Broken Trust of the Elderly - NYTimes.com

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excerpts from NY Times Editorial

The hearing of the Senate Special Committee on Aging, as well as several recent studies, make clear that elder abuse is a growing problem that far outmatches the resources available to fight it.

One national study estimated that in the last year 14 percent of older adults had been neglected, abused or exploited. The numbers could be far higher since the sample did not include people living in institutions or those with significant mental impairments. A 2009 study on financial exploitation estimated that elderly victims lost at least $2.6 billion a year to fraud and abuse.

. . .

The solutions begin with filling the gaps in data collection and services. The Government Accountability Office found that in 25 of 39 states surveyed, financing for adult protective services had fallen or flat-lined in the last five years. Case workers are poorly trained and overwhelmed. The study also found that federal programs to fight abuse are scattered ineffectively across the Department of Health and Human Services. The report urged the department to create a resource center to collect and share abuse data among the states.

Only with coordinated efforts — like those urged by the offices and agencies created years ago to advocate for children and victims of domestic violence — will real progress be made. The committee’s chairman, Senator Herb Kohl of Wisconsin, is sponsoring a bill to create an office of elder justice, in the Justice Department, to tighten reporting standards and definitions of elder abuse and to help states investigate cases and impose stricter protections for victims. Congress should pass it.

Full Editorial

TIME GOES BY | GRAY MATTERS: Preserving Social Security

by Pulitzer Prize-winning journalist Saul Friedman

It’s past time that Social Security’s advocates, friends and beneficiaries quit playing defense for the single most popular American program and take the offensive against those who attack and lie about Social Security with intent to kill it.

First, find out if you have an IRA or other retirement saving accounts with a bank or brokerage or investment house that has been calling for the privatization of Social Security. If so, transfer the account (without penalty) and tell the broker why.

My broker/financial adviser with Merrill Lynch, is a champion of Social Security as a necessary and dependable leg of one’s retirement income. Ask your broker/financial adviser where he/she stands on Social Security privatization, i.e., changing it from pension and disability insurance into millions of 401(k)s subject to the rock and roll of the stock market.

If you’re affluent enough to have invested with the Blackstone group, transfer your money elsewhere. The hedge fund, whose trade in funny money helped bring on this recession, was founded by billionaire Peter Peterson, who retains an interest in the firm and spends millions through his various foundations to undermine Social Security with the claim that the program and the benefits for the undeserving elderly population’s are bankrupting the nation.

Second, Social Security advocate organizations and politically active beneficiaries and older members can join in the new effort by the National Academy of Social Insurance to expand Social Security to resume the coverage of 22-year-old students, especially the disadvantaged, which was ended in 1981, when Social Security was in imminent financial danger.

Such an expansion could dovetail with the new health insurance reforms which mandate coverage on their parents’ policy for children up to age 25. And it would not only help these families and kids pay for college, but it would strengthen the Social Security system with support from the young which has been eroding as too many the mainstream media buy into the Peterson nonsense that Social Security is in financial trouble. It isn’t.

Indeed, the 75-year-old program, which is in the black for another 30 years even if nothing is done, will outlast Blackstone as it has outlasted Lehman Brothers, Bear Stearns. Enron, Eastern Airlines and the Pennsylvania Railroad, a few recessions and lots of wars.

During those years, Social Security has never defaulted on a payment. Indeed, it expanded to cover the disabled and the spouses and children survivors of beneficiaries who died before age 66, like those killed on 9/11.

And since the fixes of 1983-4 by the Reagan administration and Alan Greenspan’s commission, Social Security has run a surplus every year, enough to guarantee benefits for the huge boomer generation. Even this year and next, when high unemployment forces the program to pay out more than it takes in in payroll taxes, Social Security will still run surpluses of more than $100 million.

That should lead defenders to their main point, which they should repeat like a mantra: Aside from its administrative costs, Social Security’s benefits for 50 million Americans does not contribute even one dollar to the federal deficit. Let me repeat for reporters who are too lazy to understand Social Security: Aside from its relatively small administrative costs (which are in the Social Security Administration’s budget), Social Security adds nothing to the deficit.

