2020 Census Data Impacts Federal Funding Allocated to Aging Programs and Services

Published in the Woonsocket Call on January 19, 2020

By April 1, every home across the nation will receive an invitation from the U.S. Census Bureau, a nonpartisan government agency, to participate in the 2020 Census. Once this invitation arrives, it’s important for you to immediately answer the short questionnaire by either going on-line, phone, or by mail. When you respond to the census, you’ll tell the Census Bureau where you live as of April 1, 2020.

The U.S. Constitution: Article 1, Section 2, mandates that the country conduct a count of its population once every 10 years. The 2020 Census will mark the 24th time that the country has counted its population since 1790

The population statistics generated by the upcoming 2020 Census will be used to distribute over $700 billion annually in federal funds back to tribal, state and local governments. The collected census data also determines the number of seats each state has in the U.S. House of Representatives, provides insight to governments, business and community planning groups for planning purposes, and finally defines congressional and state legislative districts, school districts and voting precincts

2020 Census Statistics and the Graying of America

According to a blog story published on Dec. 10, 2019, by American Counts (AC) Staff, the upcoming 2020 Census will provide the federal government with the latest count of the baby boom generation, now estimated at about 73 million. The boomer generation born after World War II, from 1946 to 1964, will turn 74 next year. When the 2010 census was taken, the oldest had not even turned 65.

Baby Boomers are also projected to outnumber children under age 18 for the first time in U.S. history by 2034, according to Census Bureau projections. With an increasing need for caregiver and health services and less family caregiver support, the boomers will be forced to depend on federally-funded support services, their allocation depending on policy decisions based on census data.

“Data from the 2020 Census will show the impact of the baby boomers on America’s population age structure,” said Wan He, who has for over 21 years overseen the Aging Research Programs for the Population Division of the U.S. Census Bureau.

AC’s blog article, part of a Census Bureau series detailing the important community benefits that come from responding to the 2020 Census questionnaire, stresses that exact count of American’s age 65 and over is important for tribal, local, state and federal lawmakers to determine how they will spend billions of dollars annually in federal funds on critical aging programs and services for the next 10 years.

While everyone uses roads, hospitals and emergency services some state and federal programs specifically target older Americans – the 2020 Census statistics will be used to distribute funding to senior centers, adult day care facilities, nutrition programs including meals on wheels, and the Supplemental Nutrition Assistance Program, job-training programs, elder abuse programs, Medicare Part B health insurance and Medicaid, the health insurance program for low-income people including those age 65 and older.

“The census is really important to us in the aging community,” said John Haaga, of the National Institute on Aging in Washington, D.C. in the AC’s blog article. “It’s our only way to figure out how things are different across the country, what areas are aging faster, where elderly disabled people live, or where older people are concentrated, like Appalachia or West Virginia, because young people are leaving for the cities,” says Haag, noting that “Older people are remaining behind there.”

Haaga noted, “Other states, such as Florida, have large older populations because people are moving there to retire.”

“You can start to look at specifics like how many older people are living alone who are more than 10 miles from an adult day care centers,” says Haaga. “You can answer questions of access and how to improve it,” he adds, noting that census statistics helps lawmakers or business people decide where to open health clinics or senior citizen centers, among other services.

Calls for Action: Fill Out that Census Questionnaire

AARP has three main goals, according to State Director Kathleen Connell. “First,” she said, “to ensure a fair and accurate census count by educating our​ members and older adults about the census outreach efforts. Second, to provide tips and resources to encourage safe participation while protecting themselves from bad actors and census related fraud during this time. And third, to help people age 50 and over gain employment as census enumerators.”

“AARP has long been involved in informing people about the census, including the fact that the headcount is labor intensive – to the tune of 400,000 temporary staff. In the past, retired adults have made up a good portion of those who work in the decennial count of Americans, often as enumerators who go door-to-door in neighborhoods. In many communities, the Bureau will be looking for bilingual applicants.”

To be sure, Connell adds, the loss of a Congressional seat would have an impact on Medicare funding and other services that support Rhode Island’s age 50 and over population. “If a subset of people doesn’t participate in the census, the area in which they live will be represented as having fewer residents than it actually does; the costs to states and communities could be large, consequential and long-lasting. A census that is as complete and accurate as it can be – and doesn’t undercount the number of residents in a given area – is a vital resource for everyone,” she said.

