Giving a Voice to Older Adults in the Health Care Conversation

As a school administrator in the 1940s, Ethel Percy Andrus saw that America’s retired teachers were struggling to get by with miniscule pensions and no health insurance. Her relentless fight to find a company willing to underwrite coverage for teachers led to the formation of the National Association of Retired Teachers, which evolved into AARP. It was her determination to shed a light on the real economic needs – and the future economic needs – of these teachers that gave them a sense of security and a future. She was able to reflect those needs and secure coverage, justice and a future for these dedicated teachers.

Fast forward 50 years. AARP now serves the needs of over 40 million older adults: working adults, downsized boomers, caregivers, single parents, seniors and the frail elderly. Boomers caring for their aging parents are on the front lines of the battle against overwhelming health care costs, and they are turning to AARP for clarity around the issues of health care reform. More boomers and seniors are online than ever before, and they are participating in AARP’s online network and reading their publications. These adult caregivers want clarity and parity and are willing to give a bit to make sure their families are protected. They want to make sure that the donut hole is closed, that their families can get insurance for pre-existing conditions and that their Medicare benefits are protected.

Ethel Percy Andrus and I went to the same university, received the same degree and spent our lives working toward the same cause. We were bi-coastal and spent much of our lives fighting for the intellectual integrity, justice and economic security of older adults. My focus has been on new media, aging and entrepreneurship. As the founder of SeniorNet.org in l986, ThirdAge Media in l996 and Mary Furlong Associates in 2002, I have spent the greater part of my business life listening to the needs of older adults. I know the issues from both a business side and a human side, and the issues are complex.

In October, I spent a day with over 250 women at the WomanSage Conference. Fittingly, the conference theme was “Renew! Refresh! Reinvent!” as many attendees had received a pink slip and were trying to get their economic lives back on track. Many of them had lost their jobs or were underemployed; two-thirds did not have health insurance. These women were still a few years shy of being eligible for Medicare, but were facing the challenge of coming up with $600, $800 or even $1200 a month for health insurance.

One of these still-employed women shared her exasperating mission for health care coverage. At 46, she to have a routine upper endoscopy and the doctors discovered a minor condition that was easily fixed with a simple surgical procedure. Fast forward five years, when she left her job as a corporate marketer to become a full-time caregiver for her elderly parents. She went to purchase health insurance and the agent, a friend, was unable to secure it because the minor condition she had resolved through surgery five years earlier was considered to be a precursor to esophageal cancer. When she finally found a small insurer that was willing to take her on, the cost was $895 a month.

She is not alone. Boomers have been hit hard by the recession. When unemployment benefits run out, they are hard-pressed to find work at the salary and the benefit level to which they have grown accustomed. There is a lot of conversation about Medicare and seniors but the unique challenges facing older women are often overlooked. Who are these forgotten women? They are living alone; their children have moved out; they are experiencing complete ennui after many years of living for the job. For these women, the cost of COBRA benefits is huge, and they often can’t afford it after a few months, instead going through their 401K to pay for health care expenses.

When these women talk about health care, they told me that their solution, the only option that so many Americans have when they are sick or injured, is to go to the emergency room. We all know what that does to health care costs. What these women want and need is the option to enroll in health care coverage at a reasonable price, which for a single older woman would be about 10 percent of her monthly income.

When we listen to the needs of the caregiver, we dispel the myth regarding the greatest “wealth transfer” of our time. We learn that in some cases caregiving costs run up to $160,000 a year for two parents, overleveraging the family income within two years. The adult children have family meetings to discuss what will happen when the VA benefits run out in less than a year, and the parents still need round-the-clock care. Maybe the children use a reverse mortgage for a few months, and then all seven kids chip in to pay the rest of the caregiving costs.

Ethel Percy Andrus would be proud of today’s AARP leadership, which continues to reflect the complex needs of the members. She would want to know the nuances of the pain that the members feel: the frail senior who needs the protection of Medicare and Social Security; the downsized boomer who needs a new path toward a career and some protection for health care during the transition and beyond; the stressed caregiver who is caring for elderly parents and is also putting in 30 hours a week managing all of the paperwork and benefits. All of the needs of these constituents need to be represented in the proposed health care reform plan, which is why AARP is advocating for reform that will improve health care coverage for older adults. Our flawed health care system desperately needs reform, and the proposed changes would benefit older adults across the board:

• Restrict age rating for insurance premiums, keeping insurance affordable for older adults
• Close the “donut hole” prescription drug coverage gap in Medicare Part D and make prescription drugs more affordable while the gap is gradually closed
• Make preventative services free, such as mammograms and colonoscopies
• Create voluntary insurance program to cover expenses of long-term care
• Implement community rating principle so that individuals with pre-existing conditions are not denied coverage or dropped if they get too sick
• Eliminate the lifetime cap that limits how much an insurance company will spend on a patient
• Expand health care workforce in rural and underserved areas
• Eliminate scheduled payment cut to physicians who treat Medicare patients
• Create incentives for hospitals to improve quality of care and reduce readmissions (Source: healthreform.gov and aarp.org)

  AARP has always taken the stand of trying to educate members about the issues, and the time has never been more perfect for the members to respond. The social media tools of blogging, forum discussions, informal polling and surveys make it possible for all of us to take a stand on the most important domestic debate of our lifetime. We have an educated, connected and web-savvy group of older adults and we need to listen to their perspectives. The AARP website is the perfect place for the discussion to take place.

  To learn more about this critical issue, visit the AARP’s website at Web site and take part in this important conversation in their online community.

  
  Mary Furlong, ED.D., is the Dean’s Executive Professor of Entrepreneurship at Santa Clara University; she was the founder of SeniorNet.org, ThirdAge.com, and Mary Furlong and Associates. She is the recipient of the ASA Leadership Award in Aging in 2008 and the Time Digital Top 50. She spends her time helping entrepreneurs, businesses and nonprofits develop products and services for older adults.