Posts Tagged ‘baby boomers’

CDC Wants Baby Boomers Tested for Hepatitis C

Tuesday, May 29th, 2012

A latent legacy of baby boomers’ youthful antics could be hepatitis C. The number of boomers dying from a “silent epidemic” of hepatitis C infections is increasing so quickly that federal officials are planning a nationwide push for widespread testing.  Seventy-five percent of the estimated 3.2 million people who have chronic hepatitis C — and a similar number of those who die from the ailment are baby boomers.  Hepatitis C deaths nearly doubled between 1999 and 2007 to more than 15,000, according to a Centers for Disease Control and Prevention (CDC) study.  Hepatitis C is the primary infectious cause of cirrhosis and liver cancer and is the most common reason for liver transplants, according to the CDC.  In 2007, deaths from the disease surpassed those caused by HIV, and the numbers are expected to increase.

Baby boomers typically became infected in their teens and 20s, either via blood transfusions or with experimental injection drug use. Hepatitis C is often asymptomatic while it damages the liver, according to the CDC.  “It’s a bold action that’s become necessary because there’s a large population that’s unaware of their illness, becoming ill, and dying in an era of effective treatment,” said John W. Ward, director of the division of viral hepatitis at the CDC.

One in 30 baby boomers have hepatitis C, according to the CDC.  A single test of the members of that generation has the potential to identify 800,000 people with hepatitis C, which would prevent liver cancer and perhaps save 120,000 lives.  “We believe this cost-effective public health approach can help protect the health of an entire generation of Americans,” Ward said.  “It’s the fastest-growing cause of death in the U.S. and hepatitis C is the leading cause of liver cancer here.   “Most cancer deaths are going down and this is one of the few that continues to escalate.”

Many baby boomers have a potentially dangerous ‘it’s not me’ mentality about hepatitis C,  and this survey underscores how poorly most people in that generation understand that risk factors do apply to them,” said Ira M. Jacobson, M.D., AGAF, chief, division of gastroenterology and hepatology and professor of medicine, The Joan Sanford I. Weill Medical College of Cornell University, and physician co-advisor to the , American Gastroenterological Association’s (AGA) I.D. Hep C campaign. “Given the potentially deadly consequences of allowing hepatitis C to go undiagnosed, the AGA urges all baby boomers to talk to their doctors about getting tested.”

“The disease can’t be treated if people don’t know they are infected. With treatment, the chance of a cure is greater than ever,” said Michael Ryan, M.D., clinical professor of medicine, Eastern Virginia Medical School, practicing gastroenterologist with Digestive and Liver Disease Specialists of Norfolk, VA, and physician co-advisor to AGA’s I.D. Hep C campaign.  “I see every day the devastation hepatitis C can cause, especially to those who have lived with the disease for years without knowing it.  Baby boomers shouldn’t wait – they should talk to their doctors today about getting this simple test.”

Aging Population Stresses Medicare

Tuesday, May 1st, 2012

The aging population as millions of baby boomers turn 65 and a slowly recovering economy are stretching the long-term finances of Social Security and Medicare.

Soaring healthcare costs have put Medicare in a worse position than Social Security.  But both programs are likely to become insolvent in the coming decades, unless Congress takes action.  In 2011, the trustees projected the Medicare hospital insurance fund would run out of money in 2024.  Social Security’s retirement fund was projected to dry up in 2038, while the SSDI (Social Security Disability Insurance) fund was projected to be empty by 2018. Revised projections provided a more ominous assessment of the disability program, which has seen growth in applications as more disabled workers lose jobs and apply for benefits.  The non-partisan Congressional Budget Office said the disability fund will run out of money in 2016.  Social Security’s trustees have asked Congress to strengthen the disability system by reallocating money from the retirement program.  There is precedent for this since lawmakers did the same thing in 1994.

If the Social Security and Medicare funds ever run out of money, both programs would collect only enough money in payroll taxes to pay partial benefits.  “I don’t know how to make it clear to the public, but in my mind the sirens are going off,” said Mary Johnson, policy analyst for the Senior Citizens League. “I wouldn’t say we’re under attack, but we are in a very, very serious position.”

Tax revenues have started to rebound but they are still below pre-recession levels.  Also, this year’s cost-of-living adjustment (COLA) was much higher than the trustees projected it would be.  Last spring, the trustee’s projected that Social Security recipients would get a benefit increase of 0.7 percent for this year, but higher-than-expected inflation pushed it to 3.6 percent.  That was good news for seniors but it drained more resources from the system.

