[Mb-civic] Assault on the elderly - Sue Levkoff - Boston Globe Op-Ed

[William Swiggard]

  Assault on the elderly

By Sue Levkoff  |  January 13, 2006  |  The Boston Globe

IT IS HARD to reconcile the Bush administration's ''compassionate 
conservatism" with its very uncompassionate assault on the safety net 
for our nation's most needy and vulnerable citizens, low-income 
Americans and the elderly. Recent budget cuts by Congress to the 
departments of Labor, Health and Human Services, and Education target 
programs aimed at this growing segment of society.

It is not just elderly and low-income Americans who will be touched by 
these deep cuts in federal spending. It is each one of us. We are all 
aging, and many of us will become caregivers for an older parent or an 
aging spouse. What is less well known is that these budget cuts 
eliminated the only federal initiatives that fund geriatric education 
programs, which play a vital role in addressing the profound shortage of 
healthcare professionals trained to respond to the healthcare needs of 
today's older adults -- and tomorrow's rapidly graying America.

This vote begins the dismantling of a 20-year-old infrastructure that 
includes 50 geriatric education centers, located in almost every state 
across the United States, that have trained nearly half a million 
healthcare professionals. Also eliminated are geriatric training 
programs that support physicians, dentists, and mental health 
professionals who are equipped to train the next generation of leaders 
in geriatric care. Fellowship awards that support the academic career 
development of physicians committed to teaching geriatrics in medical 
schools across the country have also been discontinued.

The irony of these cuts is overwhelming. We are on the crest of an age 
wave, with the oldest members of the nation's 78 million baby boomers 
turning 60 this year, and starting to require care designed to meet the 
needs of the aging. Eliminating special geriatric training programs will 
only increase medical errors made by healthcare providers who lack 
knowledge of the special health challenges facing older adults. Lack of 
appropriate treatment will undoubtedly lead to an increase in the need 
for costly long-term care.

The paradox becomes even more bizarre. Slightly more than 1 percent of 
the nation's practicing physicians have certification in geriatric 
medicine. Similarly, fewer than 1 percent of nurses are certified in 
geriatrics. The dearth of healthcare professionals and faculty trained 
in geriatrics, in social work, pharmacology, and other health-related 
professions makes the situation even more dire. Why, on the eve of an 
expected demographic explosion, are we dismantling programs that support 
the training of the next generation of healthcare providers?

Something is terribly amiss here. These cuts in geriatric education are 
at complete odds with recent recommendations made by the President's 
White House Conference on Aging. In December, delegates from across the 
country adopted a list of 10 recommendations, two of which included a 
call for increased training for geriatric healthcare professionals. 
Perhaps most ironic of all, when proudly touting its new Prescription 
Drug Benefit of the Medicare Modernization Act, the Bush administration 
acknowledges the serious healthcare challenges facing older adults.

Does the president really believe that the recent Senate vote is a 
''victory for taxpayers, fiscal restraint, and responsible budgeting?" 
Vice President Dick Cheney flew back from a diplomatic mission in 
Pakistan, eager to break the 50-50 tie vote, in favor of a budget 
designed to cut the federal deficit by $39.7 billion. According to 
budget experts, these cuts will barely dent the federal deficit, cutting 
less than one-half of 1 percent from an estimated $14.3 trillion in 
federal spending over the next five years. Elimination of geriatric 
education programs will have rippling effects on the health of the 
current and future waves of elderly.

Perhaps some of the lawmakers who voted for these cutbacks will rue 
their decisionwhen they too are faced with a life-threatening decision 
for their aging parents, their aging spouse, or themselves, and cannot 
find an adequately trained healthcare provider to help them with making 
the right decision. But then it will be too late.

Sue Levkoff is an associate professor at Brigham and Women's Hospital 
and director of the Positive Aging Resource Center.  

http://www.boston.com/news/globe/editorial_opinion/oped/articles/2006/01/13/assault_on_the_elderly/
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