Connell sits on the RI Complete Count committee and the AARP State Office is using its email list and social media in a series of reminders and encouragement to participate in the census. AARP also is reaching out to members who might consider becoming census workers.

Adds Jennifer Baier, AARP Senior Advisor, Census lead: “Many federally funded programs rely on census data to distribute billions of dollars to states and localities across the country. According to the George Washington Institute of Public Policy, Rhode Island receives about $3.8 billion per year based on Census data. That includes funds for schools, roads and hospitals and also programs that aid older Americans, such as Medical Assistance Program (Medicaid) Medicare Part B, Special Programs for the Aging, Meals on Wheels, Heart Disease Prevention Programs and more.”

“The 2020 Census is just nine questions long, and takes about 10 minutes to fill out – those ten minutes impact millions of dollars of federal funding in every state and communities across the country,” says Baier.

Reflecting on a Loved One’s Life Time of Achievements

Published in the Woonsocket Call on December 29, 2019

A few weeks ago, my sister Nancy called to give me the bad news that my brother-in-law, Justin Aurbach, was diagnosed with an aggressive and deadly cancer known as glioblastoma, or more commonly referred to as GBM. This 77 year old Dallas-based endodontist who I knew as relatively healthy, a believer in vitamins and physically active most of his adult life, was now house-bound receiving 24 hour a day care by home health caregivers, along with his daughters Stephanie and Allison, and his partner Ruth who were now all part of a revolving schedule of care.

I booked a quick trip to Dallas to sit with him and show my support and concern. It had been a few years since I had been there and I wondered what the conversation might entail, knowing that our 53-year old relationship could cover a lot of ground. Justin and my sister were always collectors of art, and I soon found myself sitting at a kitchen table, surrounded by colorfully carved images of watermelons, where he and I reminisced as the time flew by.

Justin reminded me that we first met in 1967 when he came to pick-up my older sister Mickie, taking her to dine at Campisi’s Restaurant, a local pizza hangout. Even though it took place over five decades ago, he clearly remembered first meeting my mother as she greeted him from the couch, sitting with her thick soled shoes propped up on the ottoman, smoking a cigarette and wearing her trademark leopard print blouse. He recalls her holding Tony, the family’s three-legged Toy Poodle.

A year later, Mickie and Justin would recruit my twin brother, Jim and me to be ushers at their wedding in 1968. Through the ebb and flow of their life together, from raising children, grandchildren and building a successful dental practice, he reflected on their 41 year marriage, noting ‘how it flew by’ before Mickie passed in 2008.

Justin reminded me of the sage advice he gave me before I entered my freshman year at the University of Oklahoma. “Drink in moderation and put studies before chugging pitchers of beer,” he said. It is funny the things you tend to remember, I thought.

As our conversation became more focused on his health, Justin thought that the symptoms of the tumor might first have appeared over five years ago, when he became dizzy while taking a bike ride. Last August, the symptoms returned while riding again, and a Cat Scan would ultimately reveal his tumor.

Turning 60

In 2003, I had the opportunity to interview Justin about turning age 60 for my weekly senior commentary in the Pawtucket Times. He shared the following thoughts about being at the peak of his career professionally, while only five years shy of reaching retirement age.

In my commentary, Justin said, “It’s great [moving into your 60s], however, far too much [cultural] negativity has been directed at this chronological age.”

At that time, my brother-in-law was in relatively good physical shape. While he would acknowledge that he could not run a four-minute mile, he joked that he never could anyway. As he approached his sixth decade, he admitted that he played a little golf like many of his friends, walked and jogged, and even took time to lift weights.

Dr. Justin E. Aurbach, DDS, had accomplished much in his career by the age of 60. As the first endodontist in the Dallas-Fort Worth area, he was the first in the region to perform endodontic microsurgery, when at that time there were only 78 endodontists in the nation performing such surgery. He is past president of the DFW Endodontic Society, The Southwest Society of Endodontics, and the Dallas County Dental Society. He served as general chairman of the Southwest Dental Conference.

Justin believed strongly that he would still be ‘at the top of his professional game, improving with age’, as he proudly boasted. During my interview with him, he said, “not only am I technically better, but my years of life experience have made me wiser in respect to knowing what can and cannot be done in my life.”