The trustees overseeing the programs include Treasury Secretary Timothy Geithner, Labor Secretary Hilda Solis, Health and Human Services Secretary Kathleen Sebelius and Social Security Commissioner Michael Astrue.  More than 56 million retirees, disabled Americans, spouses and children collect Social Security.  The typical retirement benefit is $1,232 a month; the average benefit for disabled workers is $1,111.

According to Geithner, the trustees’ reports demonstrate a real need for Congress to make substantial changes to entitlement programs, although he continues to oppose Republican proposals to partially privatize Medicare.  “We will not support proposals that sow the seeds of their destruction in the name of reform, or that shift the cost of healthcare to seniors in order to sustain tax cuts for the most fortunate Americans,” Geithner said.  Last year, the trustees said that the Patient Protection and Affordable Care Act (ACA) would extend the life of the Medicare trust fund — a point that Geithner emphasized.  According to Kaiser Health News, “One of the most important things we can do right now to preserve Medicare is to implement the Affordable Care Act fully and effectively.” Geithner said.  “Still, more needs to be done.”

The positive news for Medicare is that the pace of cost increases has eased a bit. “The trends in Medicare are more modest than the cost increases we have seen in the private commercial sector,” said economist David Blitzer, who administers Standard & Poor’s index of healthcare costs.  “But both Medicare and the commercial sector face rising cost pressures no matter what, and they seem to come from virtually all directions.”

Medicare sets prices on take-it-or-leave-it terms for hospitals and doctors, who complain it doesn’t pay them adequately.  That causes them to charge privately insured patients at higher rates.  Some experts say the longer Congress waits to act on the two programs, the more difficult it could become to make effective changes.  If Congress acts quickly, it can phase in changes over time, perhaps sparing current retirees while giving those closing in on retirement time to prepare.  Unfortunately, Washington has had difficulty making tough political choices that involve raising taxes, cutting benefits or some combination of both.  Advocates for seniors oppose benefit cuts, noting that Social Security’s finances are secure for decades.

“No one is saying you don’t have to maintain it,” said Eric Kingson, co-chair of the Strengthen Social Security Campaign and professor of social work at Syracuse University.  “What I worry about is reducing the benefit structure or radically changing the system.”  Kingson believes that Social Security can be shored up by simply increasing the amount of wages subject to Social Security taxes — an idea that the majority of Republicans in Congress oppose.  Social Security is financed by a 6.2 percent tax on an individual’s first $110,100 in wages and is paid by employers and workers.  Congress temporarily reduced the tax on workers to 4.2 percent for 2011 and 2012; the program’s finances are being replace through increased government borrowing.  The Medicare tax rate is 1.45 percent on all wages, paid by employees and workers.

Healthcare Employment on a Strong Growth Trajectory

Monday, April 16th, 2012

Healthcare employment will continue to grow much faster than employment in general, with the number of jobs in home care and other ambulatory settings expected to grow by more than 40 percent by 2020, according to a new study from the Center for Health Workforce Studies (CHWS) at the State University of New York at Albany.

Recent statistics from the Department of Labor focus on an expected hiring shift away from hospitals, as the system emphasizes preventive care and fewer admissions, said Jean Moore, CHWS director.  “For a long time, acute-care services tended to trump everything else, and that seems to be changing,” Moore said.  “There’s a growing awareness that it’s penny-wise and pound-foolish not to pay attention to preventive and primary care.”

Hospitals also are expected to keep hiring — nearly one million between now and 2020 — for a growth rate of 17 percent – as baby boomers age and need more inpatient care.

Physicians’ offices and other healthcare professionals are projected to hire 1.4 million people by 2020, a 36 percent increase.  The number of home health care jobs will soar by 872,000 – that’s an 81 percent growth rate.  The total number of ambulatory-care jobs will grow by 2.7 million by 2020, or 44 percent.

According to Kaiser Health News, healthcare is projected to be a growth industry, even if the Supreme Court strikes down the Patient Protection and Affordable Care Act (ACA).  “One of the things I wasn’t expecting was how much growth there was even during the recession,” Moore said.  “I would have expected some tempering of the growth.”

Although total U.S. employment declined by two percent between 2000 and 2010, healthcare employment rose 25 percent — demonstrating the sector’s expanding share of the economy.  By 2020, nearly one of every nine American jobs will be in healthcare.  When you consider that four million new health jobs will be created and people retiring from existing ones, more than seven million new workers will be needed.  That includes more than one million nurses.

