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Journal of Aging & Social Policy

Yuan Yuan Fu, Ernest Wing-Tak Chui, Chi Kin Law, Xin Yi Zhao, Vivian Wei Qun Lou
Because of its rapidly aging population, Hong Kong faces great challenges in the provision and financing of long-term care (LTC) and needs to explore sustainable funding mechanisms. However, there is a paucity of research on older people's willingness to pay (WTP) for LTC services in Hong Kong. This study utilizes data collected in Hong Kong in 2011 (N = 536) to investigate older people's receptivity to this financing mode by assessing their copayments for a Community Care Service Voucher Scheme, and then testing how potential factors affect respondents' amount of copayment...
May 10, 2018: Journal of Aging & Social Policy
Xue Bai
Using the Photovoice research method, this study invited 36 aging Chinese adults to photograph images and voice their concerns and expectations regarding financial care in the changing family and sociocultural contexts in Hong Kong. The findings revealed high financial insecurity regarding the future, thereby reinforcing the idea that older people are in urgent need of stable income sources and self-sufficiency in light of changes in filial care practices. Employing a rights-based approach is crucial for enhancing the retirement protection policy and related services to ensure that support sources can effectively respond to the broad spectrum of financial care requirements...
April 30, 2018: Journal of Aging & Social Policy
Esteban Calvo, Maureen Berho, Mónica Roqué, Juan Sebastián Amaro, Fernando Morales, Emiliana Rivera, Luis Miguel F Gutiérrez Robledo, Elizabeth Caro López, Bernardita Canals, Rosa Kornfeld
This investigation uses case studies and comparative analysis to review and analyze aging policy in Argentina, Chile, Costa Rica, and Mexico, and uncovers similarities and relevant trends in the substance of historical and current aging policy across countries. Initial charity-based approaches to poverty and illness have been gradually replaced by a rights-based approach considering broader notions of well-being, and recent reforms emphasize the need for national, intersectoral, evidence-based policy. The results of this study have implications for understanding aging policy in Latin America from a welfare regime and policymakers' perspective, identifying priorities for intervention, and informing policy reforms in developing countries worldwide...
April 16, 2018: Journal of Aging & Social Policy
Jiby Mathew Puthenparambil
The early 1990s economic setback brought significant reforms favoring the outsourcing of care in Finnish municipalities. Here, outsourcing refers to the practice of municipalities employing private organizations through different means (e.g., open tendering) to deliver public care services. In this context, this study examines the growth in the outsourcing of service housing and home-help services in 311 municipalities from 2001 to 2015 and investigates the municipal factors associated with outsourcing using four dimensions: care needs, population size, economic situation, and political ideology of the municipality...
April 16, 2018: Journal of Aging & Social Policy
Jan E Mutchler, Yang Li, Ping Xu
Older Americans rely heavily on Social Security benefits (SSBs) to support independent lifestyles, and many have few or no additional sources of income. We establish the extent to which SSBs adequately support economic security, benchmarked by the Elder Economic Security StandardTM Index. We document variability across U.S. counties in the adequacy levels of SSBs among older adults. We find that the average SSB falls short of what is required for economic security in every county in the U.S., but the level of shortfall varies considerably by location...
April 16, 2018: Journal of Aging & Social Policy
Robert B Hudson
In his surprise election as President, Donald Trump enjoyed disproportionate electoral support from older voters, many of whom saw in Trump a person who would work to reverse demographic, economic, and cultural forces that had transformed American life as they had long seen it. Yet, Trump's campaign and incumbency has also been very much about gutting the Washington policy establishment of officials, bureaucrats, and lobbyists (aka, the Swamp) which, for over half a century, has been instrumental in enacting and expanding legislation that has benefitted older Americans, far more than any other social policy constituency in the country...