The endodontist attributed much of his success to his wife, children and the many supportive family and friends that were part of his large extended family.

By age 60, his philosophy of looking at the “glass half-full rather than half empty” allowed him to cope with life’s difficulties. This life stage was also a time of excitement and learning for him, while he glided into the years he referred to as “best time of your life.”

Getting to the Big “70”

Ten years later, we would speak again about his approaching the age 70 milestone. He reflected on how so much time had passed, which he noted flew by in “the blink of an eye.” During my 2013 interview with him published in my weekly commentary in this paper, he told me that he would “certainly keep forging ahead at a break-neck pace,” promising that new goals would replace those that were accomplished.

He recalled having attended dozens of funerals, said final goodbyes to his wife, father, father-in-law, mother-in-law, along with many close friends and colleagues. Justin noted that “reading the Dallas Morning News obituary page and constantly attending funerals made him aware of the need to accomplish his set goals with the limited time he had left -” but life goes on,” Justin told me. A year after his wife’s death in 2008, the aging widower again found love and began to date Ruth.

Looking ahead into his 70’s, Justin had no plans to retire. Though financially secure, he aspired to maintain a very full practice until his eighty-fifth birthday. He found added fulfillment teaching endodontic residents at Texas AM Baylor School of Dentistry, a job that he hoped would continue into his 70s, while also staying active in the medical group.

Justin has been an avid bike rider for over 30 years, and despite being 70, he would continue to sneak in a ride when possible, even with his busy schedule. He enjoyed the City of Dallas’s fine restaurants, loved to cook for family and friends, and looked forward to a good play or chamber music performance from time to time. His mantra may well be “Live your life to the fullest, don’t put off tomorrow what you can do today.”

Looking Ahead

Justin says, since the diagnosis of his terminal illness, his house has been flooded with family, friends, referring doctors and even former dental students. “I have made a lot of friends and accept that I have impacted people in a very positive way,” he said, as he cites as an upside of his illness.

As we concluded our talk, he says, “Don’t wait to do things. You never know what the future has in store for you,” adding that he learned this lesson from Ruth.
“Simple things in life are your best bet to living a good life,” Justin tells me, stressing that it doesn’t cost a lot of money to enjoy your life.”

Justin acknowledges that he may live another two to six months with the GBM tumor, but remains optimistic, for there are those who have lived for another 14 years. In his remaining time, he hopes to maintain a “quality of life” that allows him to continue to attend musicals and plays, or perhaps even take short trips.

Final Thoughts

As you reach your 60s and into your 70s, research tells us that exercise, eating a healthy diet, developing a strong social network of family and friends, and continuing to learn and seek out new knowledge all become important in enhancing the quality of your life and increasing your longevity in your later years. However, in our twilight years life can become of full of tough challenges and we may face difficult times.

Ultimately, like Justin, reflecting on personal and professional accomplishments can give you the inner resources necessary to meet the challenges in the final stages of your life.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Jenkins: Working Senior’s Priming the Nation’s Economic Engine

Published in the Woonsocket Call on December 22, 2019

In recent years, Senate Majority Leader Mich McConnell of Kentucky, Sen. Marco Rubio of Florida and even former House Speaker Paul Ryan of Wisconsin, have warned that the growing number of seniors is fast becoming an economic drag to the nation’s economic growth, citing the spiraling costs of Social Security and Medicare. As the 2020 presidential election looms, GOP candidates are calling for reining in the skyrocketing federal budget deficit by slashing these popular domestic programs.

In 2015, President Donald Trump declared that he would not touch Social Security and Medicare. But now some GOP insiders are saying he may cut these programs during his second term, if he wins.

But after you read the newly released AARP report, The Longevity Economy Outlook, you may just want to consider these comments about seniors being a drain on the economy as false and misleading claims, just “fake news.”

AARP’s Longevity Economy Outlook report pulls from national data detailing how much people age 50 and older spend, earn working and pay in taxes.

Just days ago, AARP CEO Jo Ann Jenkins penned a blog article on the Washington, DC-based aging group’s website highlighting the findings of this major report. AARP’s top senior executive strongly disputes the myth that people age 50 and over are an economic drain on society. Rather the report’s findings indicate that older workers, who are getting a monthly Social Security check and receiving Medicare benefits, are priming the nation’s economic engine, she says.