In fact, Social Security earns around $700 million a year, financing the federal debt by selling the Treasury its low-interest special issue bonds. Social Security could solve its long term fiscal problem if it could sell the government higher-interest bonds. But, of course, that would raise the deficit.

Ignoramuses suggest that these bonds in Social Security’s West Virginia vaults are nothing more than “worthless IOUs.” As the Chinese, Japanese and other investors know, U.S. IOUs are as good as cash. Indeed, if you examine your paper money or your employer’s check, they are IOUs until you spend or cash them out.
If the IOUs were “worthless,” why would Peterson and his greedy Wall Street and hedge fund investment banking allies be so eager to get their hands on the $2.5 trillion in Social Security bonds? What a tasty dish to set before the kings in their counting houses!

A friend at AARP says it will do no good to bash billionaires. I disagree because their message, backed by their money and the megaphone of the media, conservative Democrats in the Congress and the hysteria over the deficit has undermined support for Social Security and Medicare. And AARP has not been aggressive in helping to challenge Peterson and his deficit hawk allies who have been given aid and comfort by the administration which was bullied into creating the anti-Social Security commission on the deficit.

Fortunately, the latest defense and offense on behalf of Social Security has come from a definitive report on the future of the program prepared with the help of the Congressional Budget Office and published by the Senate Special Committee on Aging.

The seemingly alarming news is that Social Security faces a $5.3 trillion shortfall over the next 75 years. But the committee chairman, Senator Herbert Kohl (D., Wis.) echoes the current conclusion of Alan Greenspan, the Academy of Social Insurance and nearly every other expert, that the shortfall could be fixed with what Kohl called “tweaks.”

For Kohl and most advocates, cutting benefits is not an option, nor is reducing the criteria for the mandated cost of living (COLA) raises. And Kohl rejects the report’s suggestion that the future fiscal problems could be solved by raising the retirement age from 66 to 70. That would solve only 30 percent of the shortfall, and would delay and thus rob millions of workers of the benefits they now expect and count on.

Besides, many blue collar workers in tough, physically demanding jobs should not be required to work until 70; a coal miner may not be able to keep working after 66.

There are more likely alternatives which are obvious and simple: As the Social Security Trustees’ conservative outlook for the future reported last year, a 1.1 percent raise in the workers' and employers' payroll tax (now at 6.2 percent each) would wipe out the shortfall for 75 years. The trustees, incidentally, base their estimates on 1.5 percent annual growth in the GDP, which is far less than the past years.

More popular with the Obama administration, if Congress abolished the $106,800 cap on the wages subject to payroll taxes, the entire $5.3 trillion shortfall would disappear. Obama has suggested raising the cap to $250,00. Interestingly, several of the nation’s more honorable billionaires, like Warren Buffet and Bill Gates - junior and senior - have called for an end to the cap, noting that they are paying no more in Social Security taxes than a well-paid secretary.

As far as I know, they do not hold that Social Security’s assets should be put up for grabs on Wall Street. But then Buffet and the Gates's helped create wealth and something tangible, instead of a house of paper that collapsed.

You can see the Aging Committee’s information as well the views of advocates at the Committee's website, and you may read or download the full report here (pdf).
Write to saulfriedman@comcast.net


TIME GOES BY | GRAY MATTERS: Preserving Social Security

Impact on Senior Citizens of Rising Drug Prices in Medicare to Be Hearing Topic

The Special Committee on Aging will convene Wednesday, March 17, for a hearing to examine the rise of prescription drug prices in America and its impact on senior citizens who participate in the Medicare Part D program. Senator Bill Nelson (D-FL) will be the acting chairman.

Witnesses will offer testimony on various topics, including cost-sharing under Part D, how pharmaceutical pricing makes it difficult for Part D plans to negotiate discounts, and policy options for closing the doughnut hole and curbing escalating drug prices, according to a news release from the office of the committee chairman, Sen. Herb Kohl (D-WI).

“Seniors Feeling the Squeeze: Rising Drug Prices and the Part D Program,” will convene at 2:30 p.m. in Room 562, Dirksen Senate Office Building.

Among those providing testimony will be the following.

