS NextAvenue),Chris Farrell (Marketplace), Kerry Hannon (New York Times and Forbes contributor), and Carol Hymowitz (formerly of Bloomberg News).
For details see the Age Boom Academy website. For information contact Caitlin Hawke at cmh2197@columbia.edu. This year’s program is being sponsored by the RRF Foundation (formerly the Retirement Research Foundation), with additional support from the AARP Foundation.
3. LEADS FROM LIZ
GAO: U.S. Health Guidelines Don’t Reflect Older Americans
By Liz Seegert
A report from the Government Accountability Office (GAO) further confirms what many of us suspect: Federal guidelines don’t necessarily reflect the unique health needs of many older adults.
GAO noted, for instance, that federal nutrition guidelines form the basis of food assistance programs serving the older population — however, these standards assume a healthy population, and don’t take into account the specific nutritional needs of those with certain chronic conditions or of people ages 70+. Elders may also face barriers, such as a reduced appetite, or problems chewing or swallowing, which impair their ability to meet their nutritional needs.
These nutrition guidelines apply to federally funded meals served in congregate settings, such as adult day care or senior centers, and through home-delivery programs like Meals on Wheels. Nursing homes must adhere to minimum nutrition guidelines along with other food requirements.
GAO acknowledges that the demand for federal nutrition assistance will increase as the population ages. The Department of Health and Human Service s (HHS) plans to focus on older adults in its 2025-2030 update to the guidelines, but has not documented a plan for doing so. So the GAO developed several recommendations for HHS to consider as they take a closer look at this issue.
If you’re reporting on issues of food insecurity or local programs that assist older adults with meals and groceries, The National Resource Center on Nutrition and Aging is a great place to find background information on everything from dietary guidelines to statistics on diabetes prevalence. The U.S. Department of Agriculture also provides links to various nutrition assistance programs for specific groups, such as rural adults or Native Americans. But, don’t stop there.
Check out what’s going on in your own state, or community from your state and local department of aging or elder affairs. Meals must meet minimum standards, but are some programs going above and beyond, such as offering culturally appropriate fare for ethnic elders? What efforts are being made to incorporate ethnically relevant foods into these guidelines?
A one-size-fits-all standard on something as important as nutrition for older people should be a non-starter. There’s plenty of research available to bolster the case for adapting these guidelines to meet elders’ current and future requirements.
“Leads From Liz” columnist Liz Seegert is program coordinator for GBONews.org’s parent, the Journalists Network on Generations. A New York-based freelance journalist, she is also editor of the Association of Health Care Journalists’ Core Topic section on Aging.
4. THE STORYBOARD
*** “The U.S. Economy Would Be Better Off If More Senior Citizens Had Jobs,” by Alessandra Malito, MarketWatch (Jan 31, 2020): “Pushing older people out of the workforce costs the U.S. economy $850 billion a year, according to AARP. The 50-plus population contributed 40% of the country’s gross domestic product in 2018, according to research released this week by AARP and the Economist Intelligence Unit. This subsect of the workforce also supports 88.6 million jobs and $5.7 trillion in wages and salaries, their work directly and indirectly.
Yet, older workers are often discriminated against, and had they been allowed to stay in their positions, move between jobs or re-enter the workforce, the country would have amassed nearly a trillion dollars more. The 50-plus population’s economic contribution amounted to $8.3 trillion in 2018, and is expected to triple to $28.2 trillion by 2050. If age discrimination was eliminated, the total economic contribution could rise to $32.1 trillion in 2050, the AARP report said.”
In a separate commentary on PBS Next Avenue (also on MarketWatch) the AARP findings, author Chris Farrell (most recently of Unretirement and Purpose & a Paycheck) chided conventional-wise guys and gal for forecasting that the aging population will drag down growth in the new decade. He declares, “They’re wrong. This timeworn economic dictum is not only outdated, it ignores changes in American society that are turning an aging population into more of an economic and social asset than ever. For evidence, take a look at the new report, The Longevity Economic Outlook by the Economist Intelligence Unit for AARP, an update of a 2013 AARP study.
Farrell stresses, “Broadly speaking, the report is a timely reminder that too much of the conversation about aging dwells on costs and burdens of older Americans, while voicing despair at the financing challenges of Social Security and Medicare. The popular image of growing old is too often pictured as years of chronic illness and mental decline — as Shakespeare wrote, “Sans teeth, sans eyes, sans taste, sans everything.” Good point, Chris. My word, how many more hit plays might Will have written beyond his mere 52 years given better medicine and public sanitation than available to Elizabethans?