“As the number of people over 50 grows, this cohort group is transforming America’s economic markets and sparking fresh ideas, and the demand for new products and services across our economy,” says Jenkins.

Jenkins notes that when older workers delay their retirement they continue to impact the economy by earning a paycheck, purchasing goods and services, and generating tax revenues for local, state and federal government.

“The economic activity of people 50-plus supports 88.6 million jobs in the U.S. generates $5.7 trillion in wages and salaries, and accounts for $2.1 trillion in combined taxes,” says Jenkins.

AARP’s economic impact study, released on Dec. 19, reports that people age 50 and older contribute a whopping $8.3 trillion to the U.S. economy, putting this age group just behind the U.S. (20.5 trillion) and China (13.4 trillion) when measured by gross domestic product. They also create an additional $745 billion in value through being unpaid family caregivers (see my commentary in the November 17/18 issues of the Woonsocket Call and Pawtucket Times).

Jenkins says, AARP ’s major report also projects the economic impact of older works to continue in the coming decades, tripling to more than $28 trillion by 2050 as younger generations (millennials and Generation Z) turn age 50 in 2031 and 2047, respectively.

With the graying of the nation’s population (predicted to be 157 million by 2050), the AARP report predicts that older persons will have more collective spending power, too, says Jenkins. “Fifty-six cents of every dollar spent in the United States in 2018 came from someone 50 or older,” she says, adding that by 2050 this amount is expected to jump to 61 cents of every dollar.

For over six years, AARP has been tracking the economic impact of older adults on the nation’s economy, Jenkins’ penned in her recently published blog article. It’s growing steadily over these years, she says.

“When AARP began researching the economic power of people 50 and older in 2013, we found that they generated $7.1 trillion in economic activity,” says Jenkins, noting that three years later it had grown to 7.5 trillion. “The 2019 report reflects an 11 percent growth in economic impact, a 6 percent growth in jobs created and a 12 percent growth in wages and salaries over the most recent three-year period,” adds Jenkins.

Older Rhode Islanders and the State’s Economy

By virtue of Rhode Island being one of the oldest states per capita in the country we have long been aware of the contribution and buying power older people contribute to the state’s economy,” said AARP Rhode Island State Director Kathleen Connell. “When you add in those 50-64 it becomes a big and powerful percentage of the population,” she says.

Over the years, Connell has observed more engagement with AARP in the younger end of the demographic spectrum because people in their 50s have justifiable concerns about their future. They wonder: “Will they outspend their savings? Will Social Security change in ways that will reduce their benefits? Will out-of-pocket prescription drug expenses sink the savings they hope to put away for retirement?,” she says.

“Waiting for retirement to think about these issues could well be too late,” warns Connell. “This is creating greater interest in government and politics and magnifies the importance of their vote,” she adds.

“At the same time, as older Rhode Islanders remain the workforce longer, they are keep paying taxes – a sizable plus for the state’s economy,” observes Connell. “With their extensive experience, many continue to be movers and shakers, innovators and professionals lending guidance that helps fuel economic growth,” she states.

Connell adds: “Outside the workplace, they are connected in new ways via technology and social media. The great thing is that across the range of 50 and older workers it can be said that more people are sharing the workplace adding to our cultural development and participating in civic engagement more than ever before.”

Wake Up Call to Businesses, Congress

AARP’s report should be a “wake-up call” to businesses and federal and state policymakers to rethink their attitudes, warns Jenkins in the concluding of her blog article. She calls on business leaders to “build strategies for marketing their products and services to older Americans and to embrace a multi-generational workforce.” Jenkins also urges Congress and state law makers to develop policies to support the growing number of uncompensated caregivers.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase “Taking Charge: Collected Stories on Aging Boldly,” a collection of 79 of his weekly commentaries, go to herbweiss.com.

Democratic House Passes Landmark Legislation to Drive Down Spiraling Prescription Drug Costs

Published in the Woonsocket Call on December 16, 2019

Just days ago, the Democratic House leadership successfully pushed for passage of landmark legislation, the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), that would give Medicare the power to negotiate directly with drug companies to bring down pharmaceutical prices and make those savings available to seniors.