According to the report, administrative healthcare jobs were cut during the economic slump from 2008 to 2010, a time when providers added nursing and other clinical positions.  Recent reports suggest that hospitals are hiring additional administrative staff to keep up with the increased regulation required by the ACA.  “They may be rehiring the people they had to let go when times were tight,” Moore said.

Healthcare employment totaled 14.19 million in October of 2011, an increase from the 13.88 million a year earlier, according to the Bureau of Labor Statistics.  Hospital jobs increased by 84,000 during the same time period.  Ambulatory services — physician offices, outpatient clinics and home health agencies added more than 173,000 positions.

Demand is strongest for general practitioners, nurse practitioners and physician assistants at private practices, community clinics, hospitals and long-term care facilities.  Demand also is high for physical therapists.  Some analysts predict that the shortage of physical therapists will increase as healthcare reform goes into effect.  Fewer uninsured Americans translates to a greater demand for physical therapy.  In response, medical schools are expanding and developing physical therapy training programs.

If anything, the physical therapist shortage will worsen, because in 2000, 15.6 percent were between the ages 50 and 64; 10 years later, 32 percent were in that age bracket, according to a report from the American Physical Therapy Association (APTA).  Unemployment among physical therapists remains remarkably low: In 2010, only 0.4 percent — one in 250 — of physical therapists were jobless.  “Nobody knows how accountable-care organizations and medical homes will shake out, but healthcare reform in general will decrease the number of uninsured, which will increase demand for physical therapists,” said Marc Goldstein, senior director of research for the APTA.  “Physical therapy programs are being developed or expanded, so the current level of 6,000 graduates annually should creep up.”

A survey by Sullivan, Cotter and Associates, Inc., a nationally-recognized compensation and human resource management consulting firm, over the last year, nearly 75 percent of respondents reported they increased their physician staffing levels; adding an average of 12 specialists and nine primary-care physicians to their staffs.  Another 75 percent said they plan to increase their physician staffs and mid-level providers over the next year.  “These data are consistent with the labor market shift in physician employment that has been occurring over the past few years,” said Kim Mobley, practice leader for physician compensation.  “We expect this trend to continue for some time.  This shift in the labor market has resulted in what has become a highly competitive market for physicians as organizations and physicians align to provide services in a high quality, more efficient manner.”

Cost of Alzheimer’s High in Dollars and Caregiver Devotion

Tuesday, March 13th, 2012

As baby boomers age, the cost of caring for those stricken with Alzheimer’s Disease has nowhere to go but up. By 2050, the cost of treating Alzheimer’s is likely to rise from $172 billion per year in 2010 to more than $1 trillion per year in 2050.  The disease could cost Americans $20 trillion over the next few decades, according to a report from the Alzheimer’s Association.

“We saw it coming.  We knew the numbers were going to be high in the number of people getting the disease.  We as an organization have been preparing for this,” said Nancy Rainwater, vice president of communications for the Alzheimer’s Association Greater Illinois chapter.  “But to think of trillions of dollars…just the amount of money was pretty staggering.”

The statistics were calculated using an analytical model based on data from research and national surveys.  Part of the problem lies in how successful treatment has become for other diseases, Rainwater said.  “We’re living longer, so that has a lot to do with it,” she said.  “There has been so much work in other diseases – cancer, diabetes, heart disease – and people are surviving those diseases.  But then there’s a higher risk, as people age, of getting Alzheimer’s.  You look at statistics of those diseases, and the rates of death have all declined, whereas Alzheimer’s disease has increased.”

Researchers believe that the number of Americans aged 65 and older with Alzheimer’s will more than double to 13.5 million by 2050 as the population ages.  By the middle of the 21st century, nearly 50 percent of people with the disease will be in its most severe – and costly – stage.  “People in the earlier stages don’t necessarily need as much care or support,” said Darby Morhardt, social worker and research associate professor at Northwestern University’s Cognitive Neurology and Alzheimer’s Disease Center.  “But as they deteriorate, as they decline, they have more and more difficulty managing their daily care, so that care needs to be provided by someone.  Often that’s where most of the money is spent, on those last years.”

What’s most stunning is Alzheimer’s human and financial toll. According to the Alzheimer’s Association’s 2011 Facts and Figures Report, 5.4 million Americans (one in eight older Americans) suffer from the debilitating illness.  Joy Johnston of Atlanta knows how difficult caring for a parent with Alzheimer’s can be.  Her father, Patrick, like more than five million other Americans, had been diagnosed with Alzheimer’s Disease.  “It can be heartbreaking at times,” Joy said in reference to caring for her father.  “You have to relearn your relationship with your loved one.”  Caring for a family member with Alzheimer’s can take a profound financial and emotional toll.  Nearly 15 million Americans are unpaid caregivers for those sick with dementia, according to the Alzheimer’s Association.  Do the math, and it adds up to about 17 billion hours of unpaid care valued at $202 billion in 2010 alone.

