18. GHETTOIZING THE ELDERLY
"Age" is a dirty word in America. Calvin Klein image-molders
cater to a nation of dieters and Joggers who would perennially pour
themselves into jeans designed for the teenager. To age is to pass from
the limelight reserved for beautiful people into a wasteland of neglect,
despair, and poverty.
In America, your probable reward for 50 years of service to family
and society, as well as lifelong payments of social security, federal
and state taxes, will be confinement to a nursing home at age 65, where
one-third of the residents die within the first year. As Medicare insurance
makes no provision for extensive nursing home coverage, you will have
to exhaust your savings and sell your property to pay for "care"
from an institution where the administrators often earn $35,000 to $50,000
per year, and whose shareholders often earn a 40 percent return on their
investments. When your funds run dry, you will be eligible for Medicaid,
and will be quickly shuffled out of the "for-profit" nursing
home into a substandard home plagued by fire code violations and staffed
primarily by underpaid and undertrained women.
If you are fortunate enough to remain outside the walls of the nursing
home at age 65, you will nevertheless be hit with skyrocketing medical
costs. The cost of medical care in the U.S. has grown at a faster rate
for the aged than for everyone else, now consuming about 30 percent
of the national medical bill.
Medicare and Medicaid legislation, passed in 1965, brought a phenomenal
boost to profits of both the medical and nursing home industries. In
1962, the total national expenditure for long-term care of older people
totaled only $500 million. Formerly charitable institutions or "mom-and-pop"
operations, nursing homes today have become large chains, selling stock
on the open market. The industry's revenues since 1962 have increased
twenty-fold -- to $12.6 billion. More than half the revenues are paid
by Medicare and Medicaid.
In contrast to the growth of profits in the aging industries, the elderly
themselves are being plunged into poverty. Nearly 15 percent of the
elderly today live in "official" poverty; half are getting
by on $75 a week. Blacks are especially hard hit and die more than four
years sooner on the average.
When will we begin to look at creative alternatives? In other countries
the elderly are not coldly institutionalized, but are afforded care
that fosters more independence and self-respect. In England the government
pays home nursing and house-keeping services, and hot meals are available
at community centers. In Sweden apartments have been built around a
central unit providing medical care, therapy, hot meals, and social
If the media spotlight were more frequently turned from the derriere
of Brook Shields to the human tragedy of 1.3 million Americans ghettoized
in nursing homes, needed reforms could be sooner forthcoming. Or must
we consign the elderly to silent decay until the post-war baby bulge
becomes a senior citizen lobbying power in the year 2000?
The failure of the media to put the plight of the elderly on the national
agenda qualifies this story for nomination as one of the "best
censored" stories of 1980.
The Progressive, February 1980, "Nursing Home Watchdogs,"
by Karen Hering; Mother Jones, May, 1980, "Growing Old Absurd,"
by Hugh Drummond, M.D.