April 13, 2018: Journal of Aging & Social Policy
David K Jones, Michael K Gusmano, Pamela Nadash, Edward Alan Miller
The ACA has survived multiple existential threats in the legislative and judicial branches, including dozens of congressional attempts at repeal and two major Supreme Court cases. Even as it seems that the ACA is here to stay, what the law accomplishes is far from settled. The Trump administration is using executive powers to weaken the law, in many cases the same powers that President Obama used to strengthen the effects of the reform. States have responded by seeking flexibility to pursue reforms, such as work requirements, that could not pass Congress and that were not allowed by the Obama administration...
April 12, 2018: Journal of Aging & Social Policy
Leena Sharma, Carol Regan, Katherine S Villers
Over the past century, the organized voice of seniors has been critical in building the U.S. health safety net. Since the 2016 election, that safety net, particularly the Medicaid program, is in jeopardy. As we have seen with the rise of the Tea Party, senior support for healthcare programs-even programs that they use in large numbers-cannot and should not be taken for granted. This article provides a brief history of senior advocacy and an overview of the current senior organizing landscape. It also identifies opportunities for building the transformational organizing of low-income seniors needed to defend against sustained attacks on critical programs...
April 12, 2018: Journal of Aging & Social Policy
David Madland, Alex Rowell
Policymakers need to act to protect Americans' retirement security. A significant portion of Americans are at risk of not being able to maintain their standard of living in retirement and research suggests that this percentage is likely to grow. This commentary provides background on the current state of American retirement, highlights recent efforts to reform retirement policy, and predicts what to expect under President Donald Trump. Retirement has not been a major focus of national policymakers in recent years...
April 11, 2018: Journal of Aging & Social Policy
Robyn I Stone
Adequate housing is critical for low-income older adults, who face affordability and accessibility challenges that affect their quality of life, health, and ability to live independently in their communities. This article examines the federal policy role in meeting the housing and housing-related-needs of the low-income elderly population, which is expected to grow as a proportion of all older adults over the next two decades. The availability of publicly subsidized units and vouchers is woefully inadequate to assist the current low-income elderly population in need of rental assistance...
April 10, 2018: Journal of Aging & Social Policy
Pamela Nadash, Edward Alan Miller, David K Jones, Michael K Gusmano, Sara Rosenbaum
This paper discusses Republican efforts to repeal the 2010 Patient Protection and Affordable Care Act (ACA) over President Trump's first year in office (2017), and their impact on near-elderly Americans (50-64 years old). We describe how the ACA's provisions for strengthening health care coverage were particularly advantageous for near-elderly Americans: the law shored up employer-sponsored healthcare, expanded Medicaid, and - most importantly - created the conditions for a strong individual health insurance market...
April 10, 2018: Journal of Aging & Social Policy
Marc A Cohen, Judith Feder
The need for long-term services and supports (LTSS) presents a growing financial burden on disabled individuals, their families, and state Medicaid budgets. Strategies for addressing this problem pose both a policy design and a political challenge. This article begins by explaining the choices and tradeoffs policymakers face in designing new policy and offers the outlines of a specific approach to navigating these. It then concludes with an assessment of current LTSS policy directions and politics - specifically, the movement to constrain, rather than enhance, federal financing for LTSS and the counter pressures necessary to strengthen meaningful insurance protection...
April 10, 2018: Journal of Aging & Social Policy
Jacqueline L Angel, Nancy Berlinger
Health and social welfare policy proposals put forth by the Trump administration and Republican-controlled Congress could have huge impacts on low-income groups. This paper focuses on older Hispanics, with an emphasis on the Mexican-origin population who form the largest Hispanic subgroup. A demographic portrait is presented which indicates that Mexican-origin individuals have less wealth and lower incomes than do non-Hispanic whites. Given rising health care costs, lower use of nursing homes, and greater propensity to live with grown children, prevailing economic disadvantage has serious consequences for this population...
