Will You Help Fix the Retirement Crisis? It Will Affect All of You, Eventually

  Economy  

AlterNet / By Don Hazen

Editorial: Will You Help Fix the Retirement Crisis? It Will Affect All of You, Eventually

Covering the retirement crisis is our top priority in 2014.

Photo Credit: Shutterstock.com/Aletia

December 27, 2013  |  

...

Unless we get serious and do something about it now, we are quickly heading for a massive retirement crisis—not just for the huge population of aging boomers, but for generations to come. It has to be fixed, but our leaders are intent on making it worse. 

Two-thirds of working Americans will not be able to maintain their standard of living when they retire, sending many into poverty or near-poverty. And none of this is our fault. Millions of boomers, Gen Xers and so on have not been able to save for the future. Pensions have disappeared. Wages have been flat. Healthcare costs have spiraled. Private plans like 401(k)s and 403(b)s haven't kept up. There have been recessions, waves of high inflation and unemployment. 

Social Security and other benefits have to be fixed and expanded. The frustrating part is that it is all easily fixable. But the political establishment from Barack Obama to the billionaire propagandist Pete Peterson to the Washington Post editorial page, are hard at work to make it worse, by cutting benefits instead of expanding them.

AlterNet has pledged to make covering the retirement crisis a top priority in 2014. 

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To sum up the problem and the solution, here are nine key facts about the crisis to keep in mind:

1. Americans over age 65 are  projected to increase from 14 percent of the current population to about 21 percent of the population by 2035.
2. The Social Security Trust Fund had a  surplus of $2.54 trillion in it at the end of 2011, and is projected to be  solvent until 2033.
3. Though most people don't know it, Congress has cut Social Security payments by 24 percent  since 1983, via delayed cost-of-living increases and higher taxes.
4. One-third of seniors live only on SS benefits, which is an average of only $1,274 a month per retiree. For two-thirds of retirees, the Social Security benefit is  more than half of what they live on.
5. The wealth gap is skewed extraordinarily by race. For every dollar a white person has in savings, a Latino person has only 6 cents and a black person has only 5 cents.
6. Gender is a huge issue: Seven out of 10 seniors living  under 125 percent of the federal poverty line ( $14,360) are women.
7. Social Security is also the largest federal government program  helping children, with 6.5 million recipients, totaling 8 eight of every 100 children in the U.S. in 2012.
8. Many people don't realize that no Social Security taxes are paid on incomes over $117,000—so the wealth get off very easily. Slightly raising Social Security payroll taxes would  more than cover and sustain the expansion of Social Security.
9. Huge numbers of Americans support Social Security reforms, with  87 percent of the population in favor of scrapping the $117k cap and  82 percent in favor of slight Social Security tax increases.

Why do wealthy power brokers want to cut Social Security taxes which they themselves grossly underpay? That is the question at hand. There is no other issue in America where those in power are so out of sync with the voters and the people. 

A series of simple, fair-minded fixes would not just make Social Security solvent for decades, but would allow us to expand the benefits so no Americans fall into poverty as they age. That is a worthy goal for all of us, don't you think?

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Don Hazen is the executive editor of AlterNet.

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Your Terrifying Retirement Future: Why Millions Risk Sliding Into Poverty As They Age

AlterNet / By Steven Rosenfeld

Your Terrifying Retirement Future: Why Millions Risk Sliding Into Poverty As They Age

Low wages, low or no savings, and low Social Security benefits. The future is not bright, especially for women and minorities.

 

Photo Credit: Image by Shutterstock

December 23, 2013  |   

 

 

 

(Editor’s note: This AlterNet interview is part of our expanded focus on modernizing Social Security, which, to us means increasing benefits where needed and ensuring its long-term funding. Dr. Maya Rockeymoore is a longtime advocate for racial justice. She is chair of the National Committee to Protect Social Security and Medicare and president and CEO of Global Policy Solutions. She spoke to AlterNet’s Steven Rosenfeld about how America’s retirement crisis affects communties of color and women.)

AlterNet: There’s a lot about America’s growing retirement security crisis that’s not fully appreciated by the public, especially when it comes to the harmful impacts on communities of color and women. Tell us how unless we as a country have an honest discussion about this, and expand Social Security, that tens of millions of people will literally slide into poverty as they age.

Maya Rockeymoore: There is no way we cannot have this discussion given the nation’s changing demographics. The rising majority will be primarily Asian-American, African-American and Latino-American. The fact of the matter is those people are already here. Of all the babies born today, a majority are children of color. By 2019, a majority of all children under the age of 18 will be from these racial and ethnic, quote-unquote, minority groups. And by the by 2043, the nation will be majority minority.

