Aging in America

America is aging. By 2050, the number of seniors in America will pretty much double — from 43 million to 85 million — and will grow from about 20 percent of the population to nearly 40 percent. In Washington’s 8th Congressional District, we’re not much different: nearly half of our residents are 40 years old and older right now. How do we prepare for this future?

All too often, we talk about the aging of the population as a pending disaster — a “silver tsunami” that places burden and strain on our workforce and benefits, healthcare, and the economy. Something we’re powerless to change. But we could instead see the Aging of America as a potential “golden dividend”: more people with experience and judgement in the formal and informal workforces, new opportunities for healthy aging, new markets for elder goods and services. Which it is — disaster or dividend — depends on our choices of policies and leadership to ensure the answer is “dividend.”

As a “Med/Peds” physician (fully qualified in both internal medicine and pediatrics), I’ve taken care of patients from “cradle to grave.” As a public health doc, I’ve seen what’s needed beyond the clinic walls for neighbors to successfully age-in-place in the community. As a Health Policy Fellow, I’ve been privy to the unnecessary bureaucratic complexities and missed opportunities in our current laws and regulations. And as a friend, I’ve supported friends as they cared for aging parents with Alzheimer’s disease.

What do we need? Frankly, we need to do more than ever before, and urgently. Right now, the Trump Administration is launching attacks on key elements for successful aging, such as earned benefits and healthcare, and is not investing sufficiently in new research and senior opportunities. We need leaders and elected officials who will commit to policies and investments for healthy aging. Here’s what I propose:

Earned Benefits and Wages
♦ Send the clear message, routinely and repeatedly: “Hands off our earned benefits.”

♦ Social Security: Protect Social Security against privatization, and “scrap the cap” on Social Security wages to ensure solvency without raising the retirement age.

♦ Pensions: Oppose legislation and regulatory changes that would negatively impact pensions and defined benefits. Support funds like the Pension Protection Act that help protect pensions from going broke or otherwise not paying their beneficiaries. Oppose ways to fix years of misguided policies and miscalculations in some multi-employer pension plans that artificially and unnecessarily pit current workers against retirees. Remember: seniors spend a higher proportion of income on goods and services, so pensions and Social Security feed local economies.

♦ Wages: Build strong, middle-class jobs with good wages that provide a lifetime of economic stability, so seniors start their later years with adequate savings. Support basic worker protections throughout working life: a federal minimum wage that’s livable; paid sick leave, and overtime rules that pay workers fairly.

Health Services and Solutions
♦ Medicare: We love our Medicare, but it can be better. Improve Medicare for healthy aging by covering eyes, ears, and teeth and raising coverage from 80 percent to 100 percent to eliminate the “Medi-Gap” and the need for expensive supplemental insurance. Lower drug prices by empowering Medicare to negotiate for prices that are low and reasonable. Expand Medicare innovations like in-home tele-medicine, so that people in the 8th District —especially those in more rural areas—can get the right care at the right time.

♦ Support for hardships and caregivers: Make earned benefits work more seamlessly with additional supports for older people struggling with health and income hardships, without requiring seniors to become destitute before accessing help. Reduce bureaucratic barriers to smoother transitions to assisted living and protect the Medicaid dollars that support our seniors in nursing homes. Give tax credits to help ease the financial burden of families who care for elderly and disabled family members at home.

♦ Aging-in-place solutions: Recognize age-related challenges that affect activities of daily life. Support innovative technologies that assist seniors in daily tasks and connect them remotely to experts and services. Invest in “built environments” that are senior-friendly, such as housing adaptations that decrease risk of falls—falls that cost Medicare an estimated $31 billion annually.

♦ Biomedical research: Invest more heavily in biomedical research for diseases that affect the elderly, such as Alzheimer’s disease, Parkinson’s Disease, and cancer. Alzheimer’s affects more that 5 million Americans today, and may reach 16 million by 2050. We must develop what we don’t have today: diagnostic tests, treatments that actually slow the progression of disease, and a better understanding of prevention. Form public-private partnerships with initiatives such as the Bill & Melinda Gates Foundation’s Dementia Discovery Fund, in order to accelerate discovery.

Economic Opportunities
♦ Volunteerism and care-giving: Recognize that volunteering and informal care-giving contributes an estimated $162 billion to our economy each year. Healthy and active seniors already contribute greatly to this dividend, and will do so even more as the senior population grows.

♦ Senior consumer goods & services: Respect the “economic weight” aging seniors will bring to the economy, and promote the growing market for senior consumer goods and services—something that’s been called the elusive “$15 trillion prize” by Bloomberg BusinessWeek. Support small businesses that can deliver local services by ensuring access to credit, loans, and the kind of technical assistance that will help them grow.

So what will you choose — dividend or disaster? Golden Dividend or Silver Tsunami? I vote for the Golden Dividend. I hope you will, too.