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Elder Care News
Major Structural Reform of Health Care Needed to
Meet Growing Needs of Older Americans
 December 6, 2006 – The U.S. health care system is
not meeting the needs of senior citizens and a new policy report by the
International Longevity Center-USA calls for major reforms to make it
"proactive, rather than reactive" to meet the special - and mostly unmet
needs - of older adults in an aging population. The report focuses on
eight areas of concern.
Redesigning Health care for an Older America,
drawn from a consensus conference with top health experts and leaders,
recommends a complete overhaul and rethinking of a system heralded by
the invention of Medicare 40 years ago.
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The new structure would focus on health promotion,
disease prevention, the treatment of chronic disease and increased
investment in aging research.
“Our current health care system is not meeting the
needs of our older population,” says Dr. Robert Butler, president and
CEO of the ILC-USA.
“The Medicare program created in 1965 focused on
patients being treated only when sick with little or no emphasis on
prevention and coordination. We must integrate what we now know about
health care for older persons into a new system with an emphasis on
keeping people healthy and productive as they grow old.”
Although some adjustments have been made to the
services covered by Medicare, its essential structure has not changed
since its inception. Rather than attempting to patch up an ailing
system, it is time to redesign the health care system so it can meet the
challenge of the largest population of older adults in United States
history, says the report.
The ILC-USA brought together fourteen experts in
economics, social work, political science and medicine for a two-day
workshop to build on guidelines drafted by the ILC-USA’s internal Health
Care Task Force. The participants reviewed the previous guidelines and
developed eight guiding principles, providing the necessary framework to
ensure the future health of older Americans.
“We concluded that unless the system is changed,
there will be a large and significant impact upon the health of older
Americans, as well as profound social and economic effects,” says Dr.
Harrison Bloom, participant in the workshop and senior associate at the
ILC-USA. “The creation of these eight guiding principles provides public
and private leaders a roadmap for reform.”
Corporate leaders should pay particular attention
to these concerns says Dr. Charlotte Muller, Director of Longevity
Research at the ILC-USA and workshop participant. “With the retirement
of baby boomers corporate America will be facing a critical shortage of
experienced workers. Corporations need to have a vested interest in
keeping workers healthy and productively engaged as they age.”
The guidelines included in Redesigning Health Care
for an Older America are designed to stimulate and guide initial steps
toward a serious revision of geriatric care and health care in the
United States. The recommendations focus on eight key areas:
Life-Course perspective
Health in adulthood is affected by early-life exposure to adverse
physical, psychological and social factors and to inadequate health
care. Using the life-course perspective in medicine allows professionals
to incorporate both biological and social experience. It enhances their
understanding of the interaction of biological factors, physical
environment and social context over time, and provides a scientific
basis for understand the emergence of health problems.
Principles of Geriatric care training throughout
health care community
The skills taught to clinicians training in geriatrics—understanding
the process of aging, the changes in the ways diseases are manifested
with age and the variation in individual response to treatments—need to
be taught and broadly disseminated to all involved in caring for older
persons.
Protect the rights, dignity and personal needs
of older Americans
The health care system must, in a culturally sensitive and
appropriate way, protect and respect the rights, dignity and personal
needs of older patients by promoting and supporting a person-centered
approach.
Continuum of care
Comprehensive integrated health care services, providing a continuum
of care are necessary to maximize health and quality of life. An
integrated system is inclusive of all types of services that clients may
need including the coordination of social care services, management of
transitions, health care financing and the recognition of the productive
activities of older people.
Evidence-based medicine
Clinical autonomy, guided by evidence-based medicine produced by
scientific research and blended with clinician experience, is essential
to optimal quality of care for older Americans.
Investment in aging research
Investments in aging research—basic biology, age-related diseases,
clinical and health services delivery are crucial to improving care for
current and future generations of older Americans.
Universal health coverage
Universal health coverage encompassing all age groups provides the
best opportunity for assuring access to the continuum of care that can
results in a healthier population experience a better quality of life.
Optimal Workforce
The workforce to provide high-quality health care for the current
and future generations of Americans needs to be culturally and
ethnically diverse, professional trained, horizontally integrated into
interdisciplinary teams and financially well supported.
Editor's Notes:
The workshop, held in June 2006, was sponsored by
the Josiah Macy, Jr. Foundation and the workshop participants included:
Claudia Beverly, Ph.D., R.N.
Associate Director, University of Arkansas Center on Aging
Harrison Bloom, M.D.
Director, ILC-USA International Geriatrics
Clinical Education Consultation Service
Lawrence Brown, Ph.D.
Professor of Health Policy and Management, Columbia University Mailman
School of Public Health
Robert N. Butler, M.D.
President and CEO, ILC-USA
Oliver Fein, M.D.
Associate Dean, Cornell University Medical College Network Affairs
Claudia Fine, M.S.W., M.P.H., C.M.C.
Chief Professional Officer, SeniorBridge Family
Sherry Glied, Ph.D.
Department Chair, Health Policy and Management, Columbia University
Mailman School of Public Health
Michael Gusmano, Ph.D.
Senior Research Analyst, ILC-USA
Charlotte Muller, Ph.D.
Director of Longevity Research, ILC-USA
Nora O'Brien, M.A.
Director of Aging Programs & New Initiatives, Brookdale Foundation Group
June E. Osborn, M.D.
President, Josiah Macy, Jr. Foundation
Lois Quam
CEO, Ovations/United Healthcare
John Rother
Policy Director, AARP
Albert Siu, M.D.
Chairman and Professor, Mount Sinai School of Medicine Brookdale
Department of Geriatrics
To download Redesigning Health Care for an Older
America visit
http://www.ilcusa.org/_lib/pdf/Redesigning%20Healthcare.pdf.
The International Longevity Center-USA is a
research policy organization in New York City and has sister centers in
Europe, Asia, Latin America and Africa. Led by Dr. Robert N. Butler, a
world renowned physician specializing in geriatrics, the Center is a
non-for-profit, non-partisan organization with a staff of economists,
medical and health researchers, demographers and others who study the
impact of population aging on society. The ILC-USA focuses on combating
ageism, healthy aging, productive engagement and the financing of old
age. The ILC-USA is an independent affiliate of Mount Sinai School of
Medicine and is incorporated as a tax-exempt 501(c)(3) entity. More
information on the ILC-USA can be found at
www.ilcusa.org
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