Sunday, June 27, 2010

US ranks 6th in quality of retirement system

MSNBC ran a “market watch” story this morning, in which the United States was ranked sixth in an 11-nation study, on “adequacy, sustainability, and integrity”, as to the quality of its retirement system. The number 1 ranking country was the Netherlands, and number 2 was Australia.

The link for the story is here

Adequacy refers to whether the system provides a standard of living that matches expected life span.

Sustainability refers to demographics, and whether the system can stand up to an aging population if expected.

Chile, which has privatized social security, ranked lower than the US, as did Singapore, with its strict social morality, and China.

Picture: The law firm shown, Greenberg & Bederman LLP (link) is known for helping social security disability recipients.

Monday, June 21, 2010

States quietly reduce pension benefits for employees yet to be hired or new employees

States are looking for ways to control pension costs, and apparently they are doing so in the most inconspicuous way possible, by cutting benefits and raising co-contribution requirements for employees yet to be hired, according to a Sunday June 20 New York Times story by Mary Williams Walsh, “In budget crisis, states take aim at pension costs,” link here.

Illinois raised its retirement age for public employees to 67, but only for future employees. Current workers can still retire at 60, sometimes at 55.

The retirement crisis has come on quickly partly as a byproduct of union (and corporate policies for salaried or management workers) practices that for years encouraged “early retirement” as early as 55. I was part of that culture, which is no longer sustainable.

Sunday, June 20, 2010

Sharron Angle and the "social security and Medicare lockbox"

So what to make of the “rumors” that Nevada candidate Sharron Angle would “eliminate” social security and Medicare? Well, a closer look from a conservative site called “red state” says that she wants to put a “lock box” around the funds comprising contributions from workers already in the system, so that “Democrats” can’t raid it for other purposes, reducing seniors into bag people. But it’s true that she acknowledges the “Tea Party” – Cato – libertarian- conservative idea that new workers should control their own fates with lifelong private accounts, even for health care. Here’s the blog posting at Red State (web url) link

Huffington, understanbly, has another spin here.

Here is Sharron’s site.

Okay, I’m no longer violating FEC campaign finance rules by giving her link for free as a blogger.

Thursday, June 17, 2010

Medicare payment cut (21%) to doctors critical right now; when does Senate act?

According to the AARP, doctors faced a pay cut of 21% for seeing Medicare patients, while CMS froze Medicare payments to doctors to give the Senate more time to decide whether to postpone the cut to these doctors. The AARP story by Patricia Barry is here.

I will check to see where this is in the Senate (since it’s June 17 now and apparently the CMS authority ran out June 14.) I don’t see anything clear year in Bing.

John W. House (an ironic name given the name of the TV series) wrote on the Huffington post in March that the 21% cut would create a two-tiered health care system, link here. He talks about the SGR, or Sustainable Growth Rate Formula, and writes “The Sustainable Growth Rate (SGR) formula was created by Congress to control costs of Medicare. From the start, SGR never worked the way it was intended. It is unfair to cut the Medicare payment to physicians because the cost of all areas of medicine is increasing. This increase is a result of better technology, better drugs and longer life spans.”

Update: June 18

The pay cuts to doctors for Medicare  patients took effect today.

Wednesday, June 16, 2010

AARP reports on increased in independent senior living and increased home-based and community-based services

The AARP Bulletin (June 2010), p 14, has an important story by Peter Jaret, “The Great Escape”, about the trend to encourage seniors to live independently and to bring in-home care services to them, rather than have them move into or stay in “institutions”. The link for the story is here.

In the particular story, a 67 year old woman, recovering from a severe infection and surgery, moved from a nursing home into a small apartment near Philadelphia. But the story specifically deals with seniors who want to be independent and who are intact enough to be by themselves for long periods and to plan their own activities.

It does sound as though the housing market demands more apartment-style housing in planned communities, where there is security, modern amenities, and particularly quick available of in-home services when needed, but where these services are only paid for if needed and not part of the rent. The geriatric care industry calls this “independent living” (as compared to “assisted living”).

This need may be more difficult to fill now in some cities because of the housing crisis and credit line collapse, which is still not fully recovered. Indeed, had the housing market paid more heed to the need for independent living for seniors and built fewer “McMansions” in many cities, the housing crisis might have been much less severe. This one people (including investors) just didn’t see.

The other issue is the workplace market, that it can provide and pay for the workers needed to give in-home care this way, since the demand is obviously growing so fast.

Jaret quotes a statistic from the National Center for Assisted Living (NCAL): between 2001 and 2007, Medicaid spending on nursing home care rose only 9.8%, whereas on in-home and community-based care it rose 81.5%.

Tuesday, June 15, 2010

Professional geriatric care managers may be an important resource for some families (especially long distance); behave with care!

An important resource for adult children facing eldercare situations can be a geriatric care manager. The National Association of Professional Geriatric Care Managers (NAPGCM) has a useful and informative website here

Geriatric care managers assist clients in exploring care options for appropriateness, and in screening in-home caregivers. They also can assist clients in a paralegal sense, in advising clients of behaviors that should be expected of everyone affected.