To help with the staggering cost of care, the Obama Administration has included $26 million in the proposed 2013 budget.  That money will go to education, outreach and support for families affected by the disease.

“Caregivers are often in a situation where their feelings and what they have to do are in conflict,” Dr. Peter Rabins said.  “That’s very hard for most of us because we’ve related with people that we love in a certain way. The disease forces a change in that relationship.”  Rabins, the director of psychiatry at Johns Hopkins School of Medicine, notes that medical bills can pile up quickly.  “That’s a tremendous financial challenge for many families.” Rabins said.

Money isn’t the only sticking point.  The emotional costs take root as soon as dementia is diagnosed.  Family members often begin grieving a death of someone who is still physically present but disappearing mentally.  “Those feelings of loss can become quite chronic,” Rabins says.

“It’s the sort of crisis that policymakers, clinicians know is happening,” said Len Fishman, CEO of Hebrew Senior Life, the largest provider of elder care services in Massachusetts.  “I don’t think the country has absorbed it yet and in a couple of decades when the number of Alzheimer’s cases has doubled, people will look back and say,  ‘Why didn’t we know this was coming?’”

National statistics suggest that it takes an average three to four people to help care for each Alzheimer’s patient living at home; approximately 11 million Americans are currently helping to care for the estimated 70 percent of Alzheimer’s patients who are able to be at home.  That statistic does not include paid caregivers.

Although Medicaid pays for Alzheimer’s day programs for some low-income seniors; Medicare does not.  As a result, many patients and their families must pay privately for Alzheimer’s care until they’ve spent enough money to qualify for Medicaid.  Medicaid does pay for long-term nursing home care, but not the less restrictive assisted living for seniors.

New HHS Program Seeks to Cure Alzheimer’s in 13 Years

Monday, February 13th, 2012

A national Alzheimer’s disease advisory council has set  preliminary goals and  recommendations for a national strategic plan to slow — or even bring to an end to — the expected rise in new cases as the baby boomer generation ages. The plan’s goal is to prevent and successfully treat the disease as soon as 2025. The objectives include enhancing care quality and efficiency, expanding patient and family support, enhancing public awareness and engagement, and improving data to track disease progress.

The plan is part of the National Alzheimer’s Project Act that was signed into law on recently by President Barack Obama. The law created the Advisory Council on Alzheimer’s Research, Care, and Services. The new law requires the secretary of the Department of Health and Human Services (HHS) and the advisory council to create and maintain a national plan to defeat Alzheimer’s.  Members of the council’s subgroups on long-term services and supports (LTSS), clinical care, and research are meeting to comment on and provide recommendations to formulate the plan’s draft framework.

The council’s members support alternatives to Medicare coverage and physician reimbursement to encourage the diagnosis of Alzheimer’s and provide care planning to individuals diagnosed with the disease and their caregivers. Additionally, quality indicators for the care and treatment of individuals with Alzheimer’s need to be formulated. The group proposed medical home pilot projects specifically designed to improve medical management for Alzheimer’s patients using grants from the Center for Medicare and Medicaid Innovation (CMMI).

More than five million Americans have been diagnosed with Alzheimer’s, a brain disease that causes dementia and affects primarily elderly people.  Some experts estimate that treating the disease costs the United States more than $170 billion annually.  Australia, France and South Korea already have comprehensive Alzheimer’s plans, and worldwide experts have been urging the United States to assume a leadership role.

“We want to demonstrate that as a country we are committed to addressing this issue,” Dr. Howard Koh, assistant secretary for health at HHS, said.  “We know the projected number of patients is expected to rise in the future.  We know there are far too many patients who are suffering from this devastating condition and it is affecting them and their caregivers,” Koh said.

Other experts believe that the 2025 deadline is too close and unrealistic.  “No one set a deadline for the ‘War on cancer’ or in the fight against HIV/AIDS.  We make progress and we keep fighting.  The same should be true for Alzheimer’s,” said Dr. Sam Gandy, an Alzheimer’s researcher at Mount Sinai School of Medicine.  “In my mind, that provides the unfortunate sense that we will have ‘failed’ if we don’t have a cure by 2025.”  The National Alzheimer’s Project Act provides no new funding for research.  Although some drug companies have compounds in clinical trials, researchers say they are just beginning to understand the complex disease, which develops without any symptoms for 15 to 20 years before any memory problems begin to show.  “This means that if we had, today, already in hand, the funding, recruitment and the perfect drug, the trial would still take 15 to 20 years,” Gandy said.