The benefit cuts that austerity proponents are talking about today will be fully shouldered, if they ever were to pass, by a nation that looks very different than it does today. And so when you’re talking about cutting Social Security now, most proposals are not talking about cutting it for current retirees. They’re talking about implementing changes that would affect today’s youth. You should understand that you are primarily cutting benefits for a generation of young people who the odds are stacked against them having any type of retirement security.

AlterNet: And that’s on top of what’s shaping up as a retirement crisis for baby boomers.

Maya Rockeymoore: We’re already a nation experiencing a retirement crisis. The private sector mostly does not have defined benefit pensions anymore. And 401Ks have been a failure. What many people fail to appreciate is that communities of color have less access to retirement savings vehicles on the job than do white Americans. And unfortunately, even when they do have access, they are either more likely not to take advantage of it, or more likely to take loans out of it. So what we have is a population, that by virtue of their inconsistent relationship with the labor market, which is rooted in historical inequities, are already disadvantaged when it comes to retirement security.

That insecurity is most clearly represented by the racial wealth gap. For every $1 in wealth owned by the typical white family, the typical African-American family has five cents, and the typical Latino family has six cents. And layered on top of that are the effects of the Great Recession, and the effect of the housing crisis that stripped many households of color of any wealth that they may have accumulated through real estate.        
     
AlterNet: I know those figures and trends. They’re really shocking. And because as women tend to live longer than men, they’ll be taking the largest hit.

Maya Rockeymoore: That’s another feature of the story, because when you look at women of color, they actually earn less than white women. So when you often hear about the pay gap between women and men—and that about 77 cents earned by women for every dollar that a man makes—it’s actually lower for African-American and Latino women. They get paid less. And they have less wealth. In fact, many households headed by women have negative wealth—debt. That research has actually been conducted by Mariko Chang, and I urge you to read about the lack of wealth of women of color.

So when you’re talking about retirement insecurity, it’s a triple threat for women of color, who are discriminated against in the labor market, have lower rates of pay, come from households with low to no wealth, and negative wealth in many instances, and often do not have access to private retirement benefits. And then, of course, shoulder the burden of children, and that having a wealth-depleting effect on their personal economic security. So heading into retirement, many women of color, Social Security is all they’ve got. So when you’re talking about cutting benefits, you’re talking about further eroding any kind of economic security for households that are already extremely vulnerable. And have been exploited and vulnerable over a lifetime of work.

We like to think that some of these decisions are deracialized, and that maybe that the policy makers who are opposing these things are not thinking in terms of race. But I think we do ourselves a great disservice when we do not consider race and ethnicity or class. Because when we ignore the impact of proposed policy changes on differently situated groups, we can often make things like poverty much worse. And that undermines and erodes our democracy and we can’t afford to do that.

AlterNet: I completely agree. I wrote a piece on the Senate Finance subcommittee’s recent hearing on Social Security. What I didn’t put in it was how a Democratic senator said, ‘My gosh! What’s a family that’s making $150,000 a year to do?’ I thought, ‘Wow, $150,000 a year is the family you’re concerned about? And this is from a Democrat?’ What do you think is needed to reframe this discussion, so the debate can be forced to talk about solutions that affect people with real needs?

Maya Rockeymoore: I think there are two things that we need to say. The first is there is an economic argument to be made. For most of the 20^th century, America did well. If we expect to do well in the 21^st century, then we can’t erode and undercut the economic prosperity of the nation. And regardless of race and ethnicity, average Americans are pretty bad off. But when you layer on the fact that we have more people coming from households with low to no wealth, becoming a majority of the population—and we expect to still be a superpower? Can we expect to still be a superpower? I would argue no. The fact of the matter is we’re all in this boat together. And if we’re committed to national economic prosperity, and the growing productivity of the nation, we need to consider how we actually produce systems that can support the productivity of workers. Social Security has proven its value and its worth for reducing poverty, and providing insurance benefits for families throughout the 20^th century. It can continue to do so for the 21^st century if policy makers remain committed to the value of social insurance.

The second thing is the democratic argument. Our democracy cannot stand with gross wealth inequality. There may come a time, if we let these trends and trajectories continue, that the institutions that were created will not be able to stand under the weight of the despair that will be created by policies that undercut the economic security of the vast majorities of Americans. But especially those who are already vulnerable. We cannot expect that our democratic institutions will be considered valid; that they will continue to be relevant when the vast majority of our population lives in squalor and poor circumstances. And so, if we care about prepetuating this great democratic experience we call the United States of America, we should care about making sure that we are producing policies that are in the best benefit for the majority of the nation—but especially those who have been vunerable traditionally.

And there’s a moral argument. And that argument is that we should and can do better than what’s being proposed. And that we are better as a nation when we pull together to move forward to define progress for the world. The fact of the matter is Social Security of one of our great pillars of progress. We created it and we had the foresight to realize that workers could come together to contribute to their own security. And we need to continue to perpetuate it, because that’s what we do as Americans. We are problem solvers and we know how to put together systems that work. And some policy makers have forgotten that.