NAPGCM says that the profession is particularly useful for long-distance caregiving situations, where the adult child(ren) live(s) in another state or at some distance and does not want to face moving back, extensive travel, or is unable to move the parent in to the other state. It is apparently particularly useful when families choose to hire caregivers directly and have to do with a number of legal workplace requirements, which agencies will handle (although perhaps charging more); a GCM also may recommend particular agencies in a particular city. The website(in an essay by Linda Fodrini-Johnson) says that “geriatric care management” is “a viable career option for (the) private duty home care industry.” That comports with the general observation that, during the next economic recovery, the job market is likely to become much more “people centered” than it was in the past, with emphasis on labor intensive jobs that cannot be automated easily or outsourced . GCM can also help with “downsizing” into independent senior living, assisted living, or nursing homes. The sentiment in the eldercare world in the past two years has turned sharply toward more political and social support for in-home care, including discussions about improving wages and benefits for workers, in view of some legal cases (such as, in New York State in a 2007 Supreme Court decision, Long Island Care Care At Home, v. Evelyn Coke, Cornell Law School link to opinion here). I’ve covered some of this debate in previous postings and would add that eldercare needs to be a much large piece of the entire health care debate, both legislatively and within the Obama administration.

NAPGCM’s website offers a sobering (and rather detailed) discussion of elder financial abuse (in an essay by Cathy Jo Cress and Ann Bunni Dybnis), and especially as to how it can monitor families of clients for certain long-term patterns of abuse. It mentions scam artists like Bernie Madoff, but goes on to say that adult children are responsible for 33% of investigated cases of elder financial abuse according to a survey of state departments of Adult Protective Services. (She leads into this with mention of the Brooke Astor case with abuse of son Anthony in New York City a couple years ago.) Such cases increase during economic downturns and may be more likely as adult children experience their own workplace difficulties or debt burdens. The finding puts adult children caregivers on the “hot seat” a bit (or as I called it in kindergarten, “the red chair”). GCM’s are required by law in most states to report suspected financial abuse, so clients should be keeping good financial records and be careful that they are not comingling improperly before contacting GCMs. Clients might well contact attorneys first and have the proper powers of attorney documents drawn up, but powers of attorney can be abused. Clients should be careful on how they behave with respect to changes in wills, also. In some cases GCM’s may want to become more active in managing an elder’s business matters if they take on a client and perceive a conflict of interest.

The financial abuse page leads to another page (link on the left) “family caregiver agreements": when a family member is ‘paid’ to be a personal caregiver” which could probably include financial management (if risky) and medication. In such cases it’s wise to have a different person write the checks, it says, and estimate income taxes and FICA taxes must be paid (and reported to the IRS and SSA at the end of the year on tax returns). Sometimes, in “reverse live in” situations, board might be included and a tax adviser is needed to handle the situation correctly, or the caregiver might pay rent (if moving back in) and charge for services, in which case both are taxable – but the caregiver may have more independence this way. To avoid the appearance of comingling, renumeration should be reasonable, compared to what individually hired people would be paid.

Friday, June 11, 2010

United health Care/AARP explains Early Enrollment Discount Program for Medicare Part B Supplement; not available in all states

United Health Care Insurance Company has sent a letter to AARP Health Care Options enrollees who received the Early Enrollment Discount, including me, for Supplementary Insurance for Medicare Part B. I have been receiving it for two years, since July 2008 when I turned 65. (The letter mentions both Medicare Supplement and Medicare Select.)

The discount slowly decreases each year, but the letter tells me that in the coming twelve months the discount still averages 24%. However, it also warns that I must live in a state where the discounts apply. This list of states does include Virginia, where I live now.

The plan allows the patient to continue seeing physicians of his or her choice.

I don’t have the list of states where the discount applies, but if I find a link for the list I’ll pass it on as an update note here.

AARP also offers Prescription Drug benefits through Walgreens (meaning Walgreens needs to exist in your geographical area), and Eye Med Vision Care in some areas.

Thursday, June 10, 2010

Active employees are checking their defined benefit pension calculations much more often than in the past

The “Outfront” column in Workforce Management Magazine has an article on p. 8 of the June 2010 issue by Andrew Yerre of Mercer Consulting, indicating that the number of employees requesting calculation of their defined-benefit pensions rose sharply in 2009, after a law was passed in 2006 requiring Pension Plans to send employees and retirees Plan funding reports. In my own experience as a retiree (ING), those reports are sent one year after the plan year has been evaluated. Mercer says it received 80000 such requests in 2009, up 40% in one year; the company handles defined-benefit plans for 73 corporate clients, many with multiple plans.

The article is not yet available online.

Larger insurance companies are likely to do their own pensions, and have dedicated people in HR to handle requests from associates for computations, which often are done off-line. Over time, in the past few years, companies have been placing more retirement information on corporate servers, but sometimes only for current employees, not retirees, who often must use call centers or who can often see only more limited information. Hewitt is another major company in administering corporate pension benefits.