According to P.J. Skerrett, Editor of Harvard Health, “Like a powerful wave, the Alzheimer’s epidemic is expected to crest in 2050. At that time an estimated 16 million Americans will be living with this mind-robbing disease. (About 5.4 million Americans have Alzheimer’s Disease today.)  In an effort to head off the explosion, President Obama has signed into law the National Alzheimer’s Project Act.

This ambitious project aims to attack Alzheimer’s on several fronts:

  • Improving early diagnosis.  The brain changes that lead to Alzheimer’s disease probably begin years before memory loss and other problems appear. Earlier diagnosis could help families better plan for the future, and could be especially important if better treatments become available.
  • Finding effective prevention and treatment strategies.  Today’s treatments relieve symptoms for only a short time; none prevent or stop Alzheimer’s-related mental decline. New treatments that are more durable would be a huge boon to current and future Alzheimer’s sufferers.
  • Providing more family support.  Spouses and adult children are the primary caregivers for many people with Alzheimer’s disease. The day-to-day challenges of caring for someone with Alzheimer’s can be daunting. Many caregivers have no training and don’t know what resources are available to them. The project would provide better education and support for caregivers.” Skerrett said.

Mental Faculties Can Decline as Young as Age 45

Monday, January 23rd, 2012

An intensive new study has found that memory, reasoning and comprehension can start to decline as early as age 45. This finding runs counter to conventional wisdom that mental decline typically begins after the age of 60, according to the researchers “Cognitive function in normal, healthy adults begins to decline earlier than previously thought,” said study author Archana Singh-Manoux.  “It is widely believed that cognitive ability does not decline before the age of 60.  We were able to show robust cognitive decline even in individuals aged 45 to 49 years,” added Singh-Manoux, research director at INSERM’s Center for Research in Epidemiology & Population Health at the Paul-Brousse Hospital in Paris.

“These findings should be considered in the context of the link between cognitive function and dementia,” Singh-Manoux said.  “Earlier research shows small differences in cognitive performance at a young age to predict larger differences in risk of dementia in later life.  A thorough understanding of cognitive aging might make it easier to identify those at risk for dementia earlier in life,” she said.

Men aged 45 to 49 saw their reasoning skills decrease by nearly four percent; those aged between 65 and 70 saw their skills drop by about nearly 10 percent.  For women, the decline in reasoning neared five percent for those aged 45 to 49 and about seven percent for those 65 to 70, according to the research.

The study’s results are being published in the journal BMJ (formerly called the British Medical Journal). They demonstrate that the average, performance on cognition tasks deteriorated as the subjects aged. The declines were the most obvious among the oldest participants, who were aged 65-70 at the beginning of the 10-year study that began in 1997-99.

In conducting the study, researchers tracked the mental function of more than 7,000 British civil servants for 10 years.  They found that even the youngest participants, who were between the ages of 45 and 49 when the study began, showed slight yet measurable declines in short-term memory, mental reasoning, and verbal facility over the course of the study.  The declines were too small to be noticed in daily life and were detected only through tests the researchers gave the participants every three to four years.  But the findings may have implications for the prevention of dementia, and underscore the importance of taking care of our bodies and minds early in life, the researchers say.

“We, and others, have shown healthy lifestyles and good cardiovascular health to be important for cognitive outcomes,” Singh-Manoux said. “The fact that cognition declines early implies that midlife levels of these factors — health behaviors and cardiovascular risk factors and disease — might be important for cognitive outcomes later in life.”

Researchers haven’t decisively proven that cognitive decline in middle age is a  predictor of Alzheimer’s or other dementias; however, the evidence suggests that small changes in midlife mental function can become magnified later in life, says Francine Grodstein, Sc.D., an epidemiologist and associate professor of medicine at Brigham and Women’s Hospital, in Boston.  “There is a lot of evidence that (people) with cognitive decline are at highest risk of later developing dementia, so it is likely that preventing or delaying cognitive decline today will help reduce risk of dementia tomorrow,” said Grodstein, who wrote an editorial that accompanied the study.

“On an individual level this doesn’t mean very much — it certainly doesn’t mean that we’re seeing a lot of people with dementia in their 40s.  We know that’s not true,” Grodstein said.

Medicare Times Are a Changing

Monday, January 16th, 2012

Baby boomers may not like it — and whoever wins the White House this year — but the Medicare that our parents knew and love is destined to change. And it’ll be like it or lump it.

