Goodbye to the New Deal? Advocacy in a New (Dazed and Confused) Age
Minnix, Larry, Aging Today
It all started with the New Deal, which knitted the safety net for the Great Society. The former laid the foundation for income security during retirement and in the event of job loss. The latter added healthcare for elders, people with disabilities and the poor. These programs' existence reflected the values-based policy decision that vulnerable Americans are entitled to our collective support.
Successive developments have included the Older Americans Act, the White House Conference on Aging and a proliferation of associations that advance the cause of healthy aging.
Now, there is a stark new reality. The assumptions upon which these programs were based have changed. The retirement age of the New Deal was an arbitrary age 65. But current patterns of longevity, economics and workforce have unfolded differently. The structure of these important entitlements can no longer handle the weight of today's new demands.
Fast forward to a post 9/11 reality- an era inflamed by a global economic crisis, unpaid-for wars and catastrophes, and a metastatic growth in healthcare spending resulting from antiquated assumptions, systems and incentives. Many experts and pundits now believe our entitlement programs as structured are unaffordable.
Add to this mix America's unhappy populace and the acrid political hype that screams at us 24/7- vitriol that has frozen political decision-making. Political deals regarding the debt ceiling and the Super Committee have put senior programs in every community at risk. "It's all on the table," as they say. Public confusion about entitlement programs just compounds the predicament.
Tales of Ignorance and Confusion
Let me offer a few vignettes to illustrate.
During the health reform debate, I was on a public television call-in show, talking about long-term care- including the need for a plan like CLASS (Community Living Assistance Services and Supports). A woman called in, self-identifying as a Medicare and former Medicaid recipient- but she didn't believe in government-run healthcare.
One of our LeadingAge nursing home members wrote to me about his dissatisfaction with our organization's advocacy agenda to not cut Medicaid. He said America is going broke because of entitlement programs like Medicaid. But, his nursing home residents depend on Medicaid, which is inadequate in his state, and he faced further cuts.
This member said he had a new congressman who seemed to like him. That congressman favored a proposal that would block grant Medicaid, which would further reduce reimbursement. I asked this fellow if he could stay in business with those cuts. "No," he answered, "but I don't want to make my new congressman mad." I asked him how mad he wanted to make his residents, families and employees when he told them his organization must close. "I never thought of it like that," he said. I suggested he invite his new congressman to a meeting with his board, his employees and his clientele to talk about how to responsibly rein in Medicaid.
I remember a stunning meeting with a former HUD Secretary about the importance of the HUD 202 program for elders. After listening to the discussion he said, "I know what the solution to these housing projects is: Make people get jobs. …