Suchergebnisse

This discussion of older people and health care reform begins with a brief overview of the patterns through which older people use health care services and account for one third of total U.S. health care expenditures. Particular attention is paid to high usage rates at advanced old ages because the American older population is rapidly becoming older, within itself, indicating that future health care costs for older people may be enormous. Following this are analyses of measures to reform Medicare, proposals to ration the care of older people, and issues involved in expanding public long-term-care insurance. The article concludes by considering what impact the politics of older persons and old-age interest groups may have as American health care reform efforts unfold in the next few years.

Trends suggesting a dramatic increase in the pro portion of aging Americans have brought attention to the pos sibility of gains in "senior power." Consideration of this possi bility is most appropriately focused on voting and interest group politics, the political activities which have bases in large categories of citizens. Examination of electoral politics suggests there is no sound reason to expect the aging will gain power by voting more cohesively in the future. The most pow erful likely result for interest group politics is that organiza tions based on aging members, consumers, clients, and sub jects for study will have credentials to participate in the poli tics of a broader range of interest group arenas than they do now. At most, some roles in the political system may be ex changed, and some aging citizens as well as aging interest groups may achieve incremental gains in the playing out of what Lowi has characterized as interest-group liberalism. A more important political implication of increased numbers of the aging is the concomitant increase in services and facilities they will need. If government responds to those needs, how ever, it will be because of pervasive ideological considera tions and not because it is pushed to do so by so-called senior power.

Trends suggesting a dramatic increase in the proportion of aging Americans have brought attention to the possibility of gains in "senior power." Consideration of this possibility is most appropriately focused on voting & interest group politics, having bases in large categories of citizens. Election analyses suggest that the aged will not stand to gain in influence markedly by voting more cohesively. Rather the role of organizations representing particular interests will be to participate in a broader range of interest range arenas than they do now. It is possible, however, that some roles in the political system may be exchanged & some aging citizens as well as aging interest groups may achieve incremental gains in the playing out of what T. J. Lowi called interest-group liberalism (THE END OF LIBERALISM, New York, NY: W. W. Norton, 1969). A more important political implication of increased numbers on aging is the concomitant increase in services & facilities they will need. If government responds to those needs, however, it will be because of pervasive ideological considerations & not because it is pushed to do so by so-called senior power. 3 methods available to seniors to acquire greater power are discussed: (1) informal access to public officials; (2) public platforms in the national media, Congressional hearings, etc; & (3) mass membership organizations. Modified HA.