With more than 1.5 million baby boomers enrolling in Medicare every year, the program’s future is one of the most crucial economic issues for anyone who currently is 50 or older. Healthcare costs are the most erratic part of retirement expenses, and Medicare remains a great deal for retirees, who often get benefits worth significantly more than the payroll taxes they paid while working.  “People would like to have what they used to have.  What they don’t seem to understand is that it’s already changed,” said Gail Wilensky, a former Medicare administrator. “Medicare as we have known it is not part of our future.”

Consider these numbers.  Medicare’s giant trust fund for inpatient care is expected to run out of money in 2024.  When that happens, the program will collect only enough payroll taxes to pay 90 percent of benefits.  Additionally, researchers estimate that as much as one-fifth and even two-thirds of the more than $500 billion that Medicare now spends every year is spent on treatments and procedures of little or no benefit to patients.

Representative Paul Ryan (R-WI), chairman of the House Finance Committee, is leading the charge on changing Medicare.  Ryan’s current proposals will not impact people now 55 or older would not have to make any changes.  But how would it work?  Would it save taxpayers’ dollars?  Would it shift costs to retirees, who are least able to afford it?   Will Congress ultimately end traditional Medicare?  These questions are still waiting for answers.  “I’m not sure anybody has come up with a formula on this that makes people comfortable,” said health economist Marilyn Moon, who formerly served as a trustee overseeing Medicare finances.

The White House’s preference is to keep the existing structure of Medicare while “twisting the dials” to control spending, said Medicare trustee, economist Robert Reischauer of the Urban Institute think tank.

Ryan’s original approach would have put 100 percent of future retirees into private insurance.  His most recent plan, written with Senator Ron Wyden (D-OR), would keep traditional Medicare as an option, competing with private plans.

Writing for AARP, Ricardo Alonzo Zaldiver says that, “This could mean more Medicare recipients joining private insurance plans (currently, only about 25 percent of Medicare recipients are in private ‘Medicare Advantage” plans, while the other three-quarters participate in the traditional, government-run Medicare program).  A new voucher-for-private-Medicare plan would be available to anyone currently under 55.

“It could also mean keeping the existing Medicare structure but making certain tweaks to control spending.  Under President Obama’s healthcare overhaul, the Independent Payment Advisory Board could force Medicare cuts to service providers if costs rise above certain levels and Congress fails to act.  Obama has said he’ll veto any plan to cut Medicare benefits without raising taxes on the wealthy.  During failed budget negotiations last summer, he indicated a willingness to gradually raise the Medicare eligibility age to 67, revamp co-payments and deductibles in ways that would raise costs for retirees, and cut payments to drug makers.  ‘For the 76 million baby boomers signing up over the next couple of decades, it will pay to be watching.’”  President Obama has promised that he will veto any plan to cut Medicare benefits without raising taxes on the wealthy.

The Chicago Sun-Times offers this sage advice: “Fix Medicare, ignore scare talk.”  According to writer Steve Huntley, “I’ve contributed to Medicare every year of its existence. Yet, it’s a myth that seniors have paid the costs of their Medicare services, as demonstrated by the research of economists Eugene Steuerle and Stephanie Rennane of the Urban Institute think tank.  Their study showed that a two-income couple earning $89,000 a year would pay $114,000 in Medicare taxes during their careers but could expect to receive $355,000 in medical care in retirement. They could get prescriptions, doctor visits and hospital services valued at three times their contribution to Medicare.

“Medicare combined with Medicaid and Social Security add up to an entitlement time bomb —  they’ll consume all tax revenues by 2052, according to a Heritage Foundation analysis —  for the people who’ll be stuck with the bill: working Americans.  In 1950, there were 16 taxpaying workers for each retiree; by the time the baby boomers all retire, there will be two workers for each retiree. Entitlement reform has to happen.”

Why Are More Middle-Aged Women Killing Themselves?

Tuesday, August 9th, 2011

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found a 49 percent increase in emergency department visits for drug-related suicide attempts for women 50 years and older.  Women in the 40-69 age bracket are at greater risk of killing themselves than other women, according to research on age-specific suicide rates between 1998 and 2007.  In 2007, this age group comprised 60 percent of the 7,328 suicides reported among women.  The question is:  Why is this happening to middle-aged women?

There is a possibility that it is a question of numbers: One in four American adults has a treatable mental health condition; women in the 40-69-year-old age group represent one of the nation’s fastest-growing populations.  Alternatively, it could be a function of baby boomers’ elevated rates of substance abuse, a critical risk factor in suicide, said Julie Phillips, Ph.D., a social demographer and associate professor at Rutgers University.  According to Phillips, the age-specific rates were derived from data from the National Center for Health Statistics and the Census Bureau.

