Health care in the golden years

Death panels, aging Boomers, assisted living.

The past week reverberated with anxiety about health care for seniors, and for those about to be seniors.

The latter group includes me. I’m a member of the Baby Boom generation, the large segment of the American population born in the late 1940s and the 1950s. I have several years to go before I’m 65 and eligible for Medicare. Still, I was startled when Dan Day, president of the Assisted Living Association of Georgia, testified at an Atlanta hearing Wednesday that ‘’the first edge of Baby Boomers are turning 65 in January.’’

“It is vitally important to help manage the health care needs of this growing age group,’’ Day said.

Every time my body creaks and groans – more often with each passing year – I’m reminded that my health care needs will only get more pressing. Like everyone else, Baby Boomers wonder who’s going to end up caring for them – and, of course, how much it will cost.

A survey showed most Boomers believe they won’t be able to rely on Medicare, the health insurance program for those 65 and older, throughout their retirement years, the Associated Press reported Thursday. Those concerns are stoked by the rising cost of the federal Medicare program, hitting $500 billion annually.

The AP survey also found that when forced to choose between raising the Medicare age or cutting benefits, 59 percent of Boomers said they preferred to raise the age.

The demise of Medicare seems about as likely as a lottery ticket paying off. Any type of financial cut to the program is a political landmine, and as long as the country has a pulse, Medicare will remain in existence.

But it seems equally unlikely that Medicare can simply go on unchanged. Raising the entrance age may be a way to help sustain it. “You’re probably going to have to look at that,’’ says Kelly McCutchen of the Georgia Public Policy Foundation. Other ideas to control costs in Medicare, he said, include having medical providers compete more, based on their prices and quality.

The AP also reported that what older Americans have paid into the system via Medicare payroll taxes doesn’t come close to covering the cost of their medical care. And that’s with Medicare not covering much of the cost of long-term care. Families generally pay out of pocket for assisted living facilities for their loved ones.

Despite those monthly bills, family members of assisted living residents expressed their loud opposition Wednesday to proposed changes in the state’s rules for such facilities.

Many families prefer to have their loved one ‘’age in place’’ – remaining at an assisted living facility instead of moving on to a nursing home. They feel that the new proposals, though, would lead to more people moving to nursing facilities. Expect legislation on these proposed changes in the General Assembly.

End-of-life issues also received a national airing on Christmas when the New York Times reported that Medicare would pay physicians who advise patients on alternatives for end-of-life care.

This subject provoked accusations of government meddling in 2009, when the proposed health care reform bill contained a similar provision. Opponents said it would foster the withdrawal of life-sustaining treatments from people, and that the government would decide who could receive health care. Sarah Palin and other critics claimed that older Americans would essentially be at the mercy of  “death panels.” President Obama responded that the bill would not ‘’pull the plug on Grandma.’’

The legislation would have let Medicare reimburse doctors for their time if seniors chose to consult them on end-of-life issues, such as making a living will or hospice care. There was no requirement for Medicare members to do this; it was voluntary. Nevertheless, the uproar caused the Democrats to drop the provision from the health care bill before the bill passed.

Now, Medicare funding for end-of-life counseling has been revived, but the Obama administration’s rules will accomplish it by regulation instead of legislation. The counseling will be totally voluntary, just as it would have been under the law. But opponents don’t like the idea any better now than they did earlier, and they resent what they consider an end run around the legislative process.

The New York Times cited critics of advanced care planning, including Elizabeth Wickham, executive director of LifeTree, who said that with the end-of-life counseling, “patients will lose the ability to control treatments at the end of life.’’

My three brothers and I had trouble last year figuring out what do for our father during his last days. He did not have a living will, and it presented a dilemma for us. Here’s what I wrote for AOL on the family episode. It’s a discussion that families should have.