House Democrats passed Speaker Nancy Pelosi’s sweeping legislation on Dec. 12 to lower the cost of prescription drugs on a largely party-line vote. The bill, which passed 230 to 192 with unanimous Democratic support and the backing of two Republicans, Reps Brian Fitzpatrick (R-Penn) and Jamie Herrera Beutler (R-Wash), is considered “dead on arrival” in the Senate. The White House has indicated President Trump would veto H.R. 3 it if it came to his desk.

The House Republicans fought to block passage of H.R. 3 by releasing their own legislative proposal, H.R. 19, to lower drug costs. The bill, consisting of bipartisan legislative provisions to lower drug costs that had already been adopted, would have achieved lower drug prices without imposing government price controls that House Republicans believed would decrease research and development spending for new drug cures.

Although House Republican Whip Steve Scalise called on the Democratic leadership to bring H.R. 19, with 135 sponsors and no Democrats, to the House Floor, the GOP proposal did not receive a vote on its own. It was offered by Rep. Greg Walden (R-Ore.) as an amendment to H.R. 3 and failed by a vote of 201 to 223, getting eight Democrat votes.

The Nuts and Bolts

H.R. 3 would put the brakes of spiraling drug cost by giving power to the Secretary of the Department of Health and Human Services to negotiate directly with drug companies to force real price reductions while also ensuring that seniors never lose access to the medicines they need. The legislation also expands access to the lower, negotiated drug prices to persons with private insurance, not just Medicare beneficiaries.

The 320-page House bill also prevents pharmaceutical companies from price gouging patients by capping the maximum price for a negotiated drug at the average price people in countries similar to the U.S. pay. It would create a brand new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries and even delivers vision, dental, and hearing benefits to Medicare beneficiaries for the first time.

H.R. 3 also increases the number of low-income seniors eligible for assistance with their drug costs and cost sharing for hospital and doctor visits. By extending guaranteed issue protections to disabled beneficiaries and to individuals who want to switch from Medicare Advantage to traditional Medicare, the legislation improves access to private supplemental coverage that helps fill in Medicare’s gaps for beneficiaries in traditional Medicare.

“The U.S. House of Representatives resoundingly defied Big Pharma today by-passing historic legislation to lower prescription drug prices for America’s seniors and their families. The Lower Drug Costs Now Act (H.R. 3) accomplishes what we and other advocates have long demanded — that Medicare be empowered to negotiate prices with pharmaceutical companies, which the CBO says will save more than $450 billion in drug costs. It also caps Medicare beneficiaries’ out-of-pocket prescription drug costs at $2,000 per year, says Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, in a statement.

The Pros and Cons of H.R. 3

Richtman says that it is time for the Senate Chamber to act. Drug pricing legislation that passed by the Senate Finance Committee has not been brought up for a vote on the Senate floor. “We insist that the Senate follow the House’s lead and act now to lift the burden of crushing prescription drug prices. Seniors who have been rationing pills or foregoing other necessities in order to afford crucial medications have waited long enough,” he says.

In a statement released following House passage of H.R. 3, AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond, called the legislation” a bold step toward lowering prescription drug prices and high out-of-pocket costs for millions of older Americans.”
“High drug prices disproportionately hurt older Americans, particularly Medicare Part D enrollees, who take between four and five prescription medications each month and have an average annual income of just over $26,000 a year. The average annual price of a specialty drug used on a chronic basis is now $79,000. Medications cannot work if they are unaffordable, says LeaMond.

Adds AARP Rhode Island State Director Kathleen Connell, “Drug companies are price-gouging older Americans and taxpayers– who pay the highest drug costs in the world,” noting that “AARP is proud to support H.R. 3, which would allow Medicare to negotiate drug prices and cap out-of-pocket costs for Part D enrollees. The bill also enhances Medicare by improving access and adding needed dental, hearing, and vision coverage.”

Opposing the passage of H.R. 3, the White House says in a statement, “Heavy-handed government intervention may reduce drug prices in the short term, but these savings are not worth the long-term cost of American patients losing access to new lifesaving treatments.” Noting that lowering the price of prescription drugs is major concern for seniors, the White Houses warned that H.R. 3 is the wrong approach to address this issue, “especially when bipartisan legislative alternatives that encourage innovation while lowering prescription drug

During a briefing with reporters over two months ago, President and CEO Stephen Ubl, of the Pharmaceutical Research and Manufacturers of America (PhRMA), warned the passage of H.R.3 would trigger “nuclear winter” for biotech innovation. Fiercely opposing passage, PhRMA has called on the Senate to “stop H.R. 3 in its tracks.”