During the nine-year time period studied, suicide rates remained fairly stable for women younger than 40; for women older than 70, suicide rates declined.  Women 50 and older may be in crisis because pain and sleep disorders — widespread problems related to aging — often lead to increased use of prescription drugs, said Albert Woodward, Ph.D., the project director of SAMHSA’s Drug Abuse Warning Network.  According to the SAMHSA report, suicide attempts involving drugs to treat anxiety and insomnia rose 56 percent.  Woodward said that middle-aged women may experience depression because of declining health and other negative life events.   Loneliness and depression also are risk factors for suicide.  “Older women, especially in the U.S., are more isolated and separated from daily human contact outside of work and the internet,” said Ellyn Kaschak, Ph.D., emeritus professor of psychology at San Jose State University and the editor of the journal Women & Therapy.

Dr. LeslieBeth Wish, a psychologist and licensed clinical social worker in Sarasota, FL, has found  a surprising increase in suicide attempts by women aged between 45 and 54.  Women are susceptible to depression but older women may also be suffering from pre-menopause hormone fluctuations that can affect mood changes and depression.  According to Dr. Wish, women in their middle years are more aware of their mortality and may be disenchanted that they will never be happy.  Becoming an empty nester also is stressful.

Of greater concern is the 67 percent increase of women taking hydrocodone, and an astonishing 210 percent increase for women taking oxycodone.  According to SAMHSA administrator Pamela S. Hyde, J.D., “The steep rise in the abuse of narcotic pain relievers by women is extremely dangerous and we are now seeing the results of this public health crisis in our emergency rooms.  Emergency rooms should not be the frontline in our efforts to intervene.  Friends, family, and all members of the community must do everything possible to help identify women who may be in crisis and do everything possible to reach out and get them needed help.”

Because they are often members of the so-called “Sandwich Generation,” middle-aged women frequently discount their own needs as they organize commitments to jobs, marriages, kids, and aging parents.  Many say they don’t get enough sleep and eat too much junk-food.  According to medical experts, these habits — combined with soaring cortisol (a steroid hormone, or glucocorticoid, produced by the adrenal gland) levels — from stress — could mean this will be the first generation of women who don’t live five to seven years longer than males.

Medicare Changes Would Hit Lower-Income Seniors Hard

Tuesday, August 2nd, 2011

At a time when concern about federal deficits and the national debt are growing,  few quarrel with the need to reform Medicare.  The health insurance program for seniors and people with certain disabilities accounts for 15 percent of the federal budget – in third place behind Social Security and defense spending.  That share is rising as healthcare costs continue to rise and more baby boomers retire, threatening the program’s long-term solvency.

Several of the most prominent solutions under discussion largely derive their savings by shifting a greater share of the cost onto beneficiaries.  The plan sponsored by Representative Paul Ryan (R-WI) and passed by the House of Representatives would significantly cut Medicare spending by capping the government’s contribution to the program and transforming it into a system of “premium supports” given to seniors to help subsidize their purchase of private insurance plans, with seniors paying additional costs.  This would double out-of-pocket spending by the average senior to $12,500 each year, according to Congressional Budget Office estimates.

The ability of a majority of seniors to shoulder that burden appears dubious.  Just five percent of Medicare beneficiaries make $80,000 or more, a figure that includes any income from a spouse. For the 47 percent of seniors who are at or close to poverty, on average they are already spending nearly 25 percent of their budgets on healthcare, according to an analysis by the Kaiser Family Foundation.

“There’s this impression that there’s a great deal of wealth among the Medicare population, this image of wealthy seniors playing golf and enjoying their retirement years,” said Tricia Neuman, director of the Kaiser Family Foundation’s Medicare Policy Project.“But while some are lucky to do so, many are living on a fixed income, struggling to make ends meet…with really limited capacity to absorb rising costs.”

According to the Kaiser Family Foundation’s report, raising Medicare’s eligibility to 67 in 2014 would generate an estimated $5.7 billion in net savings to the federal government, but also result in an estimated net increase of $3.7 billion in out-of-pocket costs for 65- and 66-year-olds, and $4.5 billion in employer retiree healthcare costs.  In addition, the study projects that the change would raise premiums by about three percent both for those who remain on Medicare and for those who obtain coverage through health reform’s new insurance exchanges.  The study assumes both full implementation of the health reform law and the higher eligibility age in 2014 in order to estimate the full effect of both the law and the policy proposal.  In the absence of the health reform law, raising Medicare’s age of eligibility would result in an increase in the uninsured, according to other studies, as many older Americans would have difficulty finding affordable coverage in the individual market in the absence of Medicare.  With health reform, virtually all 65- and 66-year-olds would be expected to obtain alternative sources of coverage.”

