John Edwards for President-Security, Dignity and Choice: A Declaration of Independence For Older Americans

Security, Dignity and Choice: A Declaration of Independence For Older Americans

"It's time for a new kind of declaration of independence—a commitment to helping older Americans live independently, with choice over their health care, financial security and lifestyle. It's not enough to congratulate ourselves on living longer, if we are not living stronger." --John Edwards

Americans are living longer. The number of Americans over the age of 65 is expected to double by 2030, and the number over 80 will more than quadruple to almost 20 million. But our health care system is set up to treat the worst problems instead of promoting health and quality of life. Our housing policies too often force seniors to choose between isolation or institutionalization. And our policies for work and savings have not adapted to the economic and lifestyle changes of the 21st century. [Census Bureau, 2006]

John Edwards released a new agenda for older Americans based on the values of security, dignity and choice to help every older American live as independently they desire.

Financial Independence

1. KEEP THE PROMISE OF SOCIAL SECURITY:

Edwards is committed to protecting Social Security. He has strongly opposed President Bush's efforts to privatize it, which would cut guaranteed benefits and risked individuals' retirements in the stock market. The financing of Social Security can only be solved by a package of reforms that has the support of both Democrats and Republicans. Edwards supports a successor to the Greenspan commission appointed in 1981, dedicated to finding a solution that is non-ideological, strongly bipartisan, and committed to the goals of ensuring every American can retire with dignity and extending the life of the Trust Fund. One option is an additional tax on workers with very high incomes.

2. PROTECT PENSIONS AND HELP FAMILIES SAVE:

Employees who have worked hard all their lives should not be denied the pension benefits they have earned. Edwards opposes allowing companies to switch out of defined-benefit plans in order to deny long-term workers their pensions. Edwards will also prevent corporate executives from walking away with millions while companies are going bankrupt and reform the bankruptcy laws to prevent companies from shedding their obligations to workers. At the same time, because nearly half of working Americans do not own any type of personal retirement account, Edwards has proposed a series of initiatives to help millions of families realize financial security and retire with dignity. These initiatives include: creating new tax credits to match the savings of low and middle-income families, giving taxpayers the option of directly depositing their tax refunds into a retirement account, and offering free savings accounts to the nearly 28 million Americans without them so they have a way to save and avoid exorbitant check-cashing fees. [Aspen, 2007; Federal Reserve, 2007]

3. FIGHT PREDATORY LENDERS:

Older Americans' 80 percent homeownership rate makes them prime targets for predatory refinance mortgages. Seniors are also vulnerable to payday lenders, who charge over 300 percent interest on cash advances on Social Security checks. Edwards will protect families through a new federal regulator, the Family Savings and Credit Commission, whose sole job is consumer protection. He will also ban all payday loans at interest rates over 36 percent, prohibit predatory mortgage lending and reign in the credit card industry. [AARP, 2007; CRL, 2006]

4. PRESERVE FREEDOM TO WORK:

The freedom to work is critical to the dignity of older Americans. Edwards supports vigorous enforcement and strengthening of the Age Discrimination in Employment Act and the Americans with Disabilities Act to protect Congress' original intent. He will also protect older workers from early retirement "incentives" that push them out of their jobs. His health care plan will guarantee quality, affordable coverage for older Americans who transition to temporary, part-time or independent work but are not yet Medicare-eligible. He will also modernize unemployment coverage to give more security to many of these workers.

Health Security

5. PROTECT THE FUTURE OF MEDICARE:

Skyrocketing health care costs have put pressure on Medicare and threatened its long-term solvency. The Medicare trust fund is projected to be exhausted in 2019. Instead of strengthening Medicare for our seniors, George Bush has surrendered it to the drug companies and HMOs. The first step toward extending the life of Medicare is universal health care reform that makes health care more cost-effective, including investments in preventive and chronic care, electronic medical records, and promoting proven cost-effective care. Within Medicare, Edwards will clamp down on skyrocketing drug costs and stop the overpayments of insurance companies, using the savings in part to ensure that low-income Medicare beneficiaries have access to the care they need. [OASDI Trustees, 2007]

