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Medicare: Fix In-Home Elder Care

More qualified care workers needed for aging population

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Happy birthday! I can't believe it's been 47 years. I've looked at the actuarial tables and you barely look a day over 40.

But flattery aside, we have to have a talk. Because right now, every eight seconds, another boomer turns 65. This year alone, more than 3 million Americans will celebrate that birthday. And more older people means more work for you, Medicare. Are you up for it?

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Medicare can adapt to the nation's needs by helping to cover in-home elder care workers. — James Yang

I know you've had some work done recently. The Affordable Care Act will reduce fees for prescription drugs, bring down the cost of private Medicare supplements and increase access to free preventive care. According to some reports, Medicare enrollees with high prescription drug spending will save as much as $12,300 over the next 10 years thanks to that piece of reform alone. Maybe someone will use the savings to get you a present.

Plus, while economists are still debating whether your long-term fiscal health is in jeopardy, most agree the Affordable Care Act will ensure you are solvent longer. That law cuts $700 billion in unnecessary Medicare spending over the next 10 years, reducing the rate at which payments to providers are growing.

What politicians should be trying to do isn't cut you or privatize you, Medicare, but rather make you and our whole elder care system even stronger, especially given the unprecedented rise in demand. What needs fixing most? Our system for in-home elder care.

Over 90 percent of Americans age 50-plus agree that people should have the freedom to grow old at home with dignity. But that means they need qualified care workers by their side. To keep up with the aging population, we need to add at least 1.6 million new direct-care jobs by 2020. That's good news for jump-starting our economy. And since home care is less expensive than hospitals or long-term care facilities, it saves you money, too.

Yes, Medicare, we might have to raise your allowance. After all, if we value caring for older people with dignity, we should treat their care workers with dignity, too. The average U.S. home care worker makes less than $10 per hour. And many home care workers are immigrant women of color who, because they're not paid well enough and don't have sick days and access to immigration papers, can't in turn take care of their own families.

As I'm sure you remember, when the Senate passed the Medicare bill in 1965, President Lyndon Johnson said, "We have proved, once again, that the vitality of our democracy can shape the oldest of our values to the needs and obligations of today." Now that you're 47, it's time we start thinking about the needs and obligations of a new day. When we think of the health care system, we should be thinking about how to better care for everyone in it — including workers.

So happy birthday! And may you keep growing and adapting to our nation's needs.

PS — Since more than 80 percent of Americans on Medicare say they're very happy with you, I'll assume their cards are on the way to you, too.

Ai-jen Poo is codirector of Caring Across Generations, a coalition of 200 advocacy organizations, and executive director of the National Domestic Workers Alliance.

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With Medicare facing serious financial trouble, how will the program continue to care for the nation's elderly and disabled?

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