Category: Seniors

Posner: Use Research Dollars to Make Life Better, But Not Longer

[W]e can’t have a clear idea of the welfare gains from extending the life of elderly people. But we can say with reasonable confidence that the welfare of the elderly, and of altruistic members of their families, could be enhanced, without a significant increase in the longevity of the elderly, by redirecting medical research toward diseases or conditions that impair quality of life without necessarily shortening it, or at least without shortening it commensurately. Dementia (which comes in many forms, but Alzheimer’s appears to be by far the most common) is the foremost example. It does shorten life somewhat, but on the other hand, as it is largely a function of age, its prevalence is increased by increases in longevity; and dementia is not only psychologically very hard both on the demented and on their families, but also very costly in the amount of care that demented persons require. Blindness, deafness, loss of mobility, and Parkinson’s Disease and related degenerative nerve diseases (life shortening, but often the effect on lifespan is less than the effect on quality of life) are other examples of diseases where investing in medical research might yield substantial increases in elderly utility without significantly increasing longevity. Stroke is an example of a medical condition that both reduces longevity and has often dramatic negative effects on quality of life.

Yet the National Institutes of Health expect this year to spend only $18 million on dementia research, $154 million on Parkinson’s research, and $337 million on stroke research, compared to more than $8 billion on cancer, heart disease, and diabetes research, even though the diabetes “epidemic,” while real, is due largely to obesity and bad diet. (Eye disease, however, seems generously funded at $817 million.) ….But the enormous expenditures on cancer research have not been very productive, and very promising research programs in dementia (notably research on an Alzheimer’s vaccine) are greatly underfunded both publicly and privately. In my view this is a regrettable imbalance.

More from Richard Posner at The Becker-Posner Blog. See Gary Becker’s comments here.

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May 23, 2011 | 6 comments | by

Seniors Have Never Had It So Good

[C]onsult a government publication called “Older Americans 2010, Key Indicators of Well-Being.” It reminds us that Americans live longer and have gotten healthier. In 1930, life expectancy was 59.2 years at birth and 12.2 years at 65; in 2006, those figures were 77.7 and 18.5. Since 1981, death rates for heart disease and stroke have fallen by half for those 65 and over. In this population, about three-quarters rate their own health as “good” or “excellent.”

See full Robert Samuelson editorial in The Washington Post.

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May 18, 2011 | 5 comments | by

Millionaire Retirees

Starting next year…the typical husband and wife who reach age 66 and qualify for Social Security… will begin collecting a combination of cash and health-care entitlement benefits that will total $1 million over their remaining expected lifetime…

Such married couples will begin receiving monthly Social Security checks that will, on average, total about $550,000 after inflation. They will receive health-care services paid for by Medicare that, on average, will total another $450,000 after inflation.

Full article on the flaws in Social Security and Medicare.

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May 16, 2011 | 5 comments | by

Most Caregiving is Unpaid Labor

The largest caregiver group in the workforce — 65 million Americans… provide unpaid care for a chronically ill, disabled or aged family member. The value of the services they give free to our society is estimated to be $375 billion a year. That is almost twice as much as the government spends on home care and nursing home services combined ($158 billion).

They give up their savings, sell their homes, often move into the same home with their frail loved ones to cut expenses, and face the constant danger of being fired for their divided concentration between family and work.

Full article on unpaid caregivers.

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May 09, 2011 | 6 comments | by

Surprise: Long-Term Care in California is Very Wasteful

$7 billion worth of services for 1 million of the state’s low-income aged and disabled citizens are provided by seven different departments, none of which are coordinated via a central database.

This makes it virtually impossible to properly coordinate or determine how much each service actually costs, or to prevent overlapping or duplicate services. The result is that many members of this population wind up getting treatment in nursing homes and ERs, even though the purpose of these programs is to provide care in an individual’s home. Moreover, rigid bureaucracies are discouraging hospitals, nursing homes and non-profit organizations from proposing new ideas that might cut costs.

Full article on California’s wasteful long-term care system.

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May 06, 2011 | 4 comments | by

No Doctors for the Elderly

[A] report, published this month in the Journal of the American Geriatrics Society, warns that as the proportion of older adults spikes from 12% to a projected 20% by 2030, caring for 70 million people 65 and older and 10 million 85 and older will be a challenge.

Earlier studies by physicians groups predicted 36,000 additional geriatricians will be needed by 2030. But the new report calls that “impossible and unrealistic.” Fewer than 320 physicians entered geriatric medicine fellowship training from 2004 to 2008, the report said.

Full article on the shortage of geriatricians.

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Apr 29, 2011 | 5 comments | by

You Just Can’t Make this Stuff Up

The Obama administration has misused its regulatory authority to prevent planned cuts to seniors’ health plans from taking effect one month before the 2012 election, Republican lawmakers alleged Thursday. The lawmakers take issue with the Department of Health and Human Services’ recent decision to spend $8.3 billion on a nationwide Medicare Advantage payment reform demonstration. The demonstration will increase payments to MA plans by 0.4 percent, they argue, helping offset the healthcare reform law’s $200 billion in cuts to the plans that cover 25 percent of seniors on Medicare.

Full article on the nationwide Medicare Advantage demonstration.

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Apr 19, 2011 | 5 comments | by

Worst Editorial of the Week Award

How could USA Today beat out Paul (if-you-disagree-with-me-you-must-be-evil) Krugman? I admit it was close. But consider:

‘RyanCare’ won’t work without Obama’s health care law.

Really? Last time I looked there was nothing in ObamaCare that would realistically lower cost, raise quality or even improve access to care. So who needs it? Ryan’s plan certainly doesn’t.

Though private companies are now insuring some seniors through a program called Medicare Advantage, this works only because it is subsidized by taxpayers over and above regular Medicare, and because companies cherry-pick the healthiest customers.

For “some seniors” read one-fourth of the Medicare population. As for “cherry-picking,” special needs MA plans cater to the sickest enrollees—costing about $60,000 a year. Do MA plans need an extra subsidy? More than half of Medicaid enrollees are in private plans that are saving Medicaid a lot of money. Get rid of Congressional micromanaging and MA plans can compete on a level playing field.

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Apr 15, 2011 | 6 comments | by

Does AARP Rule America?

This is Robert Samuelson, writing in The Washington Post:

Power is the ability to get what you want. It suggests that you control events. By these standards, AARP runs government budgetary policy, not presidents or congressional leaders. Obama says we must “win the future,” but his budget (and, so far, the Republicans’, too) would win the past and lose the future…

President Obama’s proposed 2012 budget … reflects a long-standing bipartisan consensus not to threaten seniors. Programs for the elderly, mainly Social Security and Medicare, are left untouched. With an aging population, putting so much spending off-limits inevitably means raising taxes, shrinking defense and squeezing other domestic spending – everything from the FBI to college aid.

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Feb 25, 2011 | 6 comments | by

Solution to Long-Term Care: Abandon Your Spouse?

After immigrating to New York City from China in the 1970s, Z. Y. Tung and his wife worked hard — he as a bank manager, she as a public school secretary — lived frugally and saved every penny they could for the next generation.

Until five years ago, when his wife, Wen Mei Hu, racked by bone-marrow cancer, had to be put in a nursing home, where the bills ran past $100,000 a year, threatening to quickly drain the couple’s life savings of $500,000. The nursing home told him not to worry: If he signed a document essentially refusing to support his wife of several decades, Medicaid, the federal insurance program for the indigent, would pick up the bill.

Full article on the tactic of spousal refusal.

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Dec 17, 2010 | 8 comments | by
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