AlterNet: There’s one more thing I wanted to ask about. One under-appreciated piece of this is how immigration reform would contribute to solving this crisis. Isn’t that right?

Maya Rockeymoore: Yes, that’s correct. First of all, immigrants already contribute a whole heck of a lot of money to Social Security. It’s through undocumented labor and using fake Social Security numbers that do not match. These individuals are paying taxes and they are paying Social Security taxes. And they are primarily Latino in origin and coming from various Latin American countries. And these are individuals who tend to have larger families. We have been talking for the past several decades about the growing imbalance between the number of workers to retirees, and the fact of the matter is we have a nationwide solution staring us straight in the face. We’ve got a population that’s already contributing and eager to contribute more to the American economy. And this is a population that certainly tends to value family. And have larger families. And if we simply recognize this population and do right by them with regards to honoring their contribution to our economy, we can go a significant want toward addressing the issue of Social Security solvency.

And, of course, the other part of that is scrapping the cap [where only the first $117,300 of income is taxed for Social Security] will get us all the way there.

AlterNet: Yes, I’m well aware of that. And as pollster Celinda Lake pointed out, most people are not even aware there’s a cap because they do not earn above six-figures.

Maya Rockeymoore: That’s right. You may have heard me use the term fiscal racism. But it’s also fiscal sexism. And how is it—and I say this tongue-in-cheek—that the policy makers coming up with these austerity proposals, who tend to be overwhelmingly male, and overwhelmingly white, would come up with policies that would just happen to stick it to women and people of color? And low-income people? These are overwhelmingly well-to-do people who think that a family making $150,000 is struggling, and they are just out of touch with the reality of how Americans are living, especially Americans who have come from traditionally disadvantaged populations.

I think that we have to drive home that there are racialized, and gendered, and class implications to the policies that they are proosing and it’s simply unacceptable. What they are proposing will actually exacerbate income inequality in this country.

AlterNet: I noticed that. I wrote a piece that talked about George W. Bush’s former policy director at the Social Security Administration spoke at a Senate hearing and said that we should have a floor—nobody gets less money than the federal poverty level—and the price for that is cutting benefits in the middle. That idea was seen as great progress as it wasn’t just cut-cut-cut. But all of this is so far from what really needs to happen.

Maya Rockeymoore: That’s the whole point. Even Democrats that take that stand are actually protecting the benefits of the privileged. They are unwilling to acknowledge that their policies are perpetuating the advantages of the 1 percent. They are unwilling to explain to the American people, that they represent, that are actually not representing them. They are actually sticking up for the big guy and sticking it to the little guy and girl… Nobody blinks because they don’t realize their own bias.

It’s like the bias of the Washington Post editorial board, who seems to care greatly that the wealthy have limited resources. Well, gee—what about the average Joe? What about the average worker who’s struggling to make ends meet? The wealthy have quite a bit of resources that can go to solving our problems. And not only that, they’re deserving of being hit up on this, because of the fact of the growth of unearned income. Those are resources that have skirted the system. Social Security taxes payrolls. Basically, they’ve found a way to get away with not paying their contribution to Social Security. That has exacerbated the Social Security solvency and finaning issue. And yet the nature of their solution is not about recouping lost wages, it’s about cutting benefits for people who have been faithfully making their contributions. It’s just backwards and it needs to stop.

Steven Rosenfeld covers democracy issues for AlterNet and is the author of "Count My Vote: A Citizen's Guide to Voting" (AlterNet Books, 2008).

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Feeding America

Hunger In America

Senior Hunger

    

Senior Hunger

The number of older adults is projected to increase over the next decade and continue to rise in the following decade. In 2040 there will be 79.7 million older adults, more than twice as many as in 2000.  Additionally, the senior population is becoming increasingly diverse.  Between 2012 and 2030, the white population of 65 and plus is projected to increase by 54% compared with 125% of older minorities. ^[i]  
These changing demographics will have profound impacts on the demand for social services, especially the need for adequate and culturally appropriate nutrition services.  Seniors may have unique nutritional needs and challenges that separate them from the rest of the population and must be considered.

Emergency Food Assistance ^[ii]

• Nearly 3 million elderly persons are served by Feeding America each year.  18.6 percent of client households have at least one member who is age 65 or over, and 52 percent of these households are food insecure - an estimated 1.2 million households.
• Among all clients served by Feeding America, 8 percent were seniors age 65 or over, while 14.2 percent of adult clients interviewed at emergency feeding programs were age 65 or older.
• Among all client households with at least one senior, 10.5 percent use senior brown bag programs, 16.5 percent attend senior nutrition sites (such as senior centers that serve lunch) and 6.6 percent receive home-delivered meals or meals-on-wheels.
• 30 percent of client households with seniors indicated that they have had to choose between food and medical care and 35 percent had to choose between food and paying for heat/utilities.