Healthcare remains a major focus of budget talks on Capitol Hill,Senator Mark Kirk (R-IL) recently told the American College of Surgeons (ACS).  Every group that relies on federal funding should expect a 10 to 20 percent drop in that funding.  When Dr. L.D. Britt, president of the ACS, warned that such cuts could send some healthcare providers into a “tailspin,” Kirk responded that “the tailspin is the U.S. economy.  There is a new audience at play,” Kirk said, referring to U.S. creditors.  “The judgments they render, they are swift and severe.”  Kirk is optimistic that a solution to the country’s debt-ceiling dilemma “will have a way of concluding itself one day before the August 2 deadline.”

Baby Boomers Worry About Their Health, Memory Loss

Monday, July 25th, 2011

Baby boomers are more concerned with the ways that aging impacts their physical and mental health than the role it plays in their appearance.  Fully 65 percent of baby boomers – who are currently between the ages of 47 and 65 — expressed concern with their health, with 26 percent focused on retaining their mental faculties.  Just eight percent mentioned appearance as their biggest aging concern.

Boomers also are slightly less active than the previous generation.  Just 57 percent started a regular exercise program in 2010.  Of those who exercise regularly, 35 percent are walkers.  Nearly 4.3 million adults 50 or older used illicit drugs in the last year, according to a report from the federal Substance Abuse and Mental Health Services Administration.  According to the agency, substance abuse in this age group could create public health challenges over the next decade.

Boomers are in less agreement about whether their longer lives will be better than the previous generation: 49 percent expect a better life than their parents, while another 25 percent believe it will be about the same.  Another 26 percent expect that the quality of their lives will be worse than their parents.

Although younger adults believe that 60 is the start of old age, Baby Boomers strongly disagree.  The median age they cite is 70.  Twenty-five percent of Boomers insist you’re not old until you’re 80.  “In my 20s, I would have thought the 60s were bad, but they’re not so bad at all,” said Lynn Brown, 64, a retired legal assistant and grandmother of 11 living near Phoenix.  Boomers – 77 million strong — are celebrating their 47th through 65th birthdays in 2011.  In general, they are more optimistic about their futures than past generations.  Americans born in the population boom that followed World War II are more likely to be energized about the positive aspects of aging, such as retirement, than worried about the negatives, such as poor health.

The findings that midlifers who are worried about aging are focused more on their health over physical looks may seem surprising to some — but then when you see stunning boomer role models like Susan Sarandon and Helen Mirren, it all makes sense,” said Cindy Pearlman, entertainment writer for the Chicago Sun Times and best-selling author of “The Black Book of Hollywood Beauty Secrets” series, and regular contributor to LifeGoesStrong.com’s Style channel.  “Even in a town like Hollywood, where you’d expect nips and tucks everywhere you turn, many celebrities are saying that the secret to looking great at any age is accepting the inevitable changes that the years bring, while staying in shape and embracing your own sense of style.”

Many baby boomers have no problem working till they’re 65 or 70 as long as they’re not doing heavy lifting. A majority are enthusiastic about aging and have less concerns about physical ailments than their parents’ generation.  Tom Beumont understands that the current status of Social Security will require him to work longer, but he is fine with that.  “We kind of learned from our parents…we have a more diverse background and we also exercise more so that’s more important to us”, Beumont said.

Cindy Black, a nurse, said a lot of the people she sees at a clinic work too much. “I think we are burning the candle at both ends. They went to bed earlier back then and drank more water,” Black said.  Black said that while baby boomers exercise more than their parents and drink and smoke less, their fast paced lifestyle has a price.  According to Black, Boomers might end up working themselves to death, literally.  “They laugh when I tell them this but they need to go to bed by 10 o’clock.”

Baby Boomers are also concerned about their independence. Boomers primarily worry about losing their independence because of illness, while 44 percent are concerned about experiencing memory loss.  Approximately 41 percent have concerns about remaining financially self-sufficient.  The hedonistic Boomer generation forever changed the social scene with the dawning age of the flower child, and the explosion of the sexual revolution during the 1960s and 1970s.

Just 18 percent of Boomers worry about dying, while another 22 percent are moderately concerned about it.  More than two-thirds expect to live to at least age 76, and one in six expects to live into their 90s.