As everyone knows, a new administration is about to begin in the federal government.
So I have been thinking about what this might mean for the health and well-being of older adults, and family caregivers.
In terms of impact on the lives of seniors, the actions of federal, state, and local governments are MUCH more powerful than the impact of the health and aging innovation sector. Really, what government agencies do — and most importantly, pay for — often leads the tech innovators, rather than the other way around.
In particular, Medicare’s policies drive the health care experience for older adults, Medicaid is a major source of long-term supports and services in aging, and the services funded by the Older Americans Act provide (not yet enough) information and assistance to older adults and families.
Donald Trump, as far as I know, did not really emphasize aging or family caregiving issues during his campaign. His campaign proposed tax deductions for family caregiving. And I’m not aware of his addressing aging issues other than saying he’d leave Medicare and Social Security alone.
According to Pew, voters aged 65+ supported Trump over Clinton 53%-45%, which is similar to the margin by which they preferred Romney over Obama in the 2012 election. This Atlantic Monthly article explores some of the reasons that older adults vote more conservatively.
Trump is not yet in office. But I find the past policy proposals and activities of his cabinet picks rather sobering.
For instance, Tom Price, Trump’s pick for Secretary of Health and Human Services (HHS), is a doctor who has often worked to protect the rights and prerogatives of physicians, and seems to generally oppose the government’s involvement in healthcare.
HHS, as you presumably know, includes the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control, and the Food and Drug Administration. They suffer from the usual problems of big bureaucracies, plus I have plenty of quibbles over the way specific issues are managed.
Despite this, government agencies are necessary and so our goal should always be to improve them and help them better achieve their missions. They protect the less powerful from the more powerful, and they are needed to serve the public’s interest in ways that market-based organizations can’t or won’t do. (There’s basically no good business case for providing affordable health insurance to aging adults.)
There are countless issues affecting older adults and families that require public policy and government action to address. Improving quality of health care for older adults. Increasing access to affordable housing that facilitates aging-in-community. Providing support to family caregivers.
For instance, recently implemented Medicare regulations are designed to make nursing homes more responsive to the needs of residents. Will they work as intended? Hopefully, CMS will be able to monitor this and adjust as needed.
The list goes on and on.
My New Year’s Resolution
So in this time of upheaval and change in the federal government, my resolution is to pay a little closer attention to policy.
In particular, I’ll be paying attention to policy related to aging health, Medicare, Medicaid, long-term care supports and services, family caregiving of older adults, and services related to housing, transportation, and community services for older adults.
Fortunately, there are currently a few good online outlets for keeping up on major developments in these areas without drowning in wonky details or technical jargon. Some of my favorites include:
- Howard Gleckman‘s columns, published on Forbes.com and elsewhere. He provides insightful commentary on long-term care policy and other topics I find interesting. Here’s a good article: What may happen to services for seniors during Trump administration?
- Kaiser Health News. They have launched an excellent “Navigating Aging” column, plus they often collaborate with NPR and other major news outlets.
- Life in the End Zone, by geriatrician Muriel Gillick.
Beyond paying attention
And then what to do beyond paying attention? I don’t yet know. I suppose it will depend on what happens, and what opportunities arise to either oppose changes one feels are harmful or support changes one thinks will benefit the causes one cares about.
You can probably tell that I’m not a supporter of Trump. But I believe it’s important to not reflexively oppose him or his ideas.
Instead, we should oppose specific policies, proposals, actions — and perhaps political appointments — when we have good reasons to believe they’ll do more harm than good. We should bring attention to issues we care about. We should advocate for the changes we want to see.
And we should try to find common ground: almost everyone agrees older adults deserve a decent life while aging, and help with common age-related challenges. Working out how to do this, as a society, is a process. So we should be sure to participate.
And of course, I’ll still remain on the lookout for technological innovations that can help society, families, and individuals better manage aging and health challenges.