Food Insecurity

• In 2012, 2.8 million (8.8%) households with seniors experienced food insecurity. 1.1 million (9.1%) households composed of seniors living alone experience food insecurity. ^[iii]
• In 2011, 4.8 million Americans over the age of 60 were food insecure. This constitutes 8.4% of all seniors. ^[iv]
• The number of food insecure seniors is projected to increase by 50% when the youngest of the Baby Boom Generation reaches age 60 in 2025. ^[v]
• Seniors are more likely to be food insecure if they : ^[vi]
• Live in a southern state
• Are younger
• Live with a grandchild
• Are African American
• Are Hispanic

For seniors, protecting oneself from food insecurity and hunger is more difficult than for the general population.  For example, a study that focused on the experience of food insecurity among the elderly population found that food insecure seniors sometimes had enough money to purchase food but did not have the resources to access or prepare food due to lack of transportation, functional limitations, or health problems. ^[vii]
 

Poverty

• In 2012, 9.1 percent of seniors (3.9 million older adults age 65 and older) lived below the poverty line. ^[viii]
• In 2011, under the Supplemental Poverty Measure, seniors make up 12.6% of people in poverty as compared with 7.8% under the official measure. ^[ix]
• In 2011, under the Supplemental Poverty Measure, medical out of pocket expenses (MOOP) increase the poverty rate among seniors (8.0% excluding MOOP, 12.6% including). ^[x]

Federal Nutrition Assistance

• Elderly households are much less likely to receive help through the Supplemental Nutrition Assistance Program (SNAP) than non-elderly households, even when expected benefits are roughly the same. ^[xi]
• Seniors require greater consideration towards their health and medical needs that can become compromised when there is not enough food to eat.  A study which examined the health and nutritional status of seniors found that food insecure seniors had significantly lower intakes of vital nutrients in their diets when compared to their food secure counterparts.  In addition, food insecure seniors were 2.33 times more likely to report fair/poor health status and had higher nutritional risk. ^[xii]

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[i] U.S. Department of Health and Human Services, Administration on Aging.  (2012). A profile of Older Americans: 2012.

[ii] Cohen, R., J. Mabli,, F. Potter & Z. Zhao. (2010). Hunger in America 2010.  Mathematica Policy Research, Feeding America. 

[iii] Coleman-Jensen, A., Nord, M., & Singh, A. (2013). Household Food Security in the United States in 2012, Table 2. USDA ERS.

[iv] Ziliak, J.P. & Gundersen, C. (2013.) Spotlight on Food Insecurity among Senior Americans: 2011. National Foundation to End Senior Hunger (NFESH).

[v] Ziliak, J. & Gunderson, C. (2009, September). Senior Hunger in the United States: Differences across states and rural and urban areas.  University of Kentucky Center for Poverty Research Special Reports. Retrieved October 7, 2010. http://www.ukcpr.org/Publications/seniorhungerfollowup.pdf[v]

[vi] United States Department of Agriculture/Office of Analysis, Nutrition, and Evaluation.  Elderly Participation and the Minimum Benefit.  November 2002.

[vii] Wolfe WS, Frongillo EA, Valois P. (2003).  Understanding the experience of food insecurity by elders suggests ways to improve its measurement.  J. Nutr. 133:2762-2769, 2003.

[viii] DeNavas-Walt, Carmen, B.D. Proctor, J. Smith.  U.S. Census Bureau.  Income, Poverty, and Health Insurance Coverage in the United States:  2012.  September 2013.

[ix] The Research Supplemental Poverty Measure: 2011. (2012). U.S. Census Bureau.

[x] Ibid.

[xi] Ziliak, J. & Gunderson, C. (2009, September). Senior Hunger in the United States: Differences across states and rural and urban areas.  University of Kentucky Center for Poverty Research Special Reports. Retrieved October 7, 2010.

[xii] Lee JS, Frongillo, Jr. EA. (2001).  Nutritional and health consequences are associated with food insecurity among U.S. elderly persons.  J. Nutr. 131: 1503-1509, 2001

Here’s what chained-CPI really means: Up to $849 less for someone who retired in 2001

The Washington Post

WONKBLOG

Here’s what chained-CPI really means: Up to $849 less for someone who retired in 2001

 

Posted by Dylan Matthews on April 11, 2013 at 11:00 am

To hear critics tell it, President Obama’s plan to cut Social Security by adopting a new inflation measure is a major attack on the elderly. Rep. Greg Walden (R-Ore.), the head of the National Republican Congressional Committee, called it a “a shocking attack on seniors,” while Sen. Elizabeth Warren (D-Mass.) sent an e-mail to supporters declaring, “‘chained CPI’ is just a fancy way to say ‘cut benefits for seniors, the permanently disabled, and orphans.’”