Putting the Brakes on Rising Drug Costs in Rhode Island

“We all know someone who has been forced to ration the medication they need to live so that they can afford to keep a roof over their family’s heads or put food on the table. In America, in 2019, this should never be the case,” said Congressman David N. Cicilline (D-RI), who voted to pass the measure. “Pharmaceutical companies have abused American patients and taxpayers to increase their profits hand over fist without recourse for too long. The Lower Drug Costs Now Act will put an end to the price gouging by big pharma that sees American patients and taxpayers paying more for their prescription drugs than people in other countries, says the Rhode Island Congressman representing the state’s first congressional district.

In his 2016 campaign, President Donald J. Trump supported the government to negotiate drug prices. Cicilline calls on the president to honor this promise and urges Republican Senate Majority Leader Mitch McConnell to bring a companion measure to the Senate floor for consideration. At press time more than 300 House passed bills are stuck in the Senate (about 275 are bipartisan).

According to Cicilline, the out-of-pocket savings to Rhode Islanders will be substantial. “This year alone, more than 1,000 women in the state will be diagnosed with breast cancer, 550 people will be told they have prostate cancer, and 190 folks will be diagnosed with leukemia. H.R. 3 will lower the average costs of many popular medications for these and other cancer treatments. The cost of Ibrance for treating breast cancer will be reduced by as much as 65 percent. Zytiga, a common prescription for people with prostate cancer, will be reduced by as much as 66 percent. And the cost of Tasigna, which is commonly prescribed to people with leukemia, will go down by as much as 71 percent,” says Cicilline, who serves as the Democratic Policy and Communication Committee Chair.

Earlier this year, the Rhode Island Congressman released information detailing how much more Rhode Islanders with diabetes pay for their insulin than people in other countries. Currently, 8.6 percent of Rhode Islanders, just over 83,000 people, have diabetes. They pay from $1,200 to $20,000 per year for the most commonly used insulin medications. Under the newly passed H.R. 3, the average total cost of NovoLOG Flexpen, a common insulin medicine, would decrease by as much as 76 percent. Under H.R. 3, Rhode Islanders could spend 3.5 times less on insulin, and some of the commonly used insulins could cost as little as $400 per year.

According to Cicilline, seniors in his Congressional District will see Medicare improvements if H.R. 3 becomes law. At this time, Medicare does not provide coverage for: oral exams for 71 percent of beneficiaries, eye exams for 66 percent of beneficiaries, hearing exams for 66 percent of beneficiaries, dental exams for 75 percent of beneficiaries, eye glasses for 75 percent of beneficiaries, and hearing aids for 86 percent beneficiaries.

Under H.R. 3’s Medicare expansion, 93 percent of beneficiaries (98,800 people) stand to gain from adding a dental benefit, 75 percent of beneficiaries stand to gain from adding a vision benefit, and 97 percent (102,700 people) of beneficiaries stand to gain from adding a hearing benefit.

On December 6, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan Prescription Drug Pricing Reduction Act of 201. Will McConnell, who controls its legislative fate, allow it to be considered on the Senate floor? Can a conference committee iron out the different between a Senate bill and H.R. 3, that can be pass both chambers and be signed by the president?

The legislative clock is ticking. It’s 324 days until the upcoming 2020 presidential election and the voters are demanding Congress to put aside philosophical policy differences and come up with a compromise that will truly put the brakes on rising drug costs. We’ll see.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

House Committee Moves to Rein in Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on December 1, 2019

On Nov. 18, House Antitrust Subcommittee Chair David N. Cicilline (D-RI) and Judiciary Committee Chairman Jerrold Nadler (D-RI) introduced The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133) to put the brakes on skyrocketing prescription drug costs. The bill attacked increasing costs by prohibiting pharmaceutical companies from engaging in anticompetitive “product hopping.”

Two days later, the Committee unanimously passed the bipartisan bill to drive down the rising costs of prescription drugs. Now H.R. 5133 goes to the House floor for a vote.

“Big pharmaceutical companies have done everything they can to increase their profits regardless of who it affects. Their CEOs make millions in bonuses ever year while hardworking folks are forced to ration their medicine just so they can put food on the table for their kids,” said Cicilline, in a released statement announcing the introduction of the bill.

