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Every day, thousands of Americans turn 65. How do we help ensure that the U.S. system is ready to meet their needs?

Contributors Respond

Freda Lewis-Hall, M.D.

Freda Lewis-Hall, M.D.

EVP and Chief Medical Officer, Pfizer Inc.

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The most impactful action we can take is to move to a prevention-centered system, with policies and programs in place to preserve good health and prevent disabling disease. There is no reason why age 65 shouldn’t be the gateway to years of general good health. We have to get people in the Baby Boom generation thinking now about how they can stay vigorous and delay, for as long as possible, the issues that come when one’s health conditions impair independent functioning.

An immediate focus should be policies, programs and investments that anchor an all-out attack on chronic diseases, many of which are preventable or readily treatable. If Americans could make a stand against the “Big Three” risk factors—poor diet, lack of exercise and tobacco use—we might prevent 80 percent of heart disease and stroke, 80 percent of adult-onset diabetes, and 40 percent of cancers. Medicines and vaccines will play important parts here; so will health disciplines ranging from nutrition science to human kinetics.

Helping people change lifelong habits will not be easy, but we know that positive lifestyle changes made in the fifth, sixth and seventh decades of life can translate into longer life spans and better quality of living. Keeping people healthier, longer, and out of the clutches of disabling chronic diseases will lead to large benefits for America and Americans. Better health for more people over 65 could translate into substantial gains in national productivity, greater value for healthcare dollars spent, and stronger key industries such as housing, transportation and tourism.

Mary R. Grealy

Mary R. Grealy

President

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It’s an excellent question and one of our most important domestic priorities given, as you point out, that the baby boom generation is transitioning into retirement years – with the increasing healthcare needs that accompany them – in large numbers.

There are a number of policy actions that should accompany this demographic change, but two in particular stand out.  First, understanding that today’s senior population is living longer on average, we need to take steps to make those additional years healthy ones. Medicare coverage should reflect the imperative to prevent and effectively treat chronic disease.  This should include coverage for a wider range of treatments for obesity that have proven effective.  Almost 70 percent of Medicare beneficiaries have at least two chronic conditions. We can make their lives better and make the program stronger for current and future seniors by making chronic disease prevention a priority.

There are other good ideas circulating in Congress, such as the bill by Senators Ron Wyden (D-OR) and Rob Portman (R-OH) to incentivize seniors to engage in wellness activities and practice healthier lifestyles.

Also, for the long-term health of Medicare for those still approaching retirement, it is inevitable that we determine how to structurally strengthen the program so it can continue to meet the needs of beneficiaries well past the 2026 insolvency date announced this year by the Medicare trustees.

If left unaddressed, the Medicare program as it exists today cannot be sustained. In 1965, when Medicare began, there were 19 active workers for every beneficiary.  Today, there are approximately three and that number continues to decline.  Staying on this course, without structural change, policymakers would face the unenviable options of raising taxes, making beneficiaries pay more out-of-pocket or reducing access to care by cutting what Medicare pays for healthcare goods and services.

To meet the needs of beneficiaries, and do it even better than Medicare does today, it’s time to look at approaches that work well from both a quality and cost standpoint, like Medicare Part D and Medicare Advantage, and apply the lessons learned from those programs. These lessons include giving beneficiaries more control over their healthcare decisionmaking.  Meaningful reforms, combined with the steps U.S.  healthcare providers are already taking to emphasize value of care rather than volume of services, can ensure a stronger, more sustainable Medicare.

Robert B. Blancato

Robert B. Blancato

Executive Director, NANASP

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New Census data shows us that one in eight Americans are over the age of 65 – an 18 percent increase since 2000. Those 85 and over will triple by 2040.  Today, baby boomers are between 49 and 67 and will flood the ranks of those turning 65 for years to come.

Are we prepared? We have strong individual programs and services, but they do not constitute a national policy. What we need is to ensure that economic and health security is assured for people as they age.

For the majority of older Americans, economic security comes in the form of Social Security. One-third of seniors depend on Social Security for 90 percent or more of their income. Due to the “age wave” in America, however, projections suggest reserves will run out by 2033. As Congress and the Obama administration face a deadline this fall to raise the U.S. debt ceiling, this entitlement program will be largely debated. Given its importance to seniors, the need to keep this program cannot be overemphasized. It has helped keep older persons out of poverty, and we must keep it strong for current and future beneficiaries.

As an increasing number of Americans turn 65, providing them with health care is also critical, specifically as it relates to providing long-term home care. Not only is home care preferred by older adults, it also is much more cost effective. An AARP report based on 38 state studies from 2005-2012 found that home and community-based services are much more cost-effective than institutional care. With less than five percent of seniors live in nursing homes, and millions of individuals in their homes and needing long-term services and support, we must allocate resources appropriately to address this issue.

Our health care system needs to be ready for the influx of older Americans, and one way to provide the cost effective, long-term health care these individuals want and need is to create a system that can accommodate this new demand. Not only will it decrease overall long-term health care costs, but it also makes life easier for the individual who needs care.

In the coming years we need policies that let us effectively address aging in America as a priority with the ultimate goal of ensuring the quality of life keeps pace with the increasing quantity of life. Providing economic and health care security through social security and long-term home care is one way our health care system needs to adapt to prepare for the increasing number of older Americans. 

Robert B. Blancato

Robert B. Blancato

Executive Director, NANASP

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