Here are the facts. Chained-CPI does mean that Social Security beneficiaries will see their benefits cut. Imagine a person born in 1936 who retired in 2001, at age 65. For simplicity, let’s assume they’re eligible for the maximum benefit. Given that the cap was below $30,000 a year as recently as 1980, it’s not inconceivable that a middle or upper-middle class person with steadily increasing earnings since 1958 would be in this situation.

Their initial benefit would have been $1,538 a month, or $18,456 a year. Under existing law, they would have gotten a series of cost-of-living adjustments (COLAs). By 2013, COLAs would have increased this person’s annual benefit to $24,689.49. However, under chained CPI, it would be $23,820.19, a decrease of $869.30. That’s a 3.5 percent cut in benefits. And, of course, a 3.5 percent cut in income matters a lot more when you’re barely clearing $20,000 a year than it does when you’re making a regular middle-class salary.

There would be other complications as well. Kenneth Stewart, an economist in the Division of Consumer Prices and Price Indexes at the Bureau of Labor Statistics (BLS), is one of the guys who computes the various CPIs every month. He notes that one benefit of CPI-W and other unchained CPIs is that they are final upon issuance. That is, the numbers are never revised. Two weeks after this month ends, BLS will release the April 2013 CPI, and that will always and forever be the April 2013 CPI.

Not so for chained CPI. “The chained CPI-U is subject to revision because we don’t get the actual expenditure data until 1 or 2 years later,” he notes. For example, in 2005 we had access to final chained CPI data for 2003, and only interim data for 2004. If we were to adopt chained CPI, we’d either have to use incomplete data, or else wait until we had final data to implement COLAs, which would further compound the cuts. The former, of course, would reduce the accuracy of the measure, a feature that proponents often tout.

For that reason, critics of chained CPI have sometimes promoted the CPI-E, an experimental index meant to measure price changes within products bought by the elderly. Because it’s experimental and simply a result of reweighing the existing CPI measures to more heavily account for goods like housing and health care, the BLS doesn’t publish the data on its website, but it’s available upon request. Stewart, who helped develop CPI-E, explains that it’s an unchained measure, and because of that its numbers don’t need to be revised.

In the mid-2000s, the housing bubble and boom in health-care prices meant that CPI-E, which weights both more heavily, rose faster than conventional inflation measures. In 2008, for instance, adopting CPI-E as Social Security’s inflation measure would have given our hypothetical retiree $327.88 more a year.

However, since the housing bubble burst and health-care prices started slowing in growth, that effect has diminished. “Medical care inflation has been relatively subdued,” Stewart says. “Shelter prices have also been very tame in, really, the last seven or eight years.” As a result, in 2013 CPI-E would have resulted in only $56 in additional annual benefits for our test retiree.

The measure is not without its disadvantages. The biggest, noted by the Committee for a Responsible Federal Budget’s Adam Rosenberg and Marc Goldwein here, is that a third of Social Security beneficiaries are not elderly. If the goal is to accurately represent inflation for beneficiaries, you’d also have to look at spending patterns among survivors and the disabled, which would be a considerable new project. Also, CPI-E uses a small sample size as it relies on the same sample that normal CPI does. To bring it from the experimental phase to become ready for prime time, that’d need to change. “We’d have to do a lot of research as to where those folks are shopping, what exactly they’re buying, and what prices they’re paying,” Stewart says. “It’s very difficult and costly to measure.”

But ultimately, the question of which you prefer likely has more to do with whether you think Social Security benefits need to be pared back to ensure the program’s long-run solvency, or whether you think the elderly need, if anything, a benefit bump. Those are policy questions, not technical ones, and all the debate in the world about chained CPIs and CPI-Es relative methodological merits won’t resolve them.

More than half of elders, and 60% of older women, face economic insecurity

Daily Kos

Thu Mar 29, 2012 at 10:00 AM PDT

 

More than half of elders, and 60% of older women, face economic insecurity

by Laura ClawsonFollow for Daily Kos Labor

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More than half of people age 65 and older face the prospect of not having enough money to meet basic daily expenses while staying in their homes and communities, a new analysis (PDF) from Wider Opportunities for Women finds. We're talking basic necessities here—renting a one-bedroom apartment or having a modest mortgage, basic food, health care, and transportation, and just $265 in miscellaneous monthly expenses for a single person.

Within the 52 percent of all elders struggling to get by, though, there's a big gender gap—60 percent of women compared with 41 percent of men are economically insecure. The fact that women live longer and have more years to spend down their savings doesn't help. But that's not all. In retirement, as during their working years, women have lower incomes than men: "Elder men studied report typical annual incomes that are nearly 75% higher than the typical elder woman’s income ($24,300 compared to $14,000)." Women are more likely to be dependent on Social Security, and receive smaller Social Security payments than men. And, as in so many other things, women of color face greater struggles than white women: "[E]lder African-American women report median annual incomes of $12,000; both Asian and Hispanic women report median annual incomes that are less than one-half of the general male population's median incomes at $10,100 and $9,600, respectively."

