The population across the United States is aging, and Maryland is no exception. The number of people over 65 years of age is growing as the “baby boomers” become older.  Today’s 65 year old was born in 1937.  Due to population demographics and an increases lifespan, dramatically more seniors will be in the US by 2020 and 2030.  What is more significant is that as a percentage of the overall US population, seniors will become an increasingly larger fraction of the general public. 

People are living longer as a consequence of improved preventive medical care and more effective treatments for debilitating and fatal diseases.  Our seniors also are retiring today with an increased number of financial plans to support retirement years (social security, government retirement, IRAs, pension plans, 401Ks, etc.).  These are certainly an improvement over 20 years ago.  There are many things, however, for seniors to be concerned about.

Financial Security

The fall of the Internet and telecommunications industries was the prelude to the exposure of whole scale fraudulent accounting in such scandals as ENRON.  Seniors should have conservatively invested portfolios (more bonds than stocks), however, many seniors were hurt in the collapse of equity markets.  These “paper losses” have essentially pushed the burdens of growing old onto individual families and the public (through Medicare and Medicaid). 

The answer here is not to pass legislation which dictates to investors what they can and cannot invest in (e.g., limiting the amount of company stock a person can purchase in a 401K).  The public and employees of companies rely on public accounting firms to accurately assess the balance sheets of companies which we invest in.  Accurate accounting of financial statements and full disclosure of those findings (in clear language) are what we deserve. 

Given the pivotal role that public accounting firms play in confidence we place in our financial markets, I would support legislation which would apply stiff civil and criminal penalties to those accounting firms and individuals which engage in activities with their clients which are clearly a conflict of interest.

Health Care that Cares

Long term care, prescription drug assistance, costly hospital stays, increasing insurance costs, and nursing home expenses are issues that our society must address in the coming years.  We must do so in such a way that the  increasing number of retirees’ benefits are affordable by a shrinking work age population.  Actions which we take must also be a commitment to our seniors that we will fight to preserve their dignity and independence.

• People need to live as independently as they can – for as long as they can.

• Prescription drug bills cannot continue to escalate.

• Insurance must be affordable and obtainable by as many people as possible.In-home care must remain an affordable and reliable alternative to hospitalization or rehabilitation centers.

• Nursing homes must be held to standards of care through a formal medical certification process. 

• Medical professionals must have the freedom from lawsuit or prosecution to prescribe effective pain relief for people in need.

Our legislature has worked on prescription drug benefits (the Senior Prescription Drug Relief Act), however, the benefits under that program are only temporary -- they expire in 2003.  Worse yet, there is no hope in the near term that the federal government will institute expansions to cover these drug costs.  In addition, rising healthcare costs are threatening the Medicaid system and the most likely places to get hurt the most are nursing homes.  These financial pressures will cause these institutions to continue to look for ways to contain costs and reduce non-essential activities.

Controlling the costs of drugs

Today, many seniors find themselves having to forgo a proper course of treatment with modern medications due to the costs of these drugs.  Some seniors are faced with the choice of medicine or food,  medicine or that small gift for the grand child, etc.  Not surprisingly, a close examination of the rising overall cost of healthcare reveals that the main cause is prescription drugs.  This increase, however, is not due to research costs.  The main change since 1997 is the amount of money that drug companies spend on advertising.  In 2000, the pharmaceutical industry spent nearly $2.5 billion on mass media advertising.  This is more than a 300% increase over four years (before advertising was permitted).  In fact, in 2000 over $16 billion was spent on marketing to doctors, hospitals, clinics, and patients.  Recent increases in such advertising (particularly television) are obvious to any of us that tune in to prime time television.

In response to the impact of advertising on the cost of drugs, I would support legislation which would seek to recover or contain these costs.  A task force would study the options of: 1) opening the financial books of all drug companies whose medications are paid for with state tax dollars with the aim of limiting the amount of these advertising costs which can be passed on to consumers; 2) taxing media outlets which offer time/space to drug companies; and 3) finding other mechanisms which have the result of reducing these costs.  One such mechanism could be voluntary price reductions by the pharmaceutical companies based on volume of drugs purchased by government funds.  By taking this action, Maryland will be able to continue to support the Senior Prescription Drug Relief Act beyond its expiration in 2003.

Declaration of independence

Our seniors deserve all of the creative ideas which we can create to help them stay independent and not be a burden to their families or spouses.  A number of new technologies are becoming available which will increase the amount of attention that a person can receive in their home via computer.  Specialized computers which take blood pressure, measure oxygen content in blood, etc. are becoming available.  These computers allow the patient and the medical professional to see each other, as well as assess the general well being of the patient.  These “electronic nursing visits” could be the only visitor a person might have that day.  These computers can also be programmed to remind patients to take medications, as well as respond to voice commands.  These devices could also relay medical telemetry to monitoring stations (such as heart function, respiration, etc.) which would provide the earliest possible notification of medical distress.

The state plays a role in this in two ways.  First of all, Maryland needs to lead the way in establishing reimbursement for these costs both by state funded means, but also by insurance carriers in the state.  In addition, Maryland’s Department of Economic Development (DBED) should partition a portion of its development funds to attracting companies which would develop such devices here in the state – incentivizing them to locate here via low interest loans or tax credits.

Senior Center survival

Senior Centers all around the state are becoming overcrowded and less responsive to the needs of their communities.  Here in Anne Arundel County, our own Centers have had to adopt “shifts” in order to make sure that people can get access to facilities and programs.  Clearly, the coming substantial increase in Senior population in the country will mean that something has to be done with our current Senior Center system.  It is possible that some day in the future (perhaps twenty years from now), the number of citizens who can attend Senior Center programs may approach the number of children in our public school system. 

It is for that reason that I would support legislation to examine expanding the role of local school districts and community colleges to encompass a “life long learning” mission.  As such, a single integrated authority would be created which would allow for the efficient allocation of facilities, capital, and administrative resources.  For example, with this flexibility, underutilized school facilities could be used for Senior Centers.