April 21, 2018
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Din of economy, election usurps concern for seniors

By Laurel Coleman, Special to the BDN

I know it is hard to think about anything but the economy. While the financial crisis is dominating our thoughts and the presidential election coverage, I would like to remind Maine residents that there is another important issue to consider as you decide about your vote: The aging of Maine’s population.

Maine’s population has the oldest median age of any state, so the challenges in dealing with this demographic shift are most urgent here.

As a geriatrics physician, I have watched and listened closely to see whether the candidates would speak about the needs and concerns of older people, especially in the areas of overall health care, Medicare, long-term care, and Social Security.

Sen. John McCain’s health care plan leans heavily on deregulation of the insurance market so younger people can “shop” across state lines for policies. It is very concerning that Sen. McCain’s campaign has said that it plans to cut Medicare and Medicaid expenditures by $1.3 trillion dollars over the next 10 years to fund his insurance tax credits. This approach would cut the Medicare and Medicaid budgets by nearly 20 percent. In a time when more Maine residents will rely on Medicare for health insurance, this seems like bad policy.

Sen. Barack Obama’s health care plan places a high priority on improving the medical system by investing in electronic medical records, thereby improving management of conditions that most older patients face. Too often, health care providers are unaware of care given at other sites, or with specialists. This lack of information leads to duplicate tests and exams, and sometimes inappropriate medications.

Long-term care is an area that has not received much attention in the campaign, but it is a rapidly growing expense for many families. Sen. Obama has outlined a multifaceted approach to this national challenge.

Fifty million family caregivers provide support to older people or those with disabilities across this country. Sen. Obama supports expanding the Family and Medical Leave Act to include employers with 25 or more employees. This change will help millions of Americans to better manage their jobs and their caregiving responsibilities. Enhanced research for Alzheimer’s disease treatments is another strategic investment proposed by Sen. Obama. Five million Americans currently have Alzheimer’s and this number is expected to grow to 16 million by 2050 if we don’t invest in research to stop this disease. Sen. Obama correctly identifies Alzheimer’s as the major reason that people need help from caregivers both in the home and in long-term care facilities. This investment will pay dividends in lower costs for family caregivers and throughout the medical system.

We need to increase the number of physicians, nurses, and other health providers for an aging population with more medical needs. Maine already is experiencing a nursing shortage that is even more serious in the nursing-home setting. We risk a serious crisis in Maine, unless policies that include help with loan repayment, expansion of training programs, and improved reimbursement for nursing assistants and other front-line workers are promoted as Sen. Obama advocates.

Maine seniors need to have choices about their health care and living situations. Sen. Obama supports expansion of long-term care options and specifically the Community Living Assistance Services and Supports or CLASS, Act which would create a voluntary, budget-neutral long-term care insurance program helping adults and seniors with disabilities. Investments in senior housing, technologies to help people stay in their own homes and amending the Medicare “homebound” rule also add to his policy suggestions in this area.

In contrast to Sen. McCain’s proposed cuts, the Obama plan strengthens the Medicare and Medicaid programs while improving their efficiency and reducing waste in the programs. Sen. Obama favors eliminating subsidies to Medicare Advantage plans, and closing the “doughnut” hole in the Medicare Part D prescription drug plan, which would help thousands of Maine’s seniors. His overall health reform planning will also include the important issue of long-term care financing, as these costs are devastating to many Maine families.

The current financial crisis is hitting everyone, but older Americans may be hurt disproportionately as they try to live on fixed incomes or diminished retirement savings. Maine is the “oldest” state in the country, so it is important to vote for the candidate that appreciates both the value that the older generation brings to our communities and the unique challenges that an aging population brings. Barack Obama has the leadership skill and judgment that we need at this important time.

Laurel Coleman of Manchester is a geriatrics physician.

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