Besides AARP’s research, Farrell cites other evidence of 50+ economic power: “The recent Washington Innovation in Longevity Summit that my colleague [PBS Next Avenue Managing Editor] Richard Eisenberg attended was filled with evidence of burgeoning interest by tech entrepreneurs and investors here and abroad to serve the 50+ market. ‘Almost every week, I hear from people from another country saying: I want you to meet an entrepreneur or I have an investment fund for you to look at,’ said Mary Furlong, host of the summit.”
Farrell highlights two important economic indicators from the AARP report that help “refute conventional wisdom that older Americans are a financial burden on the nation. First, the tax contribution of the 50+ group is substantial. For example, the study says, the share of federal income taxes paid by the 50+ population amounted to 59% of the total income taxes paid in 2018, far above their share of the population Their portion of the federal tax total in 2050 is projected to rise to 65%. A similar dynamic holds on state and local levels.”
Second, he notes, “is the estimated economic value of unpaid contributions. Those are things like caring for an aging parent, grandparents supporting grandchildren and volunteering. The AARP report puts the total value of this unpaid work at $745 billion in 2018. To put that in context, $745 billion is slightly more than total amount of Medicare benefits paid in 2018.”
Farrell concludes, “Perhaps most important, especially in an era when memes like ‘OK Boomer’ manage to get an audience, is the theme of intergenerational benefits in the workplace and in society. . . . Simply put, ideas for improving economic opportunities for older adults also boost prospects for younger generations (who, after all, will age, too).”
*** “UC Davis Professor Helps With Alzheimer’s Care. Why her work goes beyond the office,” by Theodora Yu, Sacramento Bee (Dec. 30, 2019; also Minneapolis Star-Tribune, Jan. 18, 2020 and other McClatchy-connected media. Includes 7:34 minute audio version.): “Oanh Meyer is no stranger to Alzheimer’s disease. Her everyday life revolves around caring for those who suffer from the ailment. Meyer’s office is at the UC Davis Alzheimer’s Disease Center in Sacramento. But her care goes beyond the clinic: Her mother was diagnosed with Alzheimer’s, a progressive disease that commonly causes dementia and has no cure. As a primary caregiver herself, the University of California, Davis assistant adjunct professor understands the challenges, barriers and emotional burdens that come with that role — especially for newer immigrants — but are often ignored or dismissed.
Through her research and her experience as a caregiver, Meyer found that many Vietnamese elders lack knowledge about Alzheimer’s and wait a long time before seeking help or diagnosis. . . . According to a report published this year by the Alzheimer’s Association, most of the current studies on dementia among Asian subgroups are unreliable and more studies are needed to draw significant conclusions about the prevalence of Alzheimer’s and other dementias in Asian Americans and subgroups. In 2015, Meyer published a research paper documenting the experience of Vietnamese caregivers, in an attempt to help them better understand the context of the battle against Alzheimer’s. Wartime trauma is one factor that could exacerbate the effects of Alzheimer’s and dementia for Vietnamese immigrants.”
*** “Socioeconomic Inequalities in Disability-Free Life Expectancy in Older People from England and the United States: A Cross-National Population-Based Study,” by Paola Zaninotto, PhD, George David Batty, PhD and colleagues, Journals of Gerontology, Series A, Jan. 15, 2020: In reading this study, one might wonder whether your bank statement should come with an actuarial chart showing your expected mortality.
As Heather Murphy reported in the New York Times (“Rich People Don’t Just Live Longer. They Also Get More Healthy Years,” “Yes, indeed, it’s good to be rich in old age. According to a new study, wealthy men and women don’t only live longer, they also get eight to nine more healthy years after 50 than the poorest individuals in the United States and in England.” The researchers, from University College London, Harvard University and institutions in three other countries, analyzed two large data sets with people over 50 for factors including education, social class and wealth. “Though education level and social class had some effect, neither was found to be nearly as significant as wealth.”
