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Risking Old Age in America.

Public affairs books scheduled to be published this month.

Risking Old Age in America. Richard J. Margolis. Westview, Press, $36.50. "To a nation that runs more on instinct than on intellect," Margolis writes in the conclusion of his book, "elderly poverty may be the sternest cerebral challenge of all." Why elderly poverty is a bigger brain-twister than, say, childhood poverty, Margolis doesn't say, but sure enough it's a tough subject. Thinking about old age as a policy issue brings with it some of the darkest and most uncomfortable emotions that can beset a human being: namely, the absurd injustice that we are all slowly dying, and that most of us can't afford to grow old. Unfortunately, Margolis doesn't meet the intellectual challenge he recognized would confront him in trying to make sense of America's aging policies. He has gathered telling statistics. He has mastered the complex legislative histories of programs like Social Security and Medicare. He has interviewed policy experts. Most impressive, he has traveled across the country listening to the elderly poor tell how they have been disserved by government programs designed to benefit them. But having so diligently reported on the failure of Social Security and Medicare to end poverty among the elderty, Margolis ignores his own evidence and boldly defends spending still more on programs that distribute without regard to need, using arguments that are as tired as they are irrelevant to today's circumstances. it is a triumph of compassionate instinct over intellect that is almost embarrassing to witness.

Margolis certainly has all the facts he needs to demonstrate the moral, if not the political, faiture of Social Security. And indeed he is critical of the program. He notes, for example, that "the relatively generous benefits that Congress has made possible over the past generation have done almost nothing for the bottom echelon of Social Security recipients, serving only to widen the gap between the elderly poor and the elderly affluent." Social Security, he goes on to observe, "turns poor wage earners into still poorer beneficiaries." That is a powerful indictment that many others have made before. Yet Margolis's conclusion from it is to declare "the natural superiority of universal entitlements-programs for everybody-to means-tested benefits designed exclusively for the poor."

Margolis knows enough about the politics of Social Security during the last generation to realize that they have led, as he puts it, to "affluent retirees enjoying a lion's share of the gains." Yet Margolis is still persuaded, in the face of this legacy of greed and neglect of the poor, that yielding to the demands of affluent retirees for still more subsidy will somehow relieve the suffering among the needy that he has so well chronicled. Margolis was apparently driven to this conclusion by his reporting on the horrors of Medicaid, Supplemental Security Income, and other meanstested programs for the elderly. He demonstrates convincingly, for those who don't already know, that these programs are woefully underfunded, maddeningly complex in their rules, and administered by bureaucrats who are often uncaring and more often incompetent. But instead of searching for effective ways to humanize and streamline the bureaucracy, or for ways to attract greater political support for programs that target the needy, Margolis simply falls back on that cynical cliche of the New Deal generation that a means-tested program inevitably makes for a meanspirited one.

In the Reagan years and even before, that cliche was proven true. But it doesn't follow, as Margolis's own reporting unambiguously shows, that our non-means-tested programs have been of any greater benefit to the poor. Indeed, with its highly regressive payroll tax, Social Security may already be pushing as many low-income workers below the poverty line as it is lifting retirees above it. And certainly, as the population ages, any program that distributes benefits on the basis of seniority alone will impose even greater burdens on younger taxpayers while also having to spread its benefits more thinly among the swelling ranks of the elderly. If universal entitlements are now failing the elderly poor-and they certainly are-in the future such programs will become even less effective in reducing poverty among the elderly, unless we find the moral and political courage to aim benefits, in one way or another, away from the affluent and to the needy.

Margolis's fixation on poverty among today's elderly does serve a useful purpose. A new stereotype of the elderly is emerging that holds them all to be affluent greedy geezers; that is certainly not true, as Margolis ably proves. But by neglecting the challenges faced by the next generation of elderly, Margolis lapses into serious errors of logic. "Most of us probably know as much as we need to know about the demographics of aging," he opines early on, and then just marches away from the subject, as if the aging of the population had no relevance to the policy prescriptions he offers. In his discussion of Medicare, for example, Margolis proposes numerous arguments for why the program should be expanded but never mentions that Medicare is officially projected to become insolvent long before today's middle-aged Americans reach retirement age. This thoughtlessness about the future leads to all sorts of fuzzy sentiment. "Like Social Security, Medicare is a kind river in which all of us swim," Margolis writes. "In exchange for future protection, the young keep providing for the old, and in time the upstream givers become the downstream takers." It's a noble and poetic thought, but one that we have no right to believe. Today's old, when they were young, didn't contribute to Medicare because the program didn't exist. Today's young, when they are old, will have paid in throughout their working lives at ever higher rates, and Medicare will probably go broke before they retire, according to virtually all experts in the field. The solution is anybody's guess, but certainly ignoring the need for one won't make it go away.

Margolis is very good at identifying real needs, but his solutions would surely hurt the needy most of all, at least in the long run. Having committed himself ideologically to the "natural superiority" of universal entitlements, Margolis goes on to propose, for example, that every retiree in America be entitled to free home care-or in other words, a free nurse, maid, and cook. He even calls for all seniors, rich and poor alike, to be provided with a handyman, who would perform subsidized home repairs. Certainly many frail, low-income seniors could be kept out of costly nursing homes if we did a better job of helping them cope with daily routines such as shopping, cooking, and, yes, home repairs. But why younger Americans, the vast majority of whom don't even own homes, should pay extra taxes so that millionaires can fix up their mansions Margolis never explains. Nor does he explain how we will provide such expensive services to the needy if we squander so many resources on the rich. As America grows older, the real cerebral challenge before us is how to persuade more middle-class Americans that it's a good idea to support government programs that will actually insure them against poverty in old age. As Margolis shows, that's not what our current programs do, yet these programs are already enormously expensive and will become more so as the population ages. Because old age is such a vulnerable time of life for virtually everyone, I believe the challenge can be met-but only if we recognize that it exists.
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Author:Longman, Phillip
Publication:Washington Monthly
Article Type:Book Review
Date:Dec 1, 1989
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