Prime Time (47 page)

Many different solutions have been proposed to keep Social Security solvent for future generations. Experts have considered means testing (reducing benefits for individuals with higher incomes) and/or raising the age of eligibility for payout (the age is currently sixty-six, after being raised from sixty-five). The most popular proposal, however, is to broaden the taxable wage base that funds Social Security.
¹⁴
As of 2008, Social Security has been funded by a 6 percent tax on wages up to $102,000. Wages above that level were not taxed for Social Security purposes. Historically, the intent of the taxable wage cap was to draw from 90 percent of payroll earnings without overburdening those who earn higher wages. However, today’s wage base for Social Security no longer includes 90 percent of payroll earnings because wages above the taxable maximum have increased more rapidly than wages in general. If the wage base were changed to match the historically intended levels, the maximum taxable wage would be $203,000.
¹⁵
This adjustment would significantly increase projections for Social Security solvency.

• We deserve financial security throughout our retirement.
  
• Social Security should remain a public, government-run program.
  
• We deserve to see our political leaders resolve the solvency issues that will burden future generations.
  

ABUSE, DISCRIMINATION, AND EXPLOITATION

Older people are vulnerable to victimization. Sadly, hundreds of thousands of reports of elder abuse—including physical, emotional, and sexual abuse—are made to social services agencies every year. Financial exploitation of vulnerable adults is common as well. It frequently occurs among family members and is difficult to enforce. Living trusts, which give outside parties decision-making power over funds, sometimes allow conservators and guardians to mismanage property. Older people deserve opportunities to seek redress in court in cases of exploitation and abuse, regardless of their ability to pay an attorney’s fees. Elder abuse and exploitation must be categorized as criminal offenses and properly enforced.

• We deserve support in our court system even if we cannot pay for attorneys.
  
• We deserve to be safe from abuse and exploitation.
  

Age discrimination at work is another form of exploitation. Significant progress was made with the passage of the Age Discrimination in Employment Act (ADEA), which prohibited mandatory retirement in most professions. However, the ADEA does not permit victims of age discrimination to recover compensatory or punitive damages. Unlike other forms of discrimination legislation, the ADEA lacks stipulations that would serve as a deterrent to age discrimination. Futhermore, greater awareness needs to be given to subtle forms of age discrimination that persist in the workplace. Many older workers are disadvantaged at their jobs because they are denied opportunities for training, promotions, or access to benefits. Ultimately, the effectiveness of the ADEA is dependent on the responsiveness of the Equal Employment Opportunity Commission. The EEOC is responsible for monitoring and enforcing federal employment discrimination law.

• We deserve greater protection from discrimination in the workplace.
  

Ways for Seniors to Keep Working

Employers should support opportunities for older individuals to work by offering flex-time and part-time arrangements. Telecommuting and job sharing can make employment feasible for older individuals who want to maintain a work-life balance. For many, working more years is a preferred plan. Workers generally do not benefit from early retirement, because it can reduce their Social Security and/or pension payments for the rest of their lives. Additionally, staying employed after sixty-five provides social interaction, a sense of purpose, and mental stimulation. Do not forget, companies that retain older workers fare better. Older employees have proven to be more careful, with lower rates of on-the-job injuries. They report a high level of morale and loyalty to their employers. Although teenagers are often given frontline jobs as cashiers or service representatives, older workers are often better equipped to think independently and to properly analyze the features of a complex situation.
¹⁶

Older workers are proven to have good attendance rates and low turnover. This leads to significant overhead savings for the companies that employ them. Labor economists estimate that the cost to a company when an employee leaves and a new employee has to be hired and trained is significant—somewhere between $2,000 and $3,000 per worker. For large companies, holding down turnover rates can result in millions of dollars in savings. As of 2005, companies that sought to hire and/or retain older workers included Home Depot, Walgreens, MetLife, and Pitney Bowes.
¹⁷

Younger workers need not fear the retention of older workers. According to Kenneth A. Knapp, with the International Longevity Center, in New York City, there is an erroneous assumption that if older workers stay in the workforce, this will prevent younger people from getting jobs. However, Knapp has asserted that higher employment is a positive all the way around. Higher employment leads to greater economic growth, which ultimately leads to job growth.

• We deserve flexible work arrangements in discrimination-free work environments.
  

Special Concerns for Women

Nearly 72 percent of women in their fifties are in the labor force; thus, pay inequity is a salient issue for older women. As of 2008, women in full-time jobs had a median weekly wage 20 percent below that of their male counterparts. Working women are often the sole providers for their families, yet they tend to be concentrated in low-paying occupations. More than two-thirds of the part-time labor force is made up of women, leaving them with less job security and with far fewer employer-provided benefits. Furthermore, many low-wage workers are hired as part-time, contingent, or temporary workers. In these roles, low-paid employees lack job security, paid leave, and sick leave, and have limited legal protections.
¹⁸

Retired women have different needs than retired men. For one, women live longer than men. Women outnumber men in nursing homes, and roughly three out of every four individuals over eighty-five are female. Women need long-lasting retirement funds, but, compared to men, most of them have earned less and spent fewer years in the workforce.

Our current Social Security program includes adjustments for disparities in pay, but privatized Social Security programs would not. Private savings accounts and investments would likely not provide women, low-paid workers, or the unemployed with adequate retirement savings.

