You know you've arrived at a real inflection point when fashion, politics, and the urban intelligentsia collide. In New York, Carmen Dell'Orefice (81) adorns promotional banners and blogs during the run-up to the Fall Fashion shows. At the 92nd Street Y on Manhattan's Upper East Side, Mayor Koch (87) and former Fed Chairman Paul Volker (84) lead a talk to "share relevant information and wisdom" for NYC's unofficial intelligentsia. And in The Villages, Florida - the self-proclaimed "friendliest retirement hometown" -- a newly-minted Paul Ryan enters stage right with his vibrant mother (78) to declare how he and Governor Romney plan to "save Medicare."
This unlikely collision of Fashion Week, the fashionable Manhattan Y, and the impossibly unfashionable "retirement communities" of the Sunshine State speak of a larger cultural shift that is upon us. In this young century, we are witnessing a new old. We are witnessing the emergence of a new aging process where people remain healthy, active, and productive -- not to mention beautiful, smart, and politically savvy -- into their 60s, 70s, and 80s.
So it's no wonder that this new kind of aging -- and its impact on Medicare -- has become a watershed issue of the 2012 Presidential campaign. But for all the speeches delivered by the politicians and all the ink spilled by the cognoscenti, everyone is missing the point. It's not that the 77 million Baby Boomers in the U.S. are going to bankrupt Medicare. The point is just the opposite. However ironic it may seem, this new, gigantic aging cohort is going to save the social insurance program.
How, indeed, can the explosive demand brought by the unprecedented aging of the American population save a program that pays out to the aging?
Fully embraced, an active, productive aging is creating and will continue to create a culture shift in which "seniors" break out of traditional roles of "need" and "dependency" and become vibrant producers in our society. No longer the automatic recipients of government welfare -- and popular pity and condescension -- healthy, vital seniors will remain at the heart of social and economic life and spare the precious federal insurance dollars for those really in need. This is not FDR's or LBJ's aging population, and we shouldn't treat it as such.
But this transformation of aging isn't just culturally liberating. It's also economically essential. In the United States, there will soon be more people over 65 than under 15. So we're not just witnessing a new kind of aging; we're seeing the emergence of a new kind of society, one where older adults outnumber children. From both a social and a financial point of view, how can we look these demographic realities in the eye and not re-think how we provide healthcare and other essential services to the aging?
When Medicare was created in 1965, only 10 percent of Americans were over 65 and eligible. Today, this number has crept to 13 per cent, and by 2030 it will reach 20 per cent. No matter your political bent, this arithmetic is irrevocable.
An older America, however, need not be an obituary for Medicare. In fact, if we embrace this progressive, optimistic view of aging, the purported Medicare crisis becomes an opportunity. It is no secret that the American economy is in rough shape right now, and something substantial needs to change in order to jumpstart growth. The cultural change that is going to save Medicare is the same changes that put the U.S. economy back on track. If older adults remain at the heart of social and economic life, then the U.S.'s largest population segment will become the U.S.'s "demographic dividend."
Economists and demographers often refer to the "demographic dividend" as the working-aged population that is driving economic growth. For the past couple of decades, much of Asia, for example, is seen to have a demographic dividend because its 18-to-55 population is far larger than the over-55s. But this culture shift that overtaking fashion week and presidential politics reveals that the U.S.'s aging population is its demographic dividend.
Fundamentally, our current political dialogue has the Medicare issue completely backwards. It's not just that Medicare needs to change in order to survive in an era of an older society; it's that our idea of aging itself needs to change in order to allow Medicare to survive.
 |
 |
|
| Obama | Romney | |
|---|---|---|
| Electoral Votes (270 to win) |
332 | 206 |
| Obama | Romney | |
|---|---|---|
| Total | 65,899,660 | 60,932,152 |
| Percent | 51.1% | 47.2% |
| Democrats* | Republicans | |
|---|---|---|
| Current Senate | 53 | 47 |
| Seats gained or lost | +2 | -2 |
| New Total | 55 | 45 |
| Democrats | Republicans | |
|---|---|---|
| Seats won | 201 | 234 |
The issue isn't what Medicare needs, it's what we people need. We need Medicare. Expand it, make it available to more people and increase the benefits. Increase taxes as needed to fund it. That's how to fix the alleged Medicare problem.
If they can pull that one off I will vote for them. Just mean that their base will pass away sooner.
No, what the entire debate is about is whether our country will honor its promise or treat the aged, me, just like fetuses are treated after they are born. Ignored, forgotten and BLAMED.
The CBO says to purchase a Medicare-equivalent policy would cost about $20,500 by 2022. The estimated coupon amount is $8000. That means seniors would have to come up with another $12,500 per year, or over $1000 a month. Economists point out that would exceed many seniors annual incomes.
Ryan held a Medicare privatization hearing a couple of months ago. Even privatization advocates said his plan meant "some seniors" would only be able to afford a "bare bones" plan.
That means catastropic coverage only, which means seniors would pay the premium and then have to spend about $10,000 out of pocket to pay for all their health care before insurance would pay a penny.
Catastrophic coverage means people avoid seeing the doctor, skip preventive care and even skimp on crucial lifesaving meds. Eventually they end up in the hospital much sicker than they'd have had to be, much more expensive to treat, and some won't survive.
This is disguised by code language such as "patient centered health care" and "choosing the policy that best suits your needs." Both mean "only as much as you can afford."
Traditional Medicare needs to be an option, but not the only option. Face it: by the time you enrol in Parts A, B, and D and purchase(at 65) a good supplement, you're still paying close to $300/month PLUS prescription costs. If we're supposedly so much healthier, let us extend HSA'a into Medicare, where we use our own SAVED money...high-deductible medsupps are 1/3 the premium. Let us pay the deductible out of HSA funds tax-free.
http://swampland.time.com/2012/08/16/fact-check-obamacares-medicare-cuts/
I believe the cuts are designed to bring Medicare Advantage per patient costs in line with traditional Medicare per patient costs. If that's isn't what is happening, I think that's what needs to happen.
What I have a hard time grasping is the Republicans simultaneously maintaining that the private insurance solution is more economical than the single payer traditional medicare while maintaining that the subsidies to Medicare Advantage should continue.
I know, I know, the economic ideology is so sound that one shouldn't look at the data to see if it works. Examining data involves critical thinking skills, which is very bad.
I certainly believe everyone who has paid into SS should have the opportunity to work less if that is what they choose. Obviously much of this conversation needs to be about allocation of our taxpayer dollars, for us the citizen's not other countries and corporations!