Since becoming Chair of the House Antitrust Subcommittee, Cicilline has sought to take on the anticompetitive behavior in the health care and pharmaceutical sectors. “This is wrong, and it needs to stop. This bill, along with the suite of legislation to lower health care costs the House has passed already this year, will put an end to anticompetitive behavior that is driving prices up while pushing the middle class further and further down,” says Cicilline in pushing for the bill’s passage.

“This bill builds on the Committee’s strong record of bipartisan legislation to confront one of the leading drivers of high prescription drug costs—efforts by drug companies to keep generic drugs off the market so that they can preserve their monopoly profits,” adds Chairman Nadler when H.R. 5133 was thrown into the legislative hopper. “The outrageous behavior of product hopping puts profits before patients and thwarts the competition that is essential to lowering prescription drug prices,” he charges. Nadler says that H.R. 5133 would “encourage drug companies to focus on delivering meaningful innovation for sick patients rather than delivering profits to their bottom line.”

Fixing the Problem

According to Cicilline and Nadler, pharmaceutical companies use a wide array of tactics when their patent on a drug is near expiration to switch patients to another version of the drug that they have the exclusive right to sell. Called “product hopping,” this anticompetitive practice extends the manufacturer’s ability to charge monopoly prices by blocking the patient’s ability to switch to a cheaper, generic alternative. Product hopping benefits the manufacturer’s bottom line at the expense of patients who are stuck paying higher prices often for many years at a time, they say.

The two Congressmen say that there is another roadblock to lowering prescription drug costs. Although antitrust agencies have made an effort to curb product hopping, the Federal Trade Commission (FTC) still faces a number of hurdles under existing law when trying to hold companies accountable for this anticompetitive conduct. The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 strengthens the FTC’s ability to bring and win cases against pharmaceutical companies that engage in all forms of product hopping.

A similar version of H.R. 5133 was considered in the Senate and it would save taxpayers an estimated $500 million according to the nonpartisan Congressional Budget Office.

A week earlier, before H.R. 5133 was passed by the and Judiciary Committee, a new report was released by AARP Public Policy Institute (PPI), giving data to Congress to enact legislation to lowering prescription drug costs. The report findings indicate that brand-name drug prices rose more than twice as fast as inflation in 2018.

According to the AARP PPI report, retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8 percent in 2018, more than twice the general inflation rate of 2.4 percent. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006.

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a Nov. 13 statement announcing the release of the report. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices,” says Whitman.

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, notes the AARP PPI data.

If brand-name drug retail price changes had been limited to the general inflation rate between 2006 and 2018, the average annual cost of therapy for one brand-name drug would be a whopping $5,000 lower today ($2,178 vs. $7,202). The report’s findings note that the average senior takes 4 to 5 medications each month, and the current cost of therapy translates into an annual cost of more than $32,000, almost 25 percent higher than the median annual income of $26,200 for a Medicare beneficiary.

“While some people will undoubtedly see a slower rate of price increases as a sign of improvement, the reality is that there is absolutely nothing to stop drug companies from reverting back to double-digit percentage price increases every year,” said Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the report. “Americans will remain at the mercy of drug manufacturers’ pricing behavior until Congress takes major legislative action,” adds Purvis.

With over 340 days before the upcoming 2020 Presidential and Congressional elections, Senate Democrats say that more than 250 House-passed bills are “buried in Senate Majority Leader Mitch McConnell’s (R-Ky) legislative graveyard.” The Senate’s top Republican}, referred to as the “Grim Reaper,” has blocked consideration on these bills (including prescription drug pricing bills) effectively killing them. As the election day gets closer this number is expected to increase.

President Trump and Republican lawmakers are loudly chanting that the Democrats are “getting nothing done in Congress.” This is just fake “political” news. Major reforms that would prop up Social Security, Medicare, and lower Prescription Drug prices get the legislative kibosh in the GOP-controlled Senate. It is now time to put these bills to an up or down vote in the upper chamber. The voters will send a message to Congress next November if they agree with the results. It’s time for McConnell to put down his reaper

For details, of AARP report, go to http://www.aarp.org/rxpricewatch.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Uncompensated Cost of Caregivers is a Whopping $470 Billion

Published in the Woonsocket Call on November 17, 2019

Approximately 41 million unpaid family caregivers provided an estimated 34 billion hours of care in 2017 — worth a whopping $470 billion — to their parents, spouses, partners, and friends, according to the latest report in AARP’s Valuing the Invaluable series. The 2019 estimated value of family caregiving is based on 41 million caregivers providing an average of 16 hours of care per week, at an average value of $13.81 per hour. Previous AARP Public Policy reports were released in 2006, 2008, 2011 and 2015.