April 10, 2018: Journal of Aging & Social Policy
Jonathan Oberlander
The election of Donald Trump as president of the United States raises questions about the future of Medicare. How will Medicare fare under Republican-led government? There are several compelling reasons why the Trump administration and Congressional Republicans might avoid Medicare reform, including the political risks of taking on a popular program, the difficulties the party has encountered in trying to dismantle the Patient Protection and Affordable Care Act (ACA), the importance of older Americans to the GOP coalition, and President Trump's views about Medicare...
April 10, 2018: Journal of Aging & Social Policy
Michele E Tolson, Christian E Weller
Economic risk exposure through increased labor market volatility and growing caregiving responsibilities has risen for older Americans. At the same time, key protections such as unemployment insurance and Social Security have declined, while other protections, particularly in the private market are limited or non-existent. Social policy can lower the chance of risk exposure and the associated costs especially with respect to unemployment and caregiving. In virtually all instances, however, the Trump administration has already moved to weaken existing protections...
April 10, 2018: Journal of Aging & Social Policy
Colleen M Grogan, Sunggeun Ethan Park
Medicaid has grown substantially over time; indeed, more than half of all Americans has some connection to the program. Considering Medicaid retrenchment is the centerpiece of recent proposals to repeal and replace the Patient Protection and Affordable Care Act, we ask: How will the American public react to massive reductions in Medicaid funding? Using a nationally representative survey, our study investigates whether adults with elderly parents who have used long-term care services and supports (LTSS), compared to other constituency groups, (1) perceive the Medicaid program as more important, (2) are more knowledgeable about program benefits, and (3) are more likely to oppose Medicaid funding cuts...
April 9, 2018: Journal of Aging & Social Policy
Tine Buffel, Chris Phillipson
Developing age-friendly cities and communities has become a key part of policies aimed at improving the quality of life of older people in urban areas. The World Health Organization has been especially important in driving the "age-friendly" agenda, notably through its global network of age-friendly cities and communities. Despite the expansion and achievements of the network, challenges remain in responding to the growth of inequality and the impact of economic austerity on aging policies. Against the background of these limitations, this article sets out a "manifesto for the age-friendly movement" aimed at raising the aspirations of what is now a worldwide movement...
March 2018: Journal of Aging & Social Policy
Carrie Henning-Smith, Katy B Kozhimannil, Michelle M Casey, Shailendra Prasad
We conducted a qualitative content analysis of barriers to nursing home admission for rural residents. Data came from semi-structured interviews with 23 rural hospital discharge planners across five states (Georgia, Idaho, Minnesota, Pennsylvania, and Wisconsin). From those, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions across four themes: loosen bureaucratic requirements, improve communication between facilities, increase rural long-term care capacity, and address underlying social determinants of health...
March 2018: Journal of Aging & Social Policy
Kali S Thomas, Danielle Cote, Rajesh Makineni, Orna Intrator, Bruce Kinosian, Ciaran S Phibbs, Susan M Allen
The United States Department of Veterans Affairs (VA) is facing pressures to rebalance its long-term care system. Using VA administrative data from 2004-2011, we describe changes in the VA's nursing homes (called Community Living Centers [CLCs]) following enactment of directives intended to shift CLCs' focus from providing long-term custodial care to short-term rehabilitative and post-acute care, with safe and timely discharge to the community. However, a concurrent VA hospice and palliative care expansion resulted in an increase in hospice stays, the most notable change in type of stay during this time period...
March 2018: Journal of Aging & Social Policy
Andrew J Potter
Informal caregivers may face barriers accessing services like respite care, training, and support groups. Using multinomial logistic regression, I modeled caregivers' probability of using all services sought ("all services used") and nonuse of any services sought ("any unused services") as a function of caregiver and care-recipient characteristics. Care-recipient health and function, especially dementia and need for medical task assistance, were associated with all services used and any unused services, and any unused services were more likely among adult children caring for their parents, caregivers of Black and Hispanic older adults, caregivers providing intensive care, caregivers living in metropolitan areas, and residents of states that spend more on increasing access to caregiver services under the National Family Caregiver Support Program...
March 2018: Journal of Aging & Social Policy
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