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The Confused, Angry Elderly: 1989 and Today


Perhaps I'm not the first to point this out, but there is an earlier precedent for the behavior of the elderly amongst the Tea Bag protesters.  It is the response to the 1988 Medicare Catastrophic Coverage Act (MCCA).  I was just entering the health care finance field at the time, and remember it fairly well.  Here's a link to a great post-mortem:

http://content.healthaffairs.org/cgi/reprint/9/3/75.pdf  

The Act, like all modern health legislation, was fairly complex, and the result of a deal between the Reagan Administration and Congressional Democrats, particularly the storied Claude Pepper of Florida.  But the MCCA tried to do 2 big things:  prevent catastrophic illness from bankrupting those seniors (mainly low income) that didn't have add-on insurance to supplement Medicare (supplements that at the time were a common retirement perk).  The second was to cover prescription drugs, which even in the 1980s were a significant source of financial hardship for lower-income seniors.  

The political problem with MCCA was that it was paid for not by an increase in the Medicare tax (paid by all working adults), but by a tax on higher-income retirees and Medicare beneficiaries.  So, Medicare beneficiaries with good incomes (and likely good supplemental plans) were going to have to pay more to provide poorer Medicare beneficiaries with a comparable amount of coverage.  That's what sent the elderly into a tizzy.  The most memorable event was then House Ways and Means Committee Chair Dan Rostenkowski being chased down the street by angry seniors and taking refuge in his car while the angry seniors attacked it.  While the wealthy seniors may have had a legitimate beef, then as now there was a LOT of misinformation and lack of understanding about MCCA.  Misinformation that was intensified and exploited by interest groups.  Sound familiar?  

What does all this have to do with current health reform efforts and the backlash to them?  My takeaway is that the elderly are going to be a real obstacle to ANY reform plan.  It's ironic, given Medicare's position as a cornerstone of progressive politics in this country.  But too many elderly are risk-averse, tax-averse, and ill-informed.  They have theirs and don't much care if the rest of us get ours.  You see this in municipalities where the elderly repeatedly vote against taxes to support local schools.  You see this in polls showing that people 65 and over are the most concerned about health care reform having a NEGATIVE impact on their personal benefits.  It's why the anti-reform groups have ginned up the "euthanasia" stories and the like.   Given the history of the MCCA, and Obama's relatively weak vote from the elderly in 2008, it would seem that reform proponents have a substantial vulnerability in this population segment.  I think they need to act quickly to neutralize the senior citizen paranoia.  Throw the gray panthers some nice juicy bones in the legislation and promote it heavily in channels that preferentially reach the elderly (like the network news).  It's the only way to neutralize this large bloc of opposition that has an impressive track record of derailing past reform efforts.  


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At what age are you pegging elderly and how broad is your brush? I'm 68 (which I try to tell myself is the new 58 or even 55). I don't think of myself as paranoid, or even particularly concerned. As long as Josh keeps exposing bamboozlements like the privatizing of social security, I'm quite willing to rely on the voting power of my age group to keep congress in line.

All of us ain't dumb. Some of us are democrats--quite a bunch, actually. My alternate hypothesis is that the elderly in which one sees the paranoia you describe were just as paranoid as youngsters, and terribly afraid that "they" were going to screw them out of something or other--take your pick on who the "they" were--blacks, immigrants, the usual aggregate.

One party thrives on dividing "them" from "us", the other struggles to overcome that division--or so it seems to me.

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Dear Amike,

I apologize that I tarred all elderly people with the same brush in my post. However, I am concerned that the elderly in particular are uniquely susceptible to bamboozlement, not because they are demented or stupid, but because they are nervously living on fixed incomes, for example. But, I find it ironic (at best) that the one group of people in this country benefiting the most from socialized government health care (from both Medicare and Medicaid, which pays for most nursing home care), want to angrily deny that hellacious benefit to the rest of us.

I also wanted to point out that the MCCA experience, where RICH elderly were expected to pay for additional benefits that would largely benefit POOR elderly, is the sort of thing gets coded into the political DNA of individuals and organizations serving the interests of senior citizens. Because of MCCA, their radar sensitivity is turned up to 11, and the President and Congressional Dems need to know that and act proactively to counter a likely hair-trigger overreaction. The corporate astroturf industry knows this and exploits it effectively, as we have seen, again.

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