CARING FOR OLDER ADULTS
Maryland, like every other state in the country, is home to a booming population of older adults. Unfortunately, the rising cost of quality healthcare too often halts their ability to contribute to the social and economic life of our state. Older adults help anchor our economy, educational system, and communities; my administration won’t allow bad policy to hold them back.
In 2011, the first members of the Baby Boom Generation began to reach the age of 65. As this group continues to age — aided by advances in medicine and long-term trends in life expectancy — Maryland will experience a rapid increase in the number of older adults in the state, both in total population and as a percentage of total residents. Maryland currently has an older adult population of over 1.2 million. This number is expected to increase to nearly 1.7 million by 2030. In addition, individuals over the age of 60 comprised 18.35% of the state’s 5.8 million residents in 2015, and are expected to reach 25.4% of the population by 2030.
These figures are even more dramatic for Maryland’s octogenarian residents. This segment of the population is expected to grow from 96,437 individuals in 2015 to 227,527 by the year 2040, a 136% increase. 80+ year-old residents, just like any other Marylander, have a right to healthcare, and their care often requires special considerations for the chronic conditions, physical limitations, and disabilities. Yet current Medicare policy in Maryland often pays too little attention to their priorities, forcing them into burdensome medical interventions that yield few benefits during their lifetime. This system, combined with underfunded social support services from nutrition and housing to transportation and mobility programs, weakens the social safety net for older adults, forcing them to choose between the bare necessities when spending their limited savings and pushing them unnecessarily into nursing homes.
Maryland must comprehensively reform the services that we provide our senior citizens by prioritizing their unique needs, without crushing them under unmanageable costs. As Governor, I will work tirelessly to implement these reforms and ensure older adults receive the care that they want and deserve. Older adults form the bedrock of our society; we can’t afford to let a lack of political leadership undermine their ability to contribute to society and our responsibility to help them age with as much dignity and independence as possible.
Changing the System
Creating a Medicare system that better accommodates older adults will require us to recognize that individuals above the age of 65 typically require a different quality of care than younger residents. For this reason, my administration will pursue reforms to Medicare that will enable the system to create elder-directed, comprehensive care plans that reflect the values of each individual beneficiary. These plans will enable care to be delivered in the home, where it has been proven to be most beneficial to older adults, instead of in a hospital setting.
Maryland’s Medicare waiver gives our state a unique degree of flexibility to address the concerns of our aging population. As Governor, I will take advantage of this waiver to expand the coverage of Medicare to assisted-living facilities, community-based support programs, nutritional support, and other evidence-backed programs that have demonstrated impacts on older adults’ health and well being. Reimagining Medicare in Maryland means broadening its mission to health promotion and disease prevention, instead of limiting it to medical interventions constrained by a broken medical model.
Protecting Older Adults
As Governor, I will establish a community medical care authority to monitor the quality and expense of the medical care delivered to the older adults and disabled individuals in neighborhoods throughout the state of Maryland. This authority will ensure that older adults’ rights and preferences are protected when they receive care, regardless of where they live or how much money is in their bank account.
But in creating a comprehensive medical care environment for older adults, we must recognize that many of the challenges they face are not simply medical, but are the product of economic and social pressures. More than 76,000 older Marylanders (more than 7% of the population over 60 live below the federal poverty line. Over 38% of these low-income older adults live in Baltimore County, and nearly half of them are racial or ethnic minorities. We cannot address the struggles our older adults are facing without first acknowledging the disproportionate impact that structural racism and poverty have on the well being of many older adults. For many of these residents, their medical issues are related to, or the result of, instability in their housing, access to services, and safety For these Americans, we need to pair improved medical services with social and community support to lift them from poverty, and address their needs.
That means investing in chronically under-funded programs with track records of success, like wellness initiatives, nutritional support programs like My Groceries to Go! and the Senior Farmers Market Nutrition Program, educational programs about health and aging, and counseling services for caregivers, as well as general assistance with housing, finances, and home safety. As Governor, I will redirect funding to these programs and other initiatives.
Reinvesting the Savings
Implementing better geriatric care and eliminating low-value, unnecessary services will yield substantial Medicare savings; savings that I will call on the heads of our health agencies and aging services use to fund the management of our local health care infrastructure and to enhance social and supportive services for older adults.
By hiring community health workers to support and teach patients in our rural and medically underserved urban areas, we can reduce our Medicare costs by more than 25%, while returning more than three dollars for every dollar spent. By implementing injury risk reduction programs for older adults, we can return nearly five dollars for each one we spend. Yet these programs, and other health promotion initiatives, make up less than 3% of total health spending in Maryland.
As Governor, I will renew our state’s investment in these critical health promotion programs, and redirect the savings into community-based supports and services that are focused on making our neighborhoods safer and creating healthier environments for older adults to thrive. Our aging residents, with all of the work they’ve put in over the years to make this state America’s greatest, are our most treasured assets. They deserve a government that gives them the resources to live their lives without fear.