6. MAKE PRESCRIPTION DRUGS AFFORDABLE:

Drug costs have risen three times faster than inflation since 1994. Top companies spend twice as much on marketing and administration as they do on R&D. Edwards will take on the pharmaceutical and insurance industries to help seniors. He will allow Medicare to negotiate drug costs with drug makers and give Medicare beneficiaries the choice of a public plan for their prescription drugs. He will also permit safe reimportation from Canada, restrict direct-to-consumer advertising for new drugs, ensure evaluation research is truly independent, eliminating loopholes and trade obstacles that block generic drugs, and let the FDA approve biogeneric drugs to bring down costs. [KFF, 2007; Families USA, 2007]

7. REVOLUTIONIZE CHRONIC CARE:

The 23 percent of Medicare beneficiaries with five or more chronic conditions account for 68 percent of its costs, yet Medicare makes almost no effort to coordinate care. Doctors may unknowingly provide duplicative treatments and undercut each other's efforts, resulting in unnecessary problems and hospitalizations. Edwards will revolutionize chronic care by promoting proactive disease management, ensuring that doctors regularly check up on their patients, encouraging doctors to communicate with each other, and making sure that every American with chronic conditions has a patient-centered "medical home" allowing a doctor to coordinate their care and promote life-improving care as well as treat life-threatening emergencies. [Anderson, 2005]

8. STRENGTHEN GERIATRIC PRIMARY CARE:

Patients treated by doctors trained in geriatric care are a third less likely to become disabled, half as likely to develop depression and 40 percent less likely to require home health services, according to one study. But reimbursement rates for this care are so low that the division was shut down soon after the study was completed. The number of certified geriatricians fell by one-third between 1998 and 2004 and only 330 doctors nationally will complete geriatrics training this year. Edwards will emphasize primary care in the Health Care Markets by writing reimbursement rules that encourage proven geriatric care. He will also call on experienced geriatric doctors to train the next generation of primary care doctors and nurses in geriatric care, including how to identify treatable conditions in older Americans – like depression, malnutrition, isolation and podiatric problems – that, if ignored, often lead to a downward health spiral. [Boult at al., 2001; Gawande, 2007]

Living With Dignity

9. OFFER CHOICE IN LONG-TERM CARE:

Our long-term care system is poorly equipped to give independence to older Americans and forces many families to juggle elder care, child care, and their jobs or spend themselves into poverty to pay for nursing homes. Edwards will reform Medicaid and Medicare to let people to choose home-based care in their communities and test innovations such as asset and income protection programs. He will also support states and communities offering much-needed and often less expensive alternatives – like adult day care and senior villages – that allow seniors to live at home with their loved ones.

10. IMPROVE NURSING HOMES AND CRACK DOWN ON ELDER ABUSE:

Independence is the goal, but we also need to strengthen quality and safety protection in nursing homes. Edwards will establish national standards for nursing home care, increase national enforcement against abusive nursing home chains, expand inspections and increase penalties for homes that fail to provide decent care. He will also help improve quality of care with measures like reducing patient-staff ratios and improving care provider training.

11. PROMOTE LIVABLE COMMUNITIES AND ACCESSIBLE TRANSPORTATION:

Too many seniors are forced to move from their private homes because they lack supportive services or reliable transportation. Edwards will promote livable communities to make sure every American has the right to age in the setting of their choice. He will create new supportive housing options that give older Americans the choice of community-based living, vigorously enforce civil rights laws to ensure that federally-funded housing is accessible, and protect supportive services like meals-on-wheels and senior centers that sustain independent living. He will also meet the special needs of senior drivers by helping health professionals educate their senior patients about the interaction between health and driving and encourage automakers to make affordable, wheelchair-accessible vehicles. In the Edwards administration, the Department of Transportation will prioritize transportation access requirements, fund accessible mass transit like "kneeling buses" that are easier to board, and support paratransit services in rural areas.