PPA 419 Aging Services Administration

1
PPA 419 Aging Services Administration

• Lecture 1 The Context of Aging Policy,
  Services, and Administration

2
The Paradox of Aging Policy

• Safety net for the elderly receives widespread
  support. Support ranges from 93 to 96 percent.
• But, both the Medicare and Social Security trust
  funds are increasingly vulnerable to budget cuts.
• How is it possible for a set of policies with
  such broad public support to face such critical
  decisions?

3
Socioeconomic changes in the status of the elderly

• Aging of the baby boom generation.
• 1993 elderly 13 of population, 33 million
  people
• 2050 elderly 22 of population, 69 million
  people
• Greatest growth among those over 85 4.3 million
  in 2000 to 17.7 million in 2050.
• More ethnically diverse.

4
Socioeconomic changes in the status of the elderly

• Aging and economic change
• Median income increased for elderly by 60 to 75
  percent between 1969 and 1996, whereas the
  overall figure for all households increased only
  6 percent.
• Poverty among the elderly dropped from 22 percent
  in 1959 to 11 percent in 2000. Poverty among all
  households fluctuated around 13.2 percent for the
  last 20 years.
• In 1993, the highest net worth among all
  households was for 65-74 year olds (92,000 to
  95,000).

5
Socioeconomic changes in the status of the elderly

• Aging and economic change (contd.)
• But, poverty higher for elderly African-Americans
  (25 to 47 percent, depending on gender and
  marital status) and elderly Hispanics (27 to 47
  percent).
• A substantial percentage of elderly population is
  just above poverty (0 to 150 of poverty) 23
  percent.

6
Political Vulnerability of Aging Policy

• Public indifference to aging issues.
• Despite broad public support, most aging policy
  written by aging elites. Public rarely mentions
  aging policy as most serious problem.
• Support broad but shallow.
• Prospect of generational conflict
• Classic generational equity argument tradeoff
  between children and elderly.
• Poverty declining among elderly and increasing
  among children.
• Allow little evidence exists of actual conflict,
  political pressures are increasing.

7
Political Obstacles to Aging Policy Change

• Decentralization, short-term solutions, and
  policy incoherence.
• U.S. system decentralized and averse to
  long-range planning.
• Federalism and separation of powers
• Produces splintered political demands
• System rewards short-term ad hoc distributive
  policies over long-term comprehensive
  redistributive policies.
• System limits policy making capacity and
  encourages policy incoherence.
• Results in aging policy uncoordinated,
  incomplete aging policy network. Significant in
  income and health, but sparse elsewhere.

8
Political Obstacles to Aging Policy Change

• Political Polarization and Policy Gridlock
• Programmatic parties and decentralization likely
  to generate policy gridlock.
• Recent trend in U.S. has been toward more
  ideological political parties.
• Result More policy gridlock.