MATURE MARKET HEADLINES POSTED 1/15/99
Congress' Punching Bag, Elderly Immigrants
They're mad as hell, and they're not going to take it any more. That's how I size-up Congressional efforts to keep SSI benefits out of the hands of elder immigrants. Here's the scenario. Congress believes that Social Security's Supplemental Security Income (SSI) benefit is so appealing to cash-strapped elders overseas that they decide to immigrate to the United States in order to partake of Social Security's "cash cow". The solution, don't let'em have it. In other words, "if you don't give it, they won't come".
On the surface, this SSI-immigrant issue appears rather mundane. But on closer inspection, this is an intriguing two-sided story. On the one hand, it's about at-risk elders who, regardless of where in the world they reside, may very well starve to death. Who should bear the responsibility of this burden? These overseas elders are not Americans. They have not paid into the Social Security system so why should they benefit? Besides, the whole darn system is collapsing from it's only weight. And if the system can't be made right, then future generations will experience Social Security only as a footnote in a history book.
But there's a more interesting side to this story, at least as I see it. Here comes the "on the other hand" part of this SSI-immigrant issue. The way I see it, Congress has been "taking it on the chin" from the Older Americans lobby for decades. They just can't say "No" to anything "elder" because senior power is just too, well ... powerful. Here's a chance to fight back. Give the elders the "old-one-two" right back. And foreigners are a good target. They can't fight back. The perfect punching bag. However, this isn't the case when Congressmen must deal with their constituents. I imagine after the obligatory smiles and reassurances to visiting elderly constituents, members of Congress sometimes sigh and say (to themselves of course) "where does it end?". Care of the elderly is not the only issue in America. There's kids issues, jobs, education, the environment. But Congress can't say "No" because the nation's elderly are the only people who bother to vote these days, at least in a manner that is grossly disproportional to their absolute numbers.
Well, here's a chance for Congress to have their cake and eat it too. On the issue of SSI-immigrants, they can say "No" AND have their votes too ... and sleep like a baby at night. The reality is that immigrant elderly are not drawn to America because of the SSI benefit. And the folks who are advocating this point have some numbers to back them up. The availability of Supplemental Security Income (SSI) has not attracted a lot of immigrants to this country and has not accounted for the increased caseload, according to a study by Jennifer Van Hook of the Urban Institute and Frank D. Bean of the University of Texas. Rather, the increase in caseload has occurred partly because of increases in the SSI usage among non-citizen elderly who have lived in the United States for more than 10 years. They are the ones who have accounted for more than half the caseload.
Van Hook and Bean argue that if the caseload increase were due to welfare acting as a "magnet" for potential immigrants, the increase would be accompanied by increases in the rate of SSI usage among recently-arrived non-citizens. But their study indicates that only a small portion of the growth is due to increases in SSI usage among newly-arrived immigrants. The study appears in the January 1999 issue of the Journal of Gerontology, a publication of the Gerontological Society of America.
Van Hook and Bean concluded that restricting SSI usage, as the recent welfare and immigration laws attempt to do, "is therefore not likely to reduce immigration, but rather to result in larger numbers of
earlier-arriving immigrants entering their old age without adequate financial support." Here's the point. The way I see it, is Congress exercising common sense or catharsis? Are immigrant elderly Congress' punching bag?
See related articles in the AgeVenture archives.
"Worldwide Gains in Life-Expectancy"
"Elder Power in the 21st Century"
"Older Women's Market Is Sleeping Giant"
AgeVenture News Service, www.demko.com
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Don't Turn Fitness Into an Exercise in Futility
Okay, health nuts. Grab a pencil and write this down. It's the health tip of the decade, A little sugar makes the medicine go down. No, I don't mean that literally. What I do mean is, no matter how beneficial a health regimen might be, we spoiled Americans won't do it unless it tastes, feels, or looks good. Diet? Forget it. The food's gotta taste good or we become a diet dropout. Fitness? Can't be just an exercise routine. It's got to consist of enjoyable activities or the whole regimen is an exercise in futility. That seems to be the message Kansas State University professor, David Dzewaltowski is stressing to the millions of Americans who over-dosed on holiday chow and now want to get ship-shape again. Only problem is, those trying to get ship-shape are still the size of ... well ... a battleship. If you're frustrated by too many ill-fated fitness attempts, you just might want to give a listen to what this KSU professor has to say.
When starting a new fitness program this year, says Dzewaltowski, a professor of kinesiology, you have to think "physical activity" as opposed to "exercise". The professor's right on the money. When I think of the word "exercise" it conjures up images of pumping iron in a sweaty gym next to hairy guys named Bubba. Not exactly my idea of FUN. "I like to give people the term 'physical activity' to talk about or think about when making a New Year's resolution," Dzewaltowski says. "It puts the focus on increasing activity throughout the day rather than limiting yourself to thinking structured exercise." Dzewaltowski makes a good point. Many fitness success stories are those in which people have "incorporated" higher levels of activity into their daily routine, so exercise becomes a way of life rather than a compartmentalized activity.
The goal is to accumulate 30 minutes of exercise each day, says the KSU professor. This could mean taking three 10-minute walks per day, shoveling the driveway or working around the house, says Dzewaltowski. Sounds good to me, but I'd think twice about shoveling the driveway if you live in a place like Florida or Arizona. "Most people set a goal that's way too difficult," Dzewaltowski says. "It's not really how hard you exercise that is the key to achieving some of the things people want from exercise -- like improved health or weight loss. The key is really sticking with exercise."