*** “Third Time’s the Charm for Reestablishing the House Aging Committee,” by Herb Weiss, Woonsocket (RI) Call and his blog (Feb. 2, 2020): Twenty-six years after the House Democratic leaders terminated the House Permanent Select Committee on Aging to save money, U.S. Rep. David N. Cicilline has introduced legislation for the third time since 2016. The panel would be “authorized to conduct a continuing comprehensive study and review of aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care.” The committee, which existed from 1974-1993, was chaired through most of its life by Reps. Claude Pepper, D-Fla., and Edward Roybal, D-Calif. It produced groundbreaking hearings and reports on elder abuse, medical quackery and other frauds, as well as other under-covered issues.
5. 2020 PLANS FOR THAT
*** The Primaries Are Underway and—So What? That is, what’s there to say about the American condition besides which candidate is getting the up or the down arrow for their poll percentages? For those not 65 yet but ailing, such as the vulnerable 55-64 group, Sen. Bernie Sanders released his “Fighting for Disability Rights” plan days before the Iowa caucus, and Sen. Elizabeth Warren issued her plan for that in December, and Mayor Pete Buttigieg announced his version in October.
Abigail Abrams noted in her Time Magazine story (Jan. 2) on Warren, “2020 will mark the 30th anniversary of the Americans with Disabilities Act (ADA) and the 100th anniversary of the country’s vocational rehabilitation program, which helps people with disabilities find and keep jobs. But even as these milestones pass, people with disabilities remain more than twice as likely to live in poverty as nondisabled people, less likely to graduate high school or hold a job, and are overrepresented in prisons and jails across the country.” Abrams added, “While disability rights have not historically been a hot-button topic, one in four Americans has a disability and Democrats this cycle are starting to pay more attention.”
*** “Candidates Would Address Long-Term Care,” by Howard Gleckman, Forbes (Jan. 21, 2020): “All the major Democratic presidential hopefuls have proposed significant plans to support those receiving long-term supports and services and their families. While this amount of attention to long-term care is unprecedented, the candidates are taking three broadly different approaches to the problem: tax credits; universal government-funded coverage; and public long-term care insurance against catastrophic costs. Most also support higher pay for direct care workers, paid family leave for caregivers, and more funding for Older Americans Act programs. But their most ambitious—and divergent—ideas address long-term care financing.
“Two candidates, former vice president Joe Biden and Sen. Amy Klobuchar (D-MN), support new tax credits. Two others, senators Bernie Sanders (I-VT) and Elizabeth Warren (D-MA), would roll long-term care into their Medicare for All plans, including it as part of the broad new government health benefit. And one, former mayor Pete Buttigieg, favors a universal public long-term care insurance program for those with catastrophic needs.”
The article describes each proposal, briefly. Gleckman, a health care policy journalist and expert at the Urban Institute adds that he will publish his analysis of the plans in a separate blog.
*** LATE-BREAKING ADDITION – “Social Security: Where Do the 2020 Candidates Stand?” by Mark Miller, New York Times (Feb. 7, 2020): “Democratic presidential contenders are proposing expanding benefits, including Joe Biden, whose stance has evolved. President Trump’s position is much less clear.”
*** “EVERYBODY COVERED,” a 5-Part Series by Dylan Scott, Ezra Klein and Tara Golshan, Vox: What the U.S. can learn from health systems in Taiwan, Australia, The Netherlands, Maryland and the UK. (You know, those “socialized medicine” plans that are far cheaper and better than U.S. health care.) This remarkable series run during January 2020, with grant support from the Commonwealth Fund, examined health care systems around the world. The series includes:
* “Taiwan’s Single-Payer Success Story — and Its Lessons for America”: It begins, “In the 1990s, Taiwan did what has long been considered impossible in the US: The island of 24 million people took a fractured and inequitable health care system and transformed it into something as close to Sen. Bernie Sanders’s vision of Medicare-for-all as anything in the world. … By one advanced metric — mortality for causes that should be avoidable with accessible, high-quality health care — the United States ranked last among the G7 countries in 2016.”
* “Two Sisters. Two Different Journeys Through Australia’s Health Care System”: One sister used public health care when she got pregnant. The other delivered at a private hospital. Here’s how health care works down under.
* “The Netherlands Has Universal Health Insurance — and It’s All Private”: How the Dutch harnessed the market to cover everybody.
* “The Answer to America’s Health Care Cost Problem Might Be in Maryland”: Maryland has a health care system unique in the United States: a global hospital budget. Here’s how it works.”
* “In the UK’s Health System, Rationing Isn’t a Dirty Word”: The UK has one of the most equitable health care systems in the world. Here’s how.
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