● Dr. Gerard Anderson, Director, Center for Hospital Finance and Management, and Professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
● John Dicken, Director, Health Care, U.S. Government Accountability Office, Washington, D.C.
● Greg Hamilton, pharmaceutical industry expert, Algonquin, IL
● Willafay McKenna, Medicare Part D beneficiary, Williamsburg, VA
● John Calfee, Resident Scholar, American Enterprise Institute, Washington, D.C.

The hearing can be viewed live or at a later time by a webcast. A link to the webcast can be found at the committee’s website: http://www.aging.senate.gov/

KOHL MEETS WITH ASSISTANT SECRETARY FOR AGING KATHY GREENLEE

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U.S. Senator Herb Kohl (D-WI), Chairman of the Senate Special Committee on Aging, met with Assistant Secretary of Aging Kathy Greenlee to discuss the Older Americans Act, which is up for reauthorization in 2011. Traditionally, the Aging Committee takes a lead role in working with the Health, Education, Labor and Pensions Committee to reauthorize the statute that covers the programs administered by the Administration on Aging.

“The Older Americans Act serves as the pipeline for all the local agencies that offer nutrition programs, adult protective services, and legal programs, as well as those that provide caregiver support and transportation assistance,” said Kohl. “These are the crucial services so many seniors rely on in their daily lives, and I am looking forward to revisiting and improving this important legislation for America’s growing aging population.”

Kohl and Greenlee also discussed the Administration on Aging’s (AoA) expanded caregiving initiative, which stems from the work of the White House Task Force on Middle Class Families. The initiative will help families improve the care they provide to aging relatives and support seniors trying to remain independent in their communities. An estimated 38 million Americans provide unpaid care to an aging relative, including approximately 23 million caregivers with jobs and 12 million who are also caring for their own children. Roughly half of the $102.5 million requested in the FY2011 budget for this initiative would provide home and community-based services to seniors, and half would provide services to caregivers, including respite.

Both of these aims fall in line with Chairman Kohl’s Aging Committee agenda. At the beginning of the 110th Congress, Kohl was joined by Senators Blanche Lincoln (D-AR) and Bob Casey (D-PA) in introducing legislation to offer training and support to family caregivers as part of an overall effort to address the impending severe shortage of health care workers who are adequately skilled and prepared to care for older Americans. The Retooling the Health Care Workforce for an Aging America Act (S. 245) incorporates major recommendations put forth in a 2008 Institute of Medicine (IOM) report. Congresswoman Jan Schakowsky (D-IL) introduced a companion bill in the U.S. House of Representatives. Provisions of the bill have been included in both the Senate, House, and White House health reform proposals.

Kohl has also introduced, with Senator Maria Cantwell (D-WA), the Home and Community Balancing Incentives Act (S. 1256) to reform long-term care systems by offering enhanced federal Medicaid matching rates to states that are willing to implement home and community-based health care programs. With the nation’s population aging at a rapid rate, more and more Americans will need long-term care services and supports to help them with day-to-day activities. The bill will provide states with resources and financial incentives to broaden the range of Medicaid services offered to people in their homes and communities, allowing more of them to live as independently as possible, while also controlling state costs. Provisions of the bill have been included in both the Senate and White House health reform proposals.

Watch Live: Senate Special Committee on Aging Panel Discussion of Elder Benefits in Senate Bill

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At 3PM today, eastern U.S. time, Senator Herb Kohl, who is the chairman of the Senate Special Committee on Aging, will hold a live panel discussion and briefing about how the Senate Health Care Reform bill will benefit elders. Panelists will include representatives from Consumers Union, AARP, The Medicare Rights Center and The National Consumer Voice for Quality Long Term Care. You can watch live at http://www.aging.senate.gov.

The Leaf Chronical: Senate Special Committee on Aging

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U.S. Sen. Bob Corker has been named ranking member of the Senate Special Committee on Aging.

