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Dates we remember.

December 7, 1941 ... September 11, 2001 ... the day you finally decided you were no longer able to care for a loved one. In different ways, each of these dates brought forth emotional surges that changed life forever for those who lived through them.

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The bombing of Pearl Harbor and the 9/11 terrorist attacks left Americans with emotional scars that will never disappear. The lessons learned related to national defense have and will continue to influence the way Americans live for decades to come.

Yet, in many ways, our nation's leaders' failure to recognize the signs of pending disaster is likely to occur again in our social policy associated with Social Security, Medicare, Medicaid, and elements of the Older Americans Act. While no one will say that failed social policy will bristle the backs of Americans the way violent attacks on our way of life did, in private life and in alarming instances we Americans are experiencing an erosion of spending power, as Social Security fails to keep up with the cost of living, Medicare weakens, Medicaid is threatened, and funding for senior programs is cut. Each of these situations will continue to have significant impact on the way age-tenured Americans live and plan their lives for decades to come. Although the gift of medical science has added years to life, the pressing question remains: Will those be years of quality or years of distress?

Let's look at the similarities between what happened in 1941 and 2001 and what appears to be occurring in society today, relative to aging. As has been widely documented, past military or terrorist attacks on our national interest occurred not from lack of signs that they were coming, but because intelligence systems failed to respond to the signs available. Relative to homeland security, press accounts have shown that entities designed to protect the population (personal, state, local) either lacked systematic capability and/or the will to coordinate activities to ensure an effective response. The now infamous nonresponse to Hurricane Katrina was the most recent and dramatic illustration of this.

Turning our attention to America's social policy on aging--or the lack of it--much has been said in recent months about the fate of Social Security, Medicare, Medicaid, and services defined under the Older Americans Act. Beginning in 1935, President Franklin D. Roosevelt brought forth Social Security to address circumstances coming out of the Great Depression. In those days, he indicated there could be two possibilities for implementing such a program. One was "pay as you go," or tax collections to pay benefits for older Americans concurrently (the option ultimately selected); the other, tax collections saved to fund taxpayers' benefits as they become older Americans (somewhat resembling President George W. Bush's savings-based reform proposals). As President Roosevelt indicated at that time, choosing "pay as you go" could mean that future generations might encounter problems if beneficiaries increased and contributors decreased. Is this not where we find ourselves today?

Moving to the mid-1960s under the administration of President Lyndon B. Johnson, Medicare. Medicaid, and the Older Americans Act were born. All were well-intentioned programs that, with Social Security, were essentially fresstanding entities weakly joined under the federal government through the former Department of Health, Education, and Welfare (now Health and Human Services). The result we see today is four significant pieces of social legislation and programming designed to address the needs of Americans as they age with little networking to bind them together for a sound policy on aging.

As we continue to struggle with attempting to maintain these programs, it is imperative that we call on our elected leaders to bring forth a new federal policy. At a minimum, the new policy needs to do two things: first, bridge the gap between the Social Security Administration, the Centers for Medicare & Medicaid Services, and the Administration on Aging in much the same way as has been done with homeland security, bringing together the entities of the FBI, CIA, Secret Service, and state and local law enforcement and emergency responders. Second, specifically related to preparedness for widespread chronic illness via services to be supplied either at home or in an organizational setting (i.e., assisted living/nursing facility), Congress must explore in earnest incentives created through tax deductions to encourage purchase of private long-term care insurance. The long-term effect of doing so can be to ensure more secure sources of revenue to meet a broader range of individual chronic needs, while taking pressure off the Medicaid system.

While the aforementioned points in no way should be considered a panacea for the ills that often come physiologically and socially with aging, at a minimum they could be major steps forward in developing a platform responding to the needs of age-tenured Americans. Presuming responsible congressional action is forthcoming, perhaps the future will avoid social system collapse and the making of another American "date to remember."

Daniel W. Farley, PhD, is President and CEO of GlenWood Park Retirement Village, Princeton, West Virginia. He is also a member of Nursing Homes' Editorial Advisory Board. For more information, call (304) 425-8128. To send your comments on this editorial to the author and editors, e-mail farley0306@nursinghomesmagazine.com.

Guest Editorials cover the spectrum of long-term care. Do you have thoughts you'd like to share? E-mail rpeck@vendomegrp.com.

BY DANIEL W. FARLEY, PHD
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Title Annotation:attacks against Americans
Author:Farley, Daniel W.
Publication:Nursing Homes
Article Type:Column
Geographic Code:1USA
Date:Mar 1, 2006
Words:890
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