“I find myself drawn to a less friendly analogy: not that of fresh Wonder Bread
slices gently squishing us, but that of panini grills pressing us flat.”
Ada Calhoun who coined “Sandwich Generation” in The Atlantic, January 7, 2020
When the Affordable Care Act (ACA) was passed in 2010, there was much resistance to a concept where government might subsidize access to healthcare. Messing with the best “healthcare system in the world” – which even at the time was (and remains) profoundly false – was amplified by Republicans in Congress actually making a claim that universal healthcare would, of necessity, result in “death panels”: doctors meeting to decide, particularly in cases of elderly patients or those with severe and often chronic conditions, who would be denied coverage because it was not economically sustainable. Die, die, die!
Yet red states were much more likely to opt out of expanding Medicaid under the ACA, leaving millions to face health issues and even death without care. We remain the only developed nation on earth without universal healthcare… a newly developed “right.” Conservatives seem hellbent on not spending money to support “people with no options” in order to preserve tax breaks and low rates for the rich. They call anything they don’t like “creeping socialism,” when that is absolutely an incorrect description.
We are distracted and disappointed by so much, from Putin’s war, exorbitant inflation and immigrants pounding at our borders to culture wars, a civil rights averse Supreme Court and polarization on steroids. The very sustainability of our democracy was clearly one of the motivating features of Putin’s timing on invasion. But there are huge subcurrents in our nation that have slipped to the back burner, which threaten each and every one of us more deeply than that list of issues above, physical realities as opposed to political choices. Climate change and the aging of America sit atop that set of physical challenges. Today’s blog is about age demographics.
The Health and Human Services website tells us: “More than 10,000 people turn 65 every day in the United States, and people are living longer, healthier lives.” Indeed, some are. But the economics of taking care of an aging population do not augur well, if we are unable to provide affordable childcare to support women to return to the workforce, we are failing even more miserably taking care of the disabled, mentally impaired or simply “older, tired” elderly. Placing a parent or grandparent in a managed care facility is a combination of cruelty and paying an exorbitant monthly fee, often $10,000 or more (mollified by some government support… but hardly enough), for de facto incarceration in COVID factories with bad food, unending boredom and a feeling of abandonment. Sure, there are exceptions, but the rule is profoundly different. If you can afford even that!
Social Security, often the only source of elder income, is hardly up to keeping up with inflation. Americans also have notoriously failed to prepare for “retirement.” An August 21, 2021 report from CNBC tells us: “Most workers over age 40 don’t have sufficient retirement savings and aren’t setting aside enough to catch up, according to a survey from the Insured Retirement Institute…Despite the nest egg shortfall, many still expect to retire early and believe they will have ample retirement income…. More than half of older Americans have less than $50,000 for retirement. But the majority aren’t increasing savings to boost their nest eggs… Nearly six in 10 workers save less than 10% of their income and a third set aside less than 5%, the survey revealed.”
And we are among those countries with a rapidly rising “graying” population. The Census tells us: “The nation’s 65-and-older population has grown rapidly since 2010, driven by the aging of Baby Boomers born between 1946 and 1964. The 65-and-older population grew by over a third (34.2% or 13,787,044) during the past decade, and by 3.2% (1,688,924) from 2018 to 2019.” One in five Americans is over 65, and our “replacement rate” – 1.9 live births per couple – is lower than the rate needed to sustain a population (2.1 live births).
This translates to one super-harsh reality, there are fewer younger people (who make up the workforce) every year compared to those who have reached or about to reach retirement age… or are simply no longer physically able to work. Growth is now predicated on immigration, which is not a popular program these days. Yet we have a shrinking population. Thus, money from a lower relative percentage of working Americans, for the elderly who have not saved enough for their “golden years,” is what supports that growing percentage of non-working gray Americans.
Where government programs and private savings fall short, the consequences can be profound. From homelessness to severely substandard living conditions to torturing isolation. But one additional burden applies to middle-aged “children” who are saddled with the burden of supporting aging parents and grandparents. The “Sandwich Generation.” Katie Schlott, writing for the March 25th FastCompany.com, describes the plight of that defined “sandwiched” cohort: “It’s understandable why 1.8 million women have left the American workforce since the first wave of COVID. It is impossible to simultaneously care for young children, care for aging parents, and hold down a full-time job in the United States.
“‘When the pandemic hit, our deeply ingrained expectations that women would naturally shoulder these responsibilities were dramatically exposed and rightfully questioned,’ wrote Ai-Jen Poo and Palak Shah in Fast Company. ‘And we began to see and understand the true value of generations of caregiving labor, both paid and unpaid.’
“The caregiving crisis will dramatically accelerate in the decade ahead as the oldest Baby Boomers turn 80. Yet, we already have a shortage of professional caregivers: NPR recently reported that seniors often wait months for home healthcare. For Americans on Medicaid, the wait time is more than three years for home care assistance. But, we don’t have months or years to wait for care; it’s needed now.” Schott suggests that the expansion of Biden’s infrastructure legislation is a start, noting that there are possible nascent steps we should take:
Use technology to integrate our healthcare records, benefits information, and bills [stop inefficient silos and create macro-coordination].
Create a seamless solution for coordinating caregiving needs [Using big tech companies to automate and track caregiving].
Business coalition that supports each step of the caregiving journey [improving cost and effectiveness efficiencies].
It’s not that Americans don’t care; they just do not know what to do about it. They are represented by a Congress where seeking campaign contributions trumps looking after most of us. Loud rich people with $$$ are calling the shots… and they just do not like to pay taxes and are still seeking even further cuts.
I’m Peter Dekom, and we are all growing older, may have aging parents and grandparents, but with our heads in the sand, we simply do not seem able to get our priorities straight.
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