Some immediate health benefits of regular exercise include reduced risk of cardiovascular disease, some cancers, as well as relief from anxiety and depression. Long term, Dzewaltowski believes that exercise will help improve the quality of your life. It even helps prepare you for an active retirement so you can enjoy those golden years to the fullest. Too many retirees find they can't maintain an active lifestyle because "they haven't maintained their health well enough to perform those daily living activities."
See related articles in the AgeVenture archives.
"What's Your Fitness Personality?"
"Home Exercise Market Gaining Muscle"
"Healthy Habits Delay Disability by 8 Years"
AgeVenture News Service, www.demko.com
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Response to Female Depression is Depressing
It doesn't take a mental giant to appreciate the relationship between one's physical and emotional well-being. Ever witness a case of emotional "blahs" translating into sleepless nights or digestive distress? Phrases like "total fitness", "comprehensive medicine", and "treating the whole patient" have become so common place in today's society even mediocre Jeopardy players say things like "I'll take holistic medicine for $500, Alex". So if holistic is how modern medicine "thinks", is it also how modern medicine "behaves"? Not exactly, according to a study suggesting that today's health care practitioners don't exactly "walk their talk". Take a look.
Only 41 percent of doctors have asked female patients between the ages of 45 and 75 about their emotional or psychological concerns, according to a study by the National Center on Women and Aging at Brandeis University. Yet, 93 percent of all women surveyed said they would be comfortable discussing emotional problems such as depression with a doctor, leading the researchers to wonder why these difficulties are not being addressed by health care providers.
Even more alarming is the fact that even women who have suffered clinical depression are not asked about their mental health by their providers. Two out of five such women reported that their doctors had not raised these questions. The survey showed that women who reported being diagnosed with clinical depression are more likely to say they have little or no control over their own health. Compared to those who were not depressed, these women also were more likely to:
- rate their health as fair (36%) or poor (18%),
- report declining health over the past five years
- report unhealthy eating habits.
Depression is not only more common in women, but also may involve particular symptoms -- anxiety, panic attacks, and sleep difficulties for instance -- that occur more frequently in women than in men. "We are very concerned that health care providers are neglecting to inquire about an illness that strikes one in five women," stated Phyllis Mutschler, Ph.D. Executive Director of the National Center on Women & Aging. "We know that depression is not a normal part of aging and we urge providers to engage their female patients in a discussion of these serious health issues."
See related articles in the AgeVenture archives.
"Health-related Depression Higher for Men"
"90% of Elder Depression Goes Untreated"
"Embarrassment Is Major Medical Problem"
AgeVenture News Service, www.demko.com
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Quality Patient Care Counts on Nurse Count
A new study by researchers at the U.S. Agency for Health Care Policy and Research (AHCPR) that found that patients who have surgery done in hospitals with fewer registered nurses per patient than other hospitals run a higher risk of developing avoidable complications following their operations.
Studies like this demonstrate that it is critical to study the outcomes and effectiveness of changes in the organization and delivery of health care services, said AHCPR Administrator John M. Eisenberg, M.D. According to Christine Kovner, PhD, RN, one of the study’s authors, the finding of a strong inverse relationship between registered nurse staffing and adverse patient events should be considered when developing strategies to reduce costs.
Among the adverse patient events the study found associated with lower RN-to-patient staffing were increased urinary tract infections, pneumonia, thrombosis -- formation of blood clots -- pulmonary congestion, and other lung-related problems following major surgery.
Beverly Malone, PhD, RN, FAAN, President of the American Nurses Association, says, The findings of the AHCPR study come as no surprise to the ANA or to nurses on the front lines who strive 24 hours a day to ensure that patients receive the safest, highest quality care they deserve. Cutting costs by cutting the number of nurses at the bedside is a false economy today. The illnesses cited by the AHCPR study are often avoidable and thus unnecessarily increase costs both for patients and for the entire health care system.
Almost every patient admitted to the hospital is seriously ill. When patients already have serious or life-threatening illnesses, they don’t need additional serious complications on top of them. Nurses are patients’ first line of defense. The ANA believes hospitals should disclose to the public data on their staffing mix of health care providers and on patient outcomes.
See related articles in the AgeVenture archives.
"Doc's Bedside Manner Top Patient Concern"
"New Health Care Mandates Devastating"
AgeVenture News Service, www.demko.com
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Radiation Therapy Aids Angioplasty Patients
Johns Hopkins heart specialists are testing a device that delivers low doses of radiation to coronary arteries as part of a national clinical trial to see if radiation prevents the vessels from closing up after they're opened by balloon angioplasty or a stent.
The device, which hooks to a catheter containing tiny radioactive "seeds," is used in conjunction with angioplasty, in which a balloon is inflated inside an artery to flatten clumps of plaque. The hope is that the seeds will slow cell growth at the angioplasty site, reducing the chance of restenosis, a re-narrowing of the artery. Up to one half of angioplasty patients have restenosis within six months of the procedure, requiring many to have a second angioplasty or heart bypass surgery.
In the study, physicians use the device immediately following a balloon angioplasty, inserting it into the treated artery for less than five minutes, then removing it. "The radiation exposure from the catheter is less than 1 percent of that of a regular chest X-ray," says Jeffrey A. Brinker, M.D., director of interventional cardiology and one of the principal investigators of the trial. "The seeds never come in contact with the patient's tissue or blood, so they are very safe."
See related articles in the AgeVenture archives.
"New Blood Test Predicts Heart Attack Risk"
"AHCA System Comuterizes Quality Care"
AgeVenture News Service, www.demko.com
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