These numbers underscore the incredible importance of Social Security, which provides, on average, 77 percent of older women's income. They also raise a terrifying prospect: Pensions are becoming less common, but here we see how crucial they've been in keeping some seniors out of economic insecurity. What happens to a generation that's forced to rely on Social Security, or whatever's left of that after the various catfood commissions are done weakening it, and whatever savings people can cobble together despite stagnating wages and stock market crashes?

Originally posted to Daily Kos Labor on Thu Mar 29, 2012 at 10:00 AM PDT.

Also republished by Daily Kos.

Un-Happy Holidays for Seniors and the Disabled

Published on Tuesday, December 20, 2011 by CommonDreams.org

Un-Happy Holidays for Seniors and the Disabled – Here’s Your Donut

by Donna Smith

It isn’t sugar plums dancing in their dreams for America’s seniors and disabled who are covered by the Medicare program. It’s donuts. Donut holes into which many fall at this time of the year as they reach the maximum limits of the first tier of “Part D” prescription drug benefits.

I watched my 67-year-old husband trudge up the driveway on a recent morning as I pulled away. He had just showed me the printout of his drug costs for the year. He’s reached the Medicare Part D donut hole by using more than $3,000 in prescription benefits. He is disheartened because his costs tripled at just the time of the year when grandfathers like to be thinking about other things instead of how to manage the cost of their prescriptions or which drugs can be cut in half and still do some good to get through to January 1 and a new benefit year.

And it’s not as if those drugs had negotiated prices that would make it a fair playing field for Medicare beneficiaries. No, no. When Part D was put into place, Congress didn’t see fit to allow the Medicare program to negotiate for lower drug prices. You might think $3,000 sounds like a lot in medication costs, and it is until you fully understand that the prices are inflated as far as possible without any negotiated rates.

So it was a donut hole for the sick and the elderly. Reach it and you are on your own to pay for all of your drug costs until you reach the other side of the hole – or die because you could not afford to pay for those medications.

My husband’s $300 a month supplemental plan doesn’t help much or at all on most of the donut hole costs, so before folks judge him and millions of others as irresponsible and think they should be prepared for the costs, think again. Many pay40 percent or more of their retirement income out in healthcare costs even after buying plans marketed to keep them protected. Corporate America is making sure seniors and the disabled who rely on Medicare spend as much of their plan benefits and retirement funds on their profits. Not much “Ho, Ho, Ho, Merry Christmas” in that.

My 84-year-old mother called me last weekend worried about the beginning of 2012. She’s also on Medicare and a supplemental plan. She reached her donut hole last week too. But her bigger worry is the New Year when she’ll have to meet the drug and supplemental plan deductibles she has though her fixed income will not be changing. “How will I get my puffers?” She explained that one is as much as $400 when she pays out-of-pocket. She worries about paying her rent and buying her groceries during those weeks until she has paid for the medications, submitted her claims for reimbursement from the supplemental plan and finally gets a partial check for coverage. She worries.

My income is the back-up plan for both of them. Without me, my husband says, he’d be dead. My mom never knows if I’ll have enough to send her enough once I help pay my husband’s costs.

It is hard to imagine the kind of selfishness that allows our elders to worry so after decades of hard work and decades of paying taxes. It’s not as if my mother didn’t earn her keep all these years. She worked through World War II when times were tough for her family, and then in 1954, she contracted polio. She was very ill for some time and even spent time in an iron lung trying to survive and heal. She worked outside our home the whole time I was growing up, so she paid into Social Security for many years. My dad too. He also had a pension plan through his employer (ironically he worked as a pharmaceutical salesman), and he set up all that he could to keep my mom safe after he died. They did all they could do to plan for their retirement years.

But as my mom struggles to get her medications and worries about co-pays and deductibles, rent, utilities and food, the company my dad worked for has morphed through several huge buy-outs and legal entanglements (the IUD deaths in the 70s, phen-phen diet pill deaths in the 80s, and beyond). The company had to find a way to survive and keep profiting, so they cut pensions for retirees and survivors, they cut benefits, and they sold out the dead who helped build their empire of greed.

My mom’s worries this holiday season are not shared by the CEOs of the drug companies profiting off Medicare Part D and the donut hole. It is yet another example among many of why our system is so corrupt – profit rules over people. It breaks my heart and makes me mad.

I’d write shame-shame, but I’d say they’re a little beyond shame, wouldn’t you? Someday when we finally reach the point where a progressively financed, single standard of high quality care is guaranteed for all, we won’t leave our seniors and the disabled worried and upset for the holidays. Perhaps we’ll decide to honor them a bit more than what we have so far.

