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Chapter 18

Chapter 18. The Elderly: Health Politics Beyond Aging? William P. Brandon and Patricia Maloney Alt. “Senior Life” as Social Construction. Through the end of the 19 th century There was little conception of the aging members of the workforce ceasing productive work.

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Chapter 18

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  1. Chapter 18 The Elderly: Health Politics Beyond Aging? William P. Brandon and Patricia Maloney Alt

  2. “Senior Life” as Social Construction • Through the end of the 19th century • There was little conception of the aging members of the workforce ceasing productive work

  3. “Senior Life” as Social Construction • No conception of “retirement” as such • Only arose as a result in the shift toward certain types of employment, and increases in natural lifespans

  4. “Senior Life” as Social Construction • Nursing home phenomenon in the U.S. • Largely spawned by conscious policy decisions • Including Kerr-Mills Act and the shaping of Medicaid

  5. “Senior Life”as Social Construction • Other industrial nations tend to focus on caring for seniors in the home • Recent trends in the U.S. away from institutionalization • Toward home/community care of seniors

  6. Senior Institutional Landscape: Government • As of 1978: • Eighty federal programs for the elderly could be identified • Senior policy quite decentralized/fragmented • “Senior” government institutions actually serve broad constituencies

  7. Senior Institutional Landscape: Government • Medicaid, for instance, covers costs for elderly nursing care • Was originally designed to assist the poor

  8. Senior Institutional Landscape: Government • Funding of programs under the Old Age Assistance Act (1965) • Has not kept pace with the rise in the number of seniors in recent years • Crunch will be faced with aging of baby boomers

  9. Senior Institutional Landscape: Interest Groups • Up until the early 1970s • Seniors as a group were disorganized • Politically weak • With senior legislation in the late1960s: • Interest groups serving the elderly swiftly arose and proliferated

  10. Senior Institutional Landscape:Interest Groups • Mass-membership groups and ideological organizations • Proven interest groups with the greatest staying power and potency

  11. Senior Institutional Landscape:Interest Groups • AARP (once the American Association for Retired Persons) • Largest and best-endowed organization representing the interests of seniors

  12. Senior Institutional Landscape: Interest Groups • Sponsors research • Sells insurance and other benefits to members, lobbies federal government on behalf of a steadily-broadening “senior” population

  13. Senior Institutional Landscape: Interest Groups • Has generally held moderate political positions in recent years • Though fought hard for the Medicare Modernization Act (MMA) in 2003

  14. Senior Institutional Landscape: Interest Groups • Other major interest group: • Overtly political National Committee for the Preservation of Social Security and Medicare (NCPSSM) • Founded by James Roosevelt, son of FDR, in 1982 • Infused with liberal policy vision

  15. Senior Institutional Landscape: Interest Groups • Often opposes AARP, other organizations in taking positions on the political left • Offered resistance to AARP in its support for MMA

  16. Senior Institutional Landscape: Interest Groups • United Seniors Association/USA • Next presents conservative alternative to NCPSSM • Initially focused on seniors • Worked to broaden its constituency in recent years

  17. Senior Institutional Landscape: Interest Groups • Attacked AARP for its opposition to Personal Savings Accounts (PSAs) in Social Security, 2005

  18. Senior Institutional Landscape: Other Groups • Professional societies also work on behalf of the senior population • Gerontological Society of America (GSA) and National Council on Aging (NCOA) • Examples of groups that reflect the liberal perspective of most social service workers

  19. Senior Institutional Landscape: Other Groups • American Public Health Association (APHA) • Become increasingly engaged when it comes to the treatment/representation of seniors

  20. Senior Institutional Landscape:The Media • Media tends to focus on controversies involving seniors • Such as the abortive battle over Social Security reform

  21. Senior Institutional Landscape:The Media • Many senior advocacy groups have taken to the web • Also express concern about the “digital divide” excluding many seniors from this (relatively) new medium

  22. Seniors in American Politics: Medicare “Modernization” • Balanced Budget Act of 1997 (BBA) • Designed to increase the enrollment of Medicare beneficiaries in managed care plans • In ironic twist: • Policy actually caused contraction in profitable markets of managed care • Number of Medicare beneficiaries covered under such plans dropped

  23. Seniors in American Politics: Medicare “Modernization” • MMA of 2003 • Represents the first time Medicare beneficiaries are divided by income groups on basis of benefits offered AND payments • Long-term health of Medicare • Threatened because it has become relatively more valuable to lower-income groups

  24. Seniors in American Politics: Social Security Reform • Debate over the precise future form Social Security is to take arise not from any fiscal “crisis” • From continued philosophical differences over the basic goals of the program

  25. Seniors in American Politics: Social Security Reform • Broad agreement exists: • Social Security will EVENTUALLY run through its resources • Disagreement as to WHEN

  26. Seniors in American Politics: Social Security Reform • Possible remedies include: • Raising retirement age • Requiring state and local employees to enter system • Removing taxable income cap • Most controversially, privatizing elements of the system

  27. Chapter 18 Summary • Conception of “the elderly” constitutes a social construction • Which has changed over time • Four institutional venues hold particular relevance to seniors: • Government, interest groups, private service organizations, and the media

  28. Chapter 18 Summary • Interest groups representing seniors: • Mass membership organizations, ideological outfits, and professional societies • Medicare and Social Security Reform • Recent/ongoing issues of particular import for seniors

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