• Women deserve equal pay for equal work.
  
• Women deserve a government-run Social Security program that will not penalize them disproportionately, as a privatized system would.
  

Social and Psychological Difficulties

Many of the difficulties associated with getting older are psychological. While the majority of older people become happier as they age, rates of suicide, depression, and substance abuse among a portion of the elderly are far higher than the public appreciates. The suicide rate for individuals over eighty is higher than the teen suicide rate. However, according to the National Council on Aging, state spending for community programs has been undermined by the current recession, resulting in a 10 percent cut, on average, to services to seniors. While the Older Americans Act includes provisions for lifeline outreach programs such as Meals on Wheels, many states have exceptionally long waiting lists and cannot properly execute the programs, and this leaves many seniors isolated.

The Older Americans Act was enacted in 1965 by Congress and was reauthorized and modified in 2006. The legislation supports older citizens’ health and independence through community programs, including Meals on Wheels, civic engagement programs, senior centers, transportation services, support for family caregivers, health promotion, disease prevention, and service training for employment for mature workers. These well-conceived programs can be highly effective, but citizens need to make sure that they are properly funded and executed. Nearly 80 percent of states report waiting lists for home-delivered meals, and more than 50 percent have waiting lists for personal care, homemaker services, and respite care. This is important: Dollars spent on OAA programs save taxpayers money in the long run because the programs stave off premature nursing home placements and reduce Medicare spending by preventing malnutrition and controlling chronic health conditions.
¹⁹

Meaningful community connections promote good health. A prime example of an effective community-focused program is the AARP’s Blue Zones Vitality Project. Inspired by Dan Buettner’s
The Blue Zone: Lessons for Living Longer from the People Who’ve Lived the Longest,
an initiative was carried out by the United Health Foundation in the city of Albert Lea, Minnesota. Older citizens participating in the program joined walking groups, volunteered with youths, attended neighborhood picnics, ate nutritious foods, increased their social networking, and attended “purpose workshops.” The initiative included before and after measurements of respondents’ overall wellness. As measured by the “Vitality Compass,” an online tool that offers an estimate of life expectancy based on eating habits, sleeping habits, stress levels, and daily activity, participants in the project raised their life expectancy by three years.
²⁰

• We deserve social outreach programs that decrease social isolation and increase public health in every community.
  
• We deserve a decrease in waiting time for social service programs.
  

Medicare Doesn’t Cover Everything

Everyone needs to understand what Medicare covers and what it doesn’t. Medicare benefits are broken up into four categories. Part A includes hospital coverage, encompassing inpatient care, inpatient drugs, and limited home health care stays and stays in a skilled nursing facility. Inpatient stays longer than 150 days are not covered, and stays in a skilled nursing facility longer than 100 days are not covered. Part B includes physician services, some home health services that are not linked to a prior hospitalization, and outpatient services. Part C covers private health plans that contract with Medicare. Part D covers outpatient prescription drugs. Medicare does not pay for long-term nursing home care after 100 days, and sets a 190-day lifetime limit on care in psychiatric hospitals. Surveys indicate that Medicare generally covers 50 percent of health care costs, with 25 percent covered by supplemental plans and 25 percent left uncovered.
²¹

• We deserve coverage for long-term nursing home care.
  
• We deserve extensions in coverage for stays at hospitals, including psychiatric hospitals.
  

Isolation

Isolation is highly detrimental to older citizens with chronic health conditions. Older people frequently have problems communicating with physicians and navigating fragmented health care systems. This is made worse if an individual has difficulty driving to appointments, getting out to pharmacies, or keeping track of medications. Many seniors simply cannot execute their health care directives on their own—they are in need of palliative care.

I wrote about palliative care and its benefits in
Chapter 18
. Unfortunately, palliative care is not uniformly integrated in states’ Medicare budgets. According to the National Hospice and Palliative Care Organization, A-grade palliative care was available in Vermont, Montana, and New Hampshire. However, F-grade care was observed in Oklahoma, Alabama, and Mississippi.
²²
It is unsettling that one’s locality can make such a difference in the ability to access appropriate care.

Advocates of palliative care support one-stop-shopping service delivery. Medical “homes” would include offices with multidisciplinary teams serving older patients. Ideally, these teams would allow for collaboration among doctors, nurses, psychiatrists, social workers, physical and occupational therapists, and other professionals. To allow individuals to stay at home, and to reduce the costs associated with long-term care, we need policies mandating that palliative care be covered by Medicare and made available in every community.

• We deserve comprehensive coverage for palliative care.
  
• Access to quality palliative care should be universal.
  

A Nursing-Care Crisis

According to Dr. Robert Butler, the author of
The Longevity Revolution: The Benefits and Challenges of Living a Long Life,
our country is facing a nursing-care crisis. Workers in long-term-care facilities are poorly trained and poorly paid, and often leave due to lack of appreciation and/or lack of opportunity for advancement. Care workers are not uniformly required to hold certification, and many are paid merely $8 an hour, with no health benefits. Only one in ten nursing homes meets basic federal standards in the United States. This problem cannot and should not be minimized. It is nothing less than a sign of ageism that we have 1.5 million people in nursing homes, but only 10 percent of those homes meet federal standards.