As Americans die younger, corporations to reap billions in pension costs

By Kate Randall
11 August 2017

Life expectancy for Americans has stalled and reversed in recent years, ending decades of improvement. According to a new Bloomberg study, this grim reality has an upside for US corporations, saving them billions in pension and other retirement obligations owed to workers who are dying at younger ages.

In 2015, the American death rate rose slightly for the first time since 1999, according to data from the Centers for Disease Control and Prevention (CDC). Over the last two years, at least 12 large companies have reported that negative trends in mortality have led them to reduce their estimates for how much they could owe to retirees by a combined $9.7 billion, according to Bloomberg’s analysis of company filings.

It is highly unusual in modern times, except under epidemic or war conditions, for life expectancy in an industrial country to stop improving, let alone decline. Laudan Aron, a demographer at the Urban Institute, told Bloomberg that falling US life expectancy, especially when compared to other high-income countries, should be “as urgent a national issue as any other that’s on our national agenda.”

But this has not sounded alarm bells in Washington. In fact, shortened life expectancy in the 21st century is the result of deliberate government policy of both big business parties: to restrict access to affordable health care, resulting in increased disease, suffering and early death.

Those who stand to cash in on the shortened lifespans of workers include General Motors, Verizon and other giant corporations. Lockheed Martin, for instance, has reduced its estimated retirement obligations for 2015 and 2016 by a total of about $1.6 billion, according to a recent annual report.

Companies have reduced estimates of what they will owe future retirees. According to a Society of Actuaries (SOA) report, companies can expect to lower their pension obligations by about 1.5 to 2 percent, based on a 2016 update of mortality data.

Life expectancy for the US population was 78.8 in 2015, a decrease of 0.1 year from 2014, according to the CDC, with the age-adjusted death rate increasing 1.2 percent over the year. Since the introduction in 1965 of Medicare and Medicaid—the government insurance programs for the elderly, poor and disabled—US life expectancy has steadily increased.

Death rates for Americans over age 50 have improved by 1 percent on average each year since 1950, according the SOA. In 1970, a 65-year-old American could expect to live another 15.2 years, on average, until just past 80 years.

From 2000 to 2009, the death rates for Americans over age 50 decreased, with annual improvements of 1.5 to 2 percent. By 2010, a 65-year-old could expect to live to 84. But these increases have slowed in recent years, with life expectancy at 65 rising only about four months between 2010 and 2015.

The slowing in death rate improvements since 2010, and the actual lowering of life expectancy in 2015, have followed the global financial crash of 2007-2008. Despite the Obama administration’s declaration that the Great Recession ended mid-2009, millions of US workers and their families continue to suffer under the weight of unemployment, underemployment, and stagnant or falling wages.

Seven years after the Affordable Care Act was signed into law, a staggering 28 million Americans remain uninsured. Those who are insured have seen their premiums, deductibles and other out-of-pocket costs skyrocket. Families are saddled with billions of dollars in medical debt.

The lack of access to affordable health care is resulting in an unprecedented health crisis in the US. A 2015 study showed that mortality was rising for middle-aged white Americans, with deaths from suicides, drug overdoses and alcohol, collectively referred to as “ deaths of despair.” Both women and men have been affected by this phenomenon.

CDC data shows that more than 500,000 Americans have died of drug overdoses in the period between 2000 and 2015, now approaching an average of 60,000 a year.

The 10 leading causes of death in 2015 were heart disease, cancer, chronic lower respiratory diseases, unintentional injuries, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease, and suicide, according the CDC. Despite scientific advances in medical treatment and the development of new drugs to treat these diseases and conditions, they still accounted for 74.3 of all US deaths in 2015.

Moreover, from 2014 to 2015, age-adjusted death rates increased 0.9 percent for heart disease, 2.7 percent for chronic lower respiratory diseases, 6.7 percent for unintentional injuries, 3 percent for stroke, 15.7 percent for Alzheimer’s disease, 1.9 percent for diabetes, 1.5 percent for kidney disease, and 2.3 percent for suicide. Only cancer saw a reduction, of 1.7 percent.

It is on the backs of workers dying earlier from these diseases, alongside “deaths of despair,” that US corporations now stand to save billions, increasing their bottom lines by not paying out pensions and retirement benefits.

This is by design. Obamacare was the first significant effort to reduce the trend of increasing life expectancy by shifting the costs of medical care from the corporations and government to the working class. The ACA was drafted in close consultation with the insurance industry, requiring those without insurance to purchase coverage from private insurers under the threat of tax penalty.

The ACA set into motion the rationing of health care for ordinary Americans, making vitally needed treatments and medicines increasingly inaccessible for millions. This has now borne fruit in the first reduction in US life expectancy in more than half a century.

Following the Republicans’ failure to “repeal and replace” Obamacare, the Democrats have responded by offering to work with the Republicans to “repair” the ACA. But they do not mean reducing the number of uninsured or further expanding Medicaid.

Instead they have offered a five-point plan to shore up the insurance companies by setting up a “stability fund” for companies to insure high-risk enrollees, and guaranteeing they receive $8 billion in government cost-sharing payments to the insurance firms that the Trump administration has threatened to cut off.

Such