In the meantime, this holiday season if you know someone who relies on some combination of Medicare and supplemental benefits to help with their medical costs, ask if they need some help. Because many of them cannot join up out at “Occupy” sites and weigh in that way (though I’ll bet many would if they could) and because the people they elected to protect them aren’t too interested in this issue right now as they rush to get home for the holidays. Seniors and the disabled who have slipped into the donut hole aren’t on the radar this year – at least not until it’s turn-out-the-vote time.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

AARP

Alzheimer's disease: Best bets to hold off the disease

from: Los Angeles Times |

By Shari Roan

The audience wasn't happy. Its members, Jul. 30, 2010 (McClatchy-Tribune News Service delivered by Newstex) -- private citizens, healthcare professionals and advocates for the elderly _ had gathered to hear a report on how to prevent Alzheimer's; instead, they were told that, in fact, nothing has been proved to keep the disease at bay.

"We're not trying to take anyone's hope away," said report co-author Dr. Carl C. Bell, a professor of psychiatry and public health at the University of Illinois, Chicago, who noted the dejection in the air that day. "But we have to go with the hard science."

The bleak assessment was issued by a National Institutes of Health task force at an April meeting in Bethesda, Md. It was a State of the Science summary of more than 250 studies on potential ways to lower risk of the disease _ and it was entirely accurate: None of the data had been strong enough for experts to definitively say "Do this" or "Don't do that."

But that's not to say the prevention picture is without hope. Several healthy and inexpensive strategies are clearly worth trying, say neurologists and Alzheimer's researchers.

"There is an emerging body of evidence on what you can do to reduce your risk," said Debra Cherry, executive vice president of the California Southland Chapter of the Alzheimer's Association. "It's not at the levels of research from randomized, controlled trials, but it suggests things are moving in the right direction. We are learning how to reduce risk."

The strategies with the most support are regular physical activity, a Mediterranean diet and high levels of cognitive engagement.

There would appear to be little to lose. Among people 55 and older, 1 in 8 will develop Alzheimer's disease and 1 in 6 will develop some type of dementia.

Physical activity: Perhaps the best way to potentially cut the chance of developing Alzheimer's is to exercise _ regularly and with at least moderate intensity.

A large, long-term study presented earlier this month at the Alzheimer's Association International Conference on Alzheimer's Disease meeting in Honolulu found that people who perform moderate to heavy levels of exercise have a 40 percent lower risk of developing any type of dementia compared with people reporting the lowest level of exercise.

The study doesn't prove cause and effect, but it is noteworthy because of its size and the source of its data. The 1,200 participants, who had an average age of 76, were part of the long-running Framingham Study on cardiovascular health; their physical activity levels were recorded for at least a decade, along with the incidence of dementia.

Biological studies also support the idea that activity is good for the brain. In studies at the University of California Irvine, Dr. Carl Cotman has shown that exercise increases levels of a substance called brain-derived neurotrophic factor, which enhances brain function and promotes the survival of neurons.

"There is a lot of data from epidemiology studies and animal studies supporting physical activity," said Laurie Ryan, program director for Alzheimer's disease clinical trials at the National Institute on Aging. "Exercise really is promising."

But just any movement might not do. The data, she points out, suggest that moderate to heavier exercise is more beneficial than mild physical activity, such as stretching.

Diet: Numerous population-based studies suggest that people who eat a diet high in fruits, vegetables, nuts, red wine and omega-3 fatty acids _ and low in saturated fats _ have a reduced risk of dementia of any type.

"Dietary factors are important," Ryan said. "The Mediterranean diet seems more beneficial than the standard Western diet."

Omega-3 fatty acids, in particular, have been linked to a reduced risk of developing Alzheimer's. A 2005 Cochrane Review article stressed that research on omega-3s should be a priority. Because it can be hard to get enough of these nutrients from the diet _ they're found most plentifully in salmon and sardines _ some experts suggest taking a supplement of 1 or 2 grams a day.

Other dietary elements have also emerged as especially promising; among them are alcohol and tea.

Several studies have linked light to moderate alcohol intake with a reduced risk of dementia. One of the most solid pieces of research, published in the Lancet in 2002, followed more than 5,000 healthy people ages 55 and older for at least six years. That work, called the Rotterdam study, found that light-to-moderate drinkers had a 42 percent lower risk of dementia as compared with non-drinkers.

As for tea, a study presented at the recent International Conference on Alzheimer's Disease adds to the growing body of research suggesting its benefits. It found that, over time, tea drinkers have rates of cognitive decline 17 percent to 37 percent lower than non-tea drinkers.

The study's author, Lenore Arab, a professor of medicine at UCLA, examined data on 4,800 men and women 65 and older, recording their coffee and tea consumption and following them for up to 14 years. People who drank tea one to four times a week had the greatest reduced risk. Coffee intake was not linked to lower risk except among people who had the highest rate of consumption.