Monday, June 07, 2010

University study finds that "labor force participation rates" for older workers will improve a lot in the next few years

Phillip Moeller from US News and World Report has a story reprinted on Yahoo! Finance today that offers more than a “ray of hope” for older workers, with link here.

Demographics will put pressure on baby boomers to return to the workplace, as there are fewer younger and middle aged workers to support them.

A study from Northeastern University by Barry Bluestone and Mark Melnik say that in eight years, “labor force participation rates” in older workers (LFPR’s) will have to increase from 65.4% to 74.4% for workers 55 to 64. Companies will no longer have the luxury of pushing workers in their 50s out the door.

But the list of fields in which the need for workers is greatest does seem to be in “personal contact” jobs, including teachers, nurses, medical technicians, home health aides and child care workers.

The PDF for the 31 page report, sponsored in part by the MetLife Foundation, is here. The University blog entry describing the report is here.

Picture: notice the basketball; it took quite a shot to put it there (in a church gymnasium).

Sunday, June 06, 2010

Aging in place: consider reverse mortgages, home equity loans: know the differences: and then afterwards what does it take to be cared for at home?

Today, Sunday June 6, AOL Real Estate provided an article by Megan Mollman, Housing Watch Contributor, “Home Equity Loan: A Good Option for Cash Strapped Retirees,” link here.

The article comports with recent reports of greater interest in keeping seniors in their homes as they age, and gaining funding for some caregiving services at home. Many seniors, despite the housing crash, have considerable equity in their (often older) homes (at least 50% of American homes do have positive equity), and a home-equity loan could pay for maintenance, living costs, and sometimes some caregiving costs.

A site called “Mortgage 101” explains the differences between a home equity loan and a reverse mortgage (link here ). A home equity loan is still a “forward mortgage” with regular payments. A reverse mortgage is paid back by heirs with a balloon payment (rather like church). A home equity loan offers the usual mortgage interest tax deductions.

Reverse mortgages are restricted to seniors. Home equity loans don’t place restrictions on age.

Both kinds of devices usually require that the senior live in the home. (HelpFHA mentions owner occupation, link ; a typical reference for home equity is here). I’m not sure what happens if the senior moves into a facility and a relative sits on the house. In such a situation, if the real estate situation in an area is favorable to selling the house, it’s probably going to result in keeping more money for providing care.

HUD also has a paper that explains the difference between reverse mortgage and home equity loan, here

The National Council on Aging has a somewhat sobering perspective on the challenges of aging at home even if you have financial resources through reverse mortgage or home equity loan here.

To that end, CNN has a story (June 4, 2010) about Irene Zola, as one of its potential heroes, “Pairing Neighbors with the Elderly”, by Leslie Askew, link here. Here website is "Support our Seniors" or "S.O.S." with link here and an interesting quote (over to the right) from novelist Pearl S. Buck.

Update: June 8

Facebook proffered a link from the "Reverse Helpline" saying "Stimulus Plan Increases everse Mortgage Limits For Seniors", link here.

Saturday, June 05, 2010

US News points out "sneaky" ways to get more social security benefits from "family values"

MSN today (Saturday June 5) offers an article from U.S. News and World Report “6 Sneaky Ways to Get More Social Security,” link (web url) here.

And this is the “family values” article if there ever was one. Couples who were married for at least ten years stand to gain more, and particularly do couples in essentially one-earner families with stay-at-home moms (or dads). You read this, and you say, no wonder social security fits into the gay marriage debate.

There are complicated rules for the low-earning spouse involving full retirement age vs. early retirement. But in general, spouses can “claim and suspend” or “claim twice”. It’s even possible to get benefits based on ex-spouses records if the marriage lasted ten years. It’s also possible in many cases to increase benefits if there are other dependent family members.

This material would be covered in the latest (2008) version of “The Social Security Benefits Handbook” (Sphinx Publishing) by Stanley A. Tomkiel, link here.

Wednesday, June 02, 2010

Alzheimer's may target isolated extended families with intermarriage (NYT story about a Colombian family)

Pam Belluck has three stories (one long front page story and two sidebars) in the New York Times on Wednesday June 2, “Alzheimer’s stalks a Colombian family”, link here.

A number of extended family members in this remote area have developed Alzheimer’s symptoms in their 30s, attracting the attention of genetic researchers. Some of the family has Basque origin (from northern Spain).

Marriage within relatively closer relatives in a less populated area may be contributing to the occurrence of the disease.

The article also discussed other genetic combinations, that appear to be recessive, that may contribute to Alzheimer’s between age 60 and 80.

The research is critical because Alzheimer’s is expected to increase dramatically in the US and Europe in the next ten years. One possible prevention strategy includes a vaccine that would actually enable the immune system to prevent the accumulation of plaque tangles in the brain.

The June 2010 issue of Scientific American has a piece (on p 51) "Alzheimer's: Forestalling the Darkness" by Gary Stix, link here (subcription or purchase required for complete article). The article also discusses early Alzheimer's in Macondo and Medellin, Colombia.