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Medical Education CMEs

Statement of Lewis Morris Before the Senate Special Committee on Aging On behalf of Inspector General Levinson and the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS), I thank you for the opportunity to discuss commercial sponsorship of continuing medical education (CME). Physicians must keep abreast of advances in medicine, and access to objective,nbiased CME is essential to the quality of medicine practiced in this country. However, the integrity of medical practice and the quality of patient care may be compromised if biased or inaccurate CME influences the physician’s clinical practice, including the prescription of drugs, biologics, and medical devices. Preserving the independence and integrity of continuing medical education requires enhanced safeguards to preserve the boundaries separating education from marketing. Read More

Waiting for the Wrong Answer 1-800-Medicare

AsclepiosYour Weekly Medicare Consumer Advocacy Update Waiting for the Wrong Answer September 11, 2008 • Volume 8, Issue 37 There are two basic problems with 1-800-Medicare, the toll-free consumer hotline for people with Medicare: (1) It takes too long to talk to a live person, and (2) When a live person does get on the line, they often give out incorrect or incomprehensible information. The consequences of this shoddy service are numerous, but in general, bad advice on a Medicare problem means consumers pay much more out of pocket than they should and they do not receive the health care they need. Today, Senator Gordon Smith, Republican of Oregon, called Kerry Weems, acting administrator of the Centers for Medicare & Medicaid Services, and John Curtis, CEO of Vangent, the contractor running 1-800-Medicare, before the Senate Special Committee on Aging to see if improvements could be made to the hotline’s service. Senator Smith’s staff had spent hundreds of hours cataloguing the bad information given out by 1-800-Medicare operators and demonstrated that during peak hours, the typical caller waits much longer than the 8.5 minute average hold time touted by CMS. At the hearing, the Medicare Rights Center and other advocacy groups testified that the misinformation from 1-800-Medicare continues, as do frequent half-hour waits for a live customer service representative. Weems promised the committee that average wait times for the hotline would be lower when the annual enrollment period for the Part D drug benefit begins this fall, and new initiatives would reduce the number of people holding for a customer service representative. However, little was said that would give consumers confidence that much-needed improvements in operator training will be forthcoming, or that the scripts used by operators will be jargon-free and provide callers with the help they need in language they can understand. One suggestion in this regard—that CMS employ the expertise of State Health Insurance Assistance Programs (SHIPs) and counselors at the Medicare Rights Center to develop consumer-friendly scripts and effective training programs for hotline operators—is worth pursuing. People with Medicare deserve accurate and understandable information about the increasingly complex coverage choices they face. CMS should make an effective consumer hotline the centerpiece of a renewed focus on helping their customer base—people with Medicare. Medical Record “Another client from New York called 1-800-Medicare to enquire about enrolling in Medicare Part B. She is 70 years old, enrolled in Part A, and has employer-sponsored insurance. The customer service representative told the client that she would not be able to enroll in Part B until the following January, that coverage would not begin until July, and that she would be subject to a late enrollment penalty. All of the information provided by the representative was wrong. After calling the Medicare Rights Center and being given accurate information, the client went to her local Social Security Office to begin the process of enrolling in Medicare Part B.” (Testimony to Senate Special Committee on Aging, Medicare Rights Center, September 2008) “Feedback from advocates, community partners, and Congress is welcome and incorporated on a regular basis in order to improve and sustain our call center operations. CMS will continue to work with our partners in the coming months to ensure that 1-800-Medicare maintains its place as a valuable resource for all people with Medicare.” (Testimony of CMS Acting Administrator Kerry Weems before the Senate Special Committee on Aging, September 2008)

Fairness In Nursing Home Arbitration Act

On June 18th, the Senate Special Committee on Aging and the Committee on the Judiciary Sub-Comittee on Antitrust, Competition Policy and Consumer Rights conducted a joint hearing on the Fairness in Nursing Home Arbitration Act (S2838). The act provides that a pre-dispute arbitration agreement between a long-term care facility and a resident (or anyone acting on the resident's behalf) shall not be valid or specifically enforceable. The bill is sponsored by Senator Marinez (FL) and co-sponsored by Senators Feinegold, Kohl and Leahy. The House has a similar bill (HR6126) introduced by Representative Sanchez (CA) and co-sponsored by Representatives Cohen (TN), Conyers (MI), Delahunt (MA), Johnson (GA), Kucinich (OH), Lofgren (CA), Pastor (AZ), Ros-Lehtinen (FL), and Waxman (CA).