“It’s encouraging to see greater recognition of the emotional, physical and financial struggles that caregivers face,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, in an April 14th statement announcing the release of the 32-page report. “But the demands on family caregivers are not just a family issue and we must continue to push for meaningful support and solutions,” says Reinhard.

Every caregiver, as well as their families, know the value of their efforts,” said AARP Rhode Island State Director Kathleen Connell. “In Rhode Island, the estimated total value of 114 million hours of work by the state’s 136,000 caregivers is $1.8 billion. The aggregate is astounding, making a clear case for supporting this vital commitment made by family and loved ones.”

“These numbers inspire our members who spend many hours at the State House as AARP Rhode Island advocacy volunteers,” Connell added. “They have helped pass key legislation — the CARE Act, paid caregiver leaves and many other key bills — that have given caregivers resources and opportunities to make their task less daunting. Caregivers are truly invaluable,” she says.

Putting a Spotlight on the Nation’s Caregivers

AARP’s report notes that the estimated $470 billion equates to about $1,450 for every person in the United States (325 million people in 2017). Its economic impact is more than all out-of-pocket spending on US health care in 2017 ($366 billion). Uncompensated care provided by caregivers is also three times as much as total Medicaid spending on long-term services (LTSS) and supports ($154 billion in 2016) and even the total spending from all sources of paid LTSS, including post-acute care ($366 billion in 2016).

The AARP researchers say that the estimate of $470 billion in economic value of uncompensated care is consistent with nearly two decades of prior research studies, all of which found (like the current study) that the value of unpaid family care vastly exceeds the value of paid home care.

The AARP report, Valuing the Invaluable: 2019 Update Charting a Path Forward, also explores the growing scope and complexity of caregiving, including an aging population, more family caregivers in the paid workforce, and the increasing amount of medical and nursing tasks entering the home.

According to the AARP report, family care givers, who provide day-to-day supports and services and manage complex care tasks, are becoming more diverse. While most family caregivers are women, about 40 percent are men who are providing more assistance than just driving to doctor’s appointments and grocery stores or paying bills. Like all caregivers, they are assisting a parent, spouse or friend with bathing and dressing, pain management, managing medication, changing dressings, helping with incontinence and even preparing special diets.

While a majority of baby boomers are providing caregiving services, a growing number of younger adults are now shouldering this responsibility, too. Nearly 1 in 4 (24 percent) are millennials (born between 1980 and 1996). Despite their low salaries, the young adults are spending more of their salary on caregiving expenses than other generations. The researchers estimated that this spending in 2016 was about 27 percent of their income.

About 60 percent of family caregivers are juggling a job and providing care, too. This will continue as aging baby boomers choose to remain in the labor force to bring additional income into their household. Workplace benefits for caregivers becomes become even more important as they face economic and financial strain in their later years.

For those employees who choose to leave their job to become a full-time caregiver, they risk both short-and long-term financial difficulties, say the researchers.

Finally, the researcher’s recommendations to better support family caregivers included developing a robust and comprehensive national strategy with the needs of an increasingly diverse caregiver population included; providing financial relief and expanding workplace policies; developing caregiver training programs; and expanding state and federal funding for respite programs.

More Work Needs to Be Done

The AARP report warns that the rising demand for caregivers with the graying of the nation’s population, shrinking families will drastically reduce the supply. In 2010, there were 7.1 potential family caregivers for every person age 80 and over. By 2030, there may be only 4.1 potential caregivers for every person age 80 and over, they say.

Although significant federal and state policy are already in place to assist the nation’s caregivers, more work needs to be done, say the researchers. They call on Congress and state lawmakers to keep pace with the changing demographic, social trends and needs of the family caregiver.

Resources and information on family caregiving, including AARP’s Prepare to Care
Guides, are available at http://www.aarp.org/caregiving.