Good News. . . . .Bad News Chapter 11
Future Concerns • Good News: • more of us are living longer in better health, more independently, and with greater security • most of us will be the beneficiaries of technological and biomedical advances • there will be more opportunities for growth and personal enhancement in later life
Bad News • advances carry considerable economic and social costs • we will be faced with increasingly difficult resource choices, ethical dilemmas, and political decisions • there may likely be more years of dependency in later life
Effects in the next century • Will the US economy continue to expand? • Will the young adult and middle-age women continue to enter the full-time work force at current rates? • How will the demand for other federal expenditures change over the next 50 years? • “ All of these will effect the quality of lives of elder Americans in the next century”.
Social Perceptions & Attitudes • As this population increases our attitudes and perceptions will also undergo a change • As this population increases it is becoming more diverse, so no single way of understanding our elders • We can predict fertility, mortality and migration, but what other factors must we speculate?
Other Factors • Will health care costs continue to escalate? • Will family structures change? • How secure is our Social Security System? • Will older adults continue to retire early? • Will Americans’ savings rate improve?
Concerns: • 1. Some differences between today’s elderly and elderly of the future • 2. Concerns over generational equity and distributions of resources are likely to become more pressing • 3. How the burden of economic support and social and medical care will be distributed
First Concern: Future Elders • Higher level of education and probability of being married • Family size decreasing • Gap in life expectancy is narrowing • Number of women in work force for a longer time period • As elderly population grows, so does voters
Work life • Evidence is showing a change, but right now most elderly retire as soon as they are able to (finances & health) • Demand for elder workers is not there • Age Discrimination in Employment Act • Will see them planning for retirement differently • Work, education, and volunteerism will become more integrated in their lives
Elder workers • Better health than previous generations • Interest in continuing to work • Have fewer sick days • Punctual, reliable, experienced and loyal to employer
Life-long learning • There has been an increase in the adult college population • Why? Life transitions, a satisfying activity, opportunity to meet people, way to fill up free time • It has been observed that adult education increases during periods of rapid social change
Volunteerism • Have seen considerable growth, yet largely underutilized resource relative to potential contribution they could make • Self-Esteem = most common response to why they volunteer
Second Concern: • Generational Equity • Concern that as elderly population grows, it draws more of our national resources away from the needy younger population • A large proportion of these impressions are misleading • Much of the cost burden supporting an aging population is related to the costs of increased demand for medical care and health care resources
Third Concern: • Providing for the elderly: • Three sources of resources and support: • family,public government sector, private business sector • Family- unlikely that younger generation can sustain the burden • Private Sector- probable but question the quality and sustainability of private sector options • Public Sector- involves long-standing social contact that will need to be sustained at current level
Most countries are not equipped or ready to cope with the growth of elderly population • U.S. compared to Sweden • U.S. : -all S.S. recipients are eligible for Medicare • Medicaid is major source of funding for long-term care • Medicaid is income-based (payment for health care regardless of age, who do not have private resources to pay for medical care
Many elderly require more social than medical care but have neither the family nor other social support or financial resources to elect any other option than nursing home care. • Access to in-home and community-based services is limited and fragmented. • Sweden : offers a different model based on different social and political philosophies.
Sweden • Policy governing the elderly is NOT age-specific • 1982: Social Service Act - provides municipal social services to all persons who need them regardless of age • 1983: Health and Medical Services Act - provides health care and services to all members of society regardless of age
All members of society are supported through a tax system that takes about 1/2 of a working person’s income • Directs support toward independent living • (46% of those older than 70 live alone) • It is estimated that family and friends provide 2/3 of all care
Summary • What we’ve discussed is the way we might find the future- there are no certainties • What we do see is Americans living longer, healthier, and more productive lives • When we discuss the concerns they should be placed on national level, and not just concerns of the elderly (age-blind concerns)