The reason why tea may have benefits is likely related to plant-based chemicals, not caffeine, Arab said.

Other nutritional gambits have proved spectacularly unimpressive. In particular, the once highly touted gingko biloba has not been found to reduce risk of dementia or Alzheimer's disease or, in fact, to improve cognitive performance in general. And there is little evidence that vitamin B, vitamin C, folate and beta-carotene are helpful in supplement form, as early studies had suggested.

"It could be that giving supplements is not the best way to do this," Ryan said. "It may be more important to get the nutrient in the diet."

The NIH's State of the Science panel appeared to take a dim view of supplements because of the potential for consumers to waste money.

"There is a cost to supplements," noted Dinesh Patel, a panel member and geriatrician at George Washington University School of Medicine. "For some of them, we don't even know the side effects or possible harms."

Cognitive engagement: Some studies suggest that living with someone is protective _ and there is strong evidence that the loss of a spouse leads to decline. Further, staying mentally engaged also seems to be beneficial.

One of the best-known studies on this second connection is the work by Dr. David Bennett, a professor of neurological sciences at Rush University Medical Center in Chicago. His research, called the Religious Orders Study, found that people who spent the most time engaged in mentally stimulating activities _ such as reading, playing cards or doing puzzles, going to the museum _ had a 47 percent reduced risk of developing dementia compared with those with the lowest rates of cognitive activity.

But studies that provide people with "brain games" and other tools to keep their minds busy and challenged have produced inconsistent findings. Such programs aim to improve memory training, reasoning and speed of thinking, and some studies show small effects over a five-year period. But no long-term data can attest to their effectiveness.

When to start: The timing of preventive strategies may prove crucial, with the notion of "the earlier, the better" seeming to hold true.

Research has suggested that highly educated people have a larger "cognitive reserve," and a study of more than 6,000 people published last year in the journal Neurology found that higher educational attainment appears to be linked to higher cognitive function. Once dementia sets in, however, level of education seems to have no bearing on how fast the dementia progresses.

Similarly, it may be wise to adopt a healthful diet and exercise regimen as soon as possible. "These lifestyle factors may have to occur early in life," Ryan said.

That doesn't mean that older people can't decrease their risk. Research strongly implies that diseases that develop later _ such as heart disease, diabetes, hypertension and obesity _ raise the possibility of dementia. Researchers are now exploring whether medications used to treat these conditions may also reduce Alzheimer's disease risk.

Some critics of the State of the Science report note that it may be difficult to ever prove whether some prevention strategies work; it would be unethical, for example, to assess the effect of hypertension on Alzheimer's by not treating some people.

Ultimately, the most reasonable approach would seem to boil down to this: Eat healthfully, exercise, maintain a pleasant social life and rigorously treat conditions like hypertension, high cholesterol, heart disease, obesity and diabetes.

"It will not hurt any of us to follow those suggestions," Cherry said. "To me, that's very optimistic."

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AVAILABLE MEDICINES

Five medications have been approved to treat the cognitive symptoms of Alzheimer's disease. The drugs can reduce some symptoms _ such as difficulties with memory, language, attention and reasoning _ especially in the early stages of the disease. They can, accordingly, improve quality of life, but they don't work for everyone, and none of them works permanently. Eventually the disease will overtake the drugs' ability to compensate.

Four of the medications are cholinesterase inhibitors. These drugs appear to work by slowing the loss of acetylcholine in the brain, a chemical critical to cognitive function. The other, and newest drug, Namenda, is an N-methyl D-aspartate antagonist. It appears to work by regulating glutamate, a brain chemical that can cause cell death in excessive amounts.

A cholinesterase inhibitor and the NMDA antagonist are often prescribed together. In combination, or even taken alone, these medications can, in some people, improve the ability to perform simple tasks.

Namenda

Generic name: memantine

Approved: 2003

Used: In later stages

Razadyne or Reminyl

Generic name: galantamine

Approved: 2001

Used: Earlier stages

Exelon

Generic name: rivastigmine

Approved: 2000

Used: Earlier stages

Aricept

Generic name: donepezil

Approved: 1996

Use: Earlier stages

Cognex

Generic name: tacrine

Approved: 1993

Used: Rarely used due to serious side effects

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WHERE TO TURN FOR SOME HELP

For basic information on Alzheimer's disease, including the latest research developments, go to the website of the National Institute on Aging.

For caregiving advice and guidance, contact the National Alliance for Caregiving.

For information and news on the disease, contact the national Alzheimer's Assn., which also showcases the latest in Alzheimer's research and science.

To participate in a new Alzheimer's Assn. program that matches people with the disease (and related dementias) to clinical trials for which they may be eligible, go the website or call (800) 272-3900. The service is free and confidential.

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Newstex ID: KRTN-1429-47473338