Debra Ness, President

Earlier this week, I was privileged to be a part of Volunteers of America’s third annual discussion on aging issues. I was on a panel with Arianna Huffington, Huffington Post co-founder and editor-in-chief; Mike King, National President and CEO of Volunteers of America, Inc.; and Lorraine Cortés-Vázquez, AARP Executive Vice President of Multicultural Markets and Engagement.  Our topic:  How our nation’s public policies affect older Americans, especially women.  Medical journalist and best-selling author Dr. Bob Arnot moderated the discussion, which addressed how to improve the U.S. health care system, how women can best prepare for old age and care for their loved ones, and how we can press for better coordinated care that lessens the burdens on family caregivers.

During the panel, I talked about the work of the Campaign for Better Care to improve care for the oldest and sickest patients, and described the good-news-bad-news reality of women aging in America.  The good news is that women are living longer. The bad news is that they are living poorer and sicker.  And when you take a hard look – in particular at the lot of older women and their family caregivers – it isn’t a pretty picture.  In the workplace, women experience persistent discrimination and lower earnings on average than men. In the workforce, they face employer policies that make it extremely difficult to be both wage-earners and caregivers.  In the obstacle course that is the U.S. health care system, they are forced to jump through hoops to secure the care they need.

My fellow panelists each brought valuable, personal perspectives on caring for the aged. Arianna Huffington talked about the cultural issues involved, as well as the distinct joy she derived from caring for her own late mother. Mike King seconded those sentiments, adding that caring for his mother was an honor.

Lorraine Cortés-Vázquez stressed that we need to educate ourselves to better prepare for aging, and create livable communities that offer long term care services.  She also raised an issue that doesn’t get nearly as much attention as it should:  the fact in that in some underserved communities, doctors’ offices are vanishing, forging an even stronger link between poverty and poor health.

We also discussed the current debate about the federal deficit.  I wanted to stand up and cheer when Mike stated a principle that we all should embrace: “We’re not going to balance the budget on the backs of the older Americans who built this country. It’s not fair.  We have to stand up and say that.”

Some time after Mike made that statement of conscience about what we must not do, a woman in the audience asked a great question about what we should do.  What kind of strategies can we employ, she asked, to advance change in Congress? I told her what I believe:  that one way to influence lawmakers and policymakers is through the Campaign for Better Care.  We launched this nonpartisan campaign last year to organize Americans across the political spectrum to make their voices heard.  By recounting their real-life struggles in the U.S. health care system, members are giving policymakers both the incentive and the information needed to create change.  Older women and their caregivers desperately need a health care system that delivers timely, coordinated, appropriate, affordable care.  The Campaign is focused on changing our health care system so that the oldest and sickest patient can get this kind of care and live in their communities for as long as possible.

I commend Volunteers of America for organizing such a fantastic discussion.  In preparation for this week’s event, Volunteers of America commissioned a nationwide survey to find out how the elderly and their caregivers are faring during these tough economic times. Its white paper on the findings – “Boomer Bust 2011: Still Unprepared and Unaware” – is well worth reading, and passing along.  If you weren’t able to attend the panel, an archived webcast of it is available here.

Judith L. Lichtman, Senior Advisor

This week is the first anniversary of the Affordable Care Act – the greatest advance for women’s health in a generation.

This law is helping me, my 97-year-old mother, my daughters and granddaughter. It’s making care more affordable, more secure, and more responsive to women’s needs at all stages of our lives.

And it’s giving families the security they need to avoid financial devastation when illness strikes.

It saddens me that opponents are keeping up their relentless, baseless attacks instead of joining with us to make the health care system work for all of us.

I wrote a piece about it that’s running on Kaiser Health News. I hope you’ll read it and tell me what you think. Also check out our new fact sheets on the health reform law and how it affects women, older women and lower-income women.

And take a look at our Campaign for Better Care, which is doing incredible work to make sure reform is implemented in ways that will help the sickest, most vulnerable patients – who often are older women.

~ Judy

Lynn Feinberg

Imagine living with someone you are crazy about who gradually turns into a stranger. Alzheimer’s disease is a heartbreaking disease, not just because it takes a loved one in death, but because first, it takes that person’s mind, personality, memory and character – the things that made us love them in the first place.

Today, more than 5 million Americans suffer from Alzheimer’s disease, and that number is expected to grow to over 13 million by 2050, according to the Alzheimer’s Association. In most of these cases spouses, adult children and other family members take on the burden of treatment decisions and care coordination, while also helping their loved one maximize their quality of life and live in dignity and comfort. Although this terrible disease is devastating to all Americans, it is women – our mothers, grandmothers, great-grandmothers, aunts, sisters – who are most affected not only by having the disease itself, but also by being the primary caregivers of persons with Alzheimer’s disease and other chronic conditions in the U.S.

A recent report released by Maria Shriver and the Alzheimer’s Association, The Shriver Report: A Woman’s Nation Takes on Alzheimer’s, explores the issues around caring for a family member or friend with Alzheimer’s. The report outlines the struggle women, in particular, face as they balance their responsibilities in the workplace while also caring for a parent or grandparent with the disease. According to the report, the average unpaid Alzheimer’s caregivers are working women over the age of 50 providing care most frequently to their mothers (31%) and spouses (15%).

From the Campaign for Better Care’s national opinion research, we know they are taking on these responsibilities in a health care system that is fragmented and uncoordinated, making the weight of their caregiving responsibilities much heavier. In a country like ours, it just isn’t right that people with Alzheimer’s disease and other chronic conditions don’t get the high quality, coordinated care they deserve.

Today, doctors lack the time to develop a relationship with the patient and his/her family – or coordinate with their other doctors, health and social service providers, and community supports. I envision a day when our health care system provides incentives for primary care doctors to routinely hold a family meeting with Alzheimer’s families in order to have a focused conversation about their values and preferences and plan their care, rather than just paying for more procedures and treatments. We need a health care system that promotes more effective communication among health care providers, patients and their families; strengthens continuity of care; and is organized to deliver team-based care that includes direct care workers (like home care aides) who are vital to the well-being of Alzheimer’s families – and every family that is caring for a loved one who is suffering.

This is what the Campaign for Better Care is all about. We know that chronic conditions like Alzheimer’s disease affect not only patients, but their families too. We know that we must make our voices heard to make improvements in the health care system so that it delivers high quality, comprehensive, and coordinated care, especially for vulnerable older adults with multiple chronic conditions. Now is the time to act.

In November, as we celebrate both National Alzheimer’s Disease Awareness Month and National Family Caregivers Month, let us transform the national conversation and make meaningful change for our families and for ourselves.

Read about one family’s experience with Alzheimer’s disease here.

Debra Ness, President

Six months ago today, President Obama signed the health care bill into law.  And with his signature, our health care system was opened up for renovation.  But, like any remodeling job, we’ve got a long way to go before the final product will be ready for a ribbon cutting ceremony.

So, why is the six month anniversary of the Affordable Care Act important?  Because today some key provisions in the law go into effect – and that means it’s time to take stock of where we are and where we’re going. Meaningful implementation of the health reform law – implementation that focuses on what’s best for patients and families – in the months and years ahead is critical.  But there is already much to celebrate.

Consider that we’ve already seen important patient protections put into place so that insurance companies can’t deny or drop your coverage based on your age, gender, or pre-existing conditions.  And, starting now, any new private health plans will cover the full cost of preventive health services like cancer screenings.  On January 1st, cost-sharing for preventive services under Medicare will be eliminated.  This means people will be able to access the most basic health care – the kind of care that can help identify disease early or prevent it altogether.

Today we can also celebrate the first steps towards improving care coordination and rewarding good primary care. The Afffordable Care Act increases payment for primary care providers in Medicare and Medicaid which will help ensure that patients have better access to primary and preventive care. The law also lays the groundwork for improving coordination of care by testing new and innovative approaches to delivering health care to promote higher quality, improve communication and collaboration among providers, ensure safer and smoother transitions when patients move across different settings of care, and provide more time, support and information for patients and family caregivers. It also supports medication management services to reduce adverse interactions and medication errors — which will especially help patients and families who are managing multiple chronic conditions.

These improvements, coupled with the funding for improving health care through better health information technology (IT) under the stimulus package passed in January of 2009, will create better patient outcomes and reduce costly duplication and waste.

And just as these new policies are being put into place, longer-term strategies required by the new law are being developed and rolled out. Just last week, the Obama Administration issued a core element for the implementation of health reform:  a national strategy for health care quality improvement.  The National Partnership for Women & Families and the Campaign for Better Care are at the table and ready to help shape this important strategy to make sure it truly meets the needs of patients and consumers.  In the end, we’re hopeful that this new plan will help reduce health disparities, increase positive health outcomes, and improve patient and caregiver experiences in the health care system.

We’re off to a good start, but our efforts to make the health care system work for patients and families are just beginning. When doctors can spend enough time with their patients – and when they talk to each other to manage our care better – we will all benefit.  We will be less likely to experience bad drug interactions or unnecessary and duplicate tests.  Our medical records will be at our fingertips – and available to our health care providers so that they have the whole picture when treating us. We will be less likely to suffer from preventable medical errors that can result in injury or even death.  And we won’t have to fend for ourselves or our loved ones in an uncoordinated and fragmented system.

These things are the foundation of a good health care system and, ultimately, a healthy population.  It will take some time – as any renovation does – but in the end it will finally get us to a health care system that delivers the comprehensive, coordinated, high quality care that everyone deserves.

Portia Wu, Vice President

Sunday was National Grandparents Day – and this year, we can do more for our grandparents than send candy or flowers. Let’s take action to improve the health and economic security of our grandparents — and all of America’s grandparents. Here are five things you can do to show grandparents that you care:

Protect Social Security. Our grandparents have worked for a lifetime and they deserve to retire in dignity. Taking away their economic security by pushing back the retirement age — or cutting the benefits they count on — will hurt seniors and all families. Let the Deficit Commission know that our budget shouldn’t be balanced on the backs of hard-working seniors. Sign the petition »

Support the Paycheck Fairness Act. Too many women in this country have worked hard all their lives, and taken home lower wages because of discrimination. Pay discrimination costs women for a lifetime, reducing wages as well as the savings, pensions and Social Security benefits that we rely on in old age. Tell the Senate that it’s time to vote for equal pay. Send a message »

Join the Campaign for Better Care. More than three in four Americans age 55 or older (78 percent) are dealing with at least one chronic health condition like diabetes, heart disease or arthritis. The Campaign for Better Care is working to ensure that health reform is implemented in ways that will give the older patients who rely on the system most the coordinated, quality care they deserve. Join the Campaign »

Recognize that grandparents are key caregivers, and often need care themselves. Grandparents are a vital link in strong families and increasingly, they help care for our nation’s children. Their role has only increased during this recession, as more grandparents are serving as primary caregivers and more grandchildren are living with their grandparents. But too often our laws fail to recognize grandparents’ central role. The Department of Labor has taken important steps that will help some families, but we need laws that give workers the time they need to care for their seriously ill grandparents or grandchildren. It’s time for our country to do more! Read our fact sheet »

Pass the Protecting Older Workers Against Discrimination Act. The Supreme Court has made it harder for older workers who face discrimination on the job to prove they’ve been discriminated against because of their age. Learn more »

Kirsten Sloan, Vice President

The Labor Day weekend is upon us, and many of you will be able to enjoy a much-needed holiday.

But if you’re helping to care for a loved one, you know that there is no holiday from that crucial job. So, while you’re flipping burgers on the grill, basking in the sun, or working in the garden — why not take the opportunity to share with your family, friends, and neighbors your work to make our health care system deliver for those who need it most: older adults with numerous health problems, and their caregivers!

You may be thinking, “Should I really go there, when most of our conversations are focused on who made the potato salad… and how you like your burgers cooked?”
We say go for it! And we’ve prepared a few conversation starters to help you out.

Download your very own “cheat” sheet here.

Good luck and enjoy the long weekend!

Debra Ness, President

Today, President Obama appointed Dr. Donald Berwick to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). I truly believe that Dr. Berwick is the best man for the job – he is a highly qualified candidate with extraordinary skill, vast experience and a deep dedication to improving America’s health care system.

However, he has been the victim of ugly and baseless attacks by opponents of health reform who wanted to undermine his nomination.

Just last week , the Campaign for Better Care organized some 90 of the nation’s top consumer, purchaser and provider groups to issue a strong defense of Berwick. Despite that strong, broad-based support, opponents have continued to misrepresent his work and distort his positions.

A recess appointment should not have been necessary but, given the circumstances, it was. The White House was right to appoint a man who is, quite simply, one of the nation’s leading experts on our health care system. He is sure to be a dedicated and effective public servant who works tirelessly to improve care for vulnerable older adults and others with multiple health problems.

It is past time to put politics aside. We should all unite behind Dr. Berwick and work together to ensure that we realize the promise of reform and make quality, coordinated care available to all.

Kirsten Sloan, Vice President

For many American families, women are the ones who gather information, compare plans, and make the decision about which plan best suits their needs and budget. Today, your job got a little easier.

In a first step of implementing the new health care reform law, the Obama administration launched a new website that gives women access to critical, unbiased information about their private and public insurance coverage options – so women can feel confident they are choosing the best plan for themselves and their families.

We recommend you take a look: http://www.healthcare.gov.

Debra Ness

Enough is enough. Dr. Berwick – nominee for Administrator of the Centers for Medicare and Medicaid Services (CMS) – has been the victim of partisan and baseless attacks, and at the Campaign for Better Care, we think it’s time to set the record straight. That’s why we organized a strongly worded letter in support of Dr. Berwick’s nomination, which was signed by some 90 of the nation’s top consumer, purchaser and provider groups. Dr. Berwick is the right leader, at the right time, to make health care reform work for patients and their families.

Why should you care about Dr. Berwick’s nomination? The CMS is a critical federal agency that runs government-insurance programs for tens of millions of older persons, children, and those living in poverty. As Administrator, Dr. Berwick will help decide how to implement the new health reform law – a crucial role for the future of health care in the United States. That’s why his opponents would have you believe that he will ration care and let the government make health care decisions that should be made by patients and their doctors.

On the contrary, Dr. Berwick has consistently prioritized patients’ needs and preferences – and his record shows that commitment to patient-centered care. He is one of the nation’s leading authorities on health care quality and improvement, and has dedicated his professional career to closing the gap between the health care we have and the health care we should have.

Driven by his belief that health care is a human right, Berwick has launched groundbreaking initiatives to reduce unnecessary deaths, minimize preventable harm from surgical complications, and put control of health care decisions in the hands of informed patients and their families – goals we share at the National Partnership and with the Campaign for Better Care.

Berwick’s supporters describe him as a “passionate advocate for patients’ rights,” and he is “highly regarded in health-policy circles for his work to impose quality-control systems inside medical facilities and improve treatments.”

The New York Times writes that “[w]orking with numerous hospitals and clinics around the country, Dr. Berwick has shown that it is possible to reduce medical errors and improve the quality of care while reducing its cost.”

The Washington Post agrees: although Berwick’s focus “has been on improving care, several health policy experts said his methods often result in lower costs as well.”

And in a glowing endorsement of Berwick, a Los Angeles Times editorial states that “[o]nly in the topsy-turvy world in which end-of-life counseling services are called ‘death panels’ could a doctor who champions patients’ rights and better medical treatment be labeled a threat to healthcare consumers.”

So don’t let the negative, partisan spin fool you: Berwick is the highly qualified, experienced, and patient-centered Administrator CMS needs in order to implement health reform in a way that will lower costs and improve health care coordination.

And the experts agree – Berwick has widespread support from doctors, hospitals, medical schools, consumer groups and several former directors of CMS who served under presidents on both sides of the aisle.

The Washington Post sums it up best: Donald Berwick is “just what the doctor ordered for CMS.”

Lynn Feinberg

My two sisters and I are a team.  For several years, as we each juggled our own work and family responsibilities, we willingly took on the role of “advocate” and “coordinator” of health care across settings (home, hospital, nursing home) for my father, who died last year at the age of 94.  It wasn’t easy.  At times it sapped our energy and our spirits.  But we took on the role out of love and a deep respect for our father.

Now we are teaming up again for my mom.  We have to – because none of our parents’ health care providers have taken on the critical role of coordinating care, communicating with each other, or linking us to the community supports that older adults need to maintain their independence, functional status, and quality of life. Older adults with multiple health problems, in particular, need doctors, nurses and other health providers who talk to each other and work together – along with the patient and their family caregivers – as a team. That’s the better way, but it’s out of reach for too many patients and families.

That’s why I hope you will get involved in our major new initiative, the Campaign for Better Care. The Campaign’s policy agenda aims to ensure that the reformed health care system provides the comprehensive and coordinated care that older adults with multiple health problems need and deserve.  It will advocate at the federal and state levels to ensure that new models of delivering care are patient- and family-centered, team-based, and include important services like geriatric assessment, care planning, comprehensive care coordination, transition management between care settings, medication management, and community support for older adults and their family caregivers.  It will promote payment strategies that support primary care practice and reward better quality, coordination and communication among health providers, patients and family caregivers.

May is Older Americans Month – a tradition dating back to 1963 that honors the legacies and ongoing contributions of older Americans. When Older Americans Month was established 47 years ago, only 17 million living Americans had reached their 65th birthdays.  Today, there are nearly 40 million adults age 65 and older.  And with the aging of the baby boom generation – the largest in our history – the U.S. older population is expected to grow to 71.5 million by 2030.  In fact, the first baby boomers turn age 65 in 2011 and they will become eligible for Medicare. Will the health care policies of the future meet our needs more adequately than the policies affecting older Americans today?

If the Campaign for Better Care is successful, the answer will be yes!  So during this Older Americans Month, let us all honor elders – our fathers, our mothers, our grandparents, great-grandparents, and other older relatives and friends. And let’s celebrate and support the launch of the Campaign for Better Care and work together to improve health care for older Americans and their families.