AARP and Medicare

“Thirty-three million Americans in love with airline discounts.”  This was former Senator Alan Simpson’s snide quip about AARP, née the American Association of Retired Persons.

Since the time of Simpson’s broadside, the organization has grown to some 35 million, not counting those who have burned their membership cards in the last few weeks.

You cannot count me among the card burners since, for the last quarter century, I have steadfastly refused to join this thinly disguised big business. But, had I ever relapsed, I would definitely have burned my card weeks ago over AARP’s endorsement of the now-passed Medicare bill.

Despite AARP’s dubious record of advocacy for needy older people, I felt shock that this organization would support a piece of legislation that serves elder citizens and the whole nation so poorly. It forms a curious bookend to AARP’s refusal to back Medicare at all, when it was first enacted in 1965.

This time, AARP planned to spend 25 million dollars to spread word of its endorsement. In full-page newspaper ads and radio and television blurbs the association defended putting its weight behind a bill that even they admitted was “not perfect.” Now, after passage, we continue to read further justifications by AARP for its action.

“Not perfect” qualifies as the understatement of the year. In fact, the supposed main reason for the bill, the much ballyhooed prescription drug benefits contained within it, is seriously flawed. Among other problems, the drug coverage has a big hole in it, creating a so-called “doughnut.” If you should have incurred $2,200 of drug costs (not counting a monthly premium of $35 and a deductible of $250), then coverage ceases altogether until you have spent $3500.

But the legislation goes far beyond drugs. As economist Jeff Madrick writes: “What began as a prescription drug plan for the elderly has been turned into a major revision of the entire Medicare program.” Private health care companies will soon compete with Medicare so as to make one of our basic social welfare institutions almost unrecognizable.

The AARP’s action looks, for all the world, like a political ploy, designed to get George W. Bush elected to a second term. It raises the question of what kind of deal AARP has been promised, perhaps a quid pro quo that will result in the organization growing yet fatter on money.

Families USA , formerly the Villers Foundation, sums up the some other serious problems with the legislation. “It will cause deep disappointment for America's seniors and people with disabilities. It provides very limited drug coverage; fails to moderate skyrocketing drug costs; and spends lavishly to push seniors into managed care plans.”

Unfortunately, passage of this legislation has a deeper meaning. As Robert Binstock, professor of political science at Case Western Reserve University, laments, it represents “the dismantling of the old age welfare state.” It brings to a crashing end an era when the federal government provided for the well-being of elders who needed help.

At a recent meeting of the Gerontological Society of America in San Diego, Professor Binstock spoke out boldly about the likely effects of the changes in Medicare. He regards it as a reversal of American history of the last seven decades and foresees damage to the social structure carefully built up over this period.

Binstock, one of the nation’s leading gerontologists, is widely known for his ability to present clearly governmental and political issues as they touch upon the interests of us elders. I took a course from him some 25 years ago when he taught at Brandeis and still value his incisive accounts of dramatic improvements in the economic and social status of America’s elders during most of the twentieth century.

Binstock also foresees baby boomers being left high and dry by the future lack of Social Security funding, as younger Americans have long thought would happen. To him, it forms part of a “starve the beast” strategy designed to make money unavailable for social services. By next year, the federal deficit is slated to reach 500 billion dollars and the federal government will be constrained to stop feeding social services.

Before it becomes too late, he wonders if members of the boomer generation will organize and mount nonviolent confrontational challenges to governmental policies.

Important is that the new Medicare program will not start to take effect until 2006. That presumably will allow social policy experts to publicize little-known parts of this huge bill. Repeal does not seem at all likely in a Republican-controlled Congress, as happened to the Medicare Catastrophic Coverage Act in 1988, but pressure to fix some parts might develop. Don’t expect AARP to be part of that process any time soon.

Meantime, it’s worth taking note how AARP now shuns words like old, retired, or such language. It will no longer be caught associated with anything that smacks of advanced age. Can it now be that AARP is practicing a subtle ageism that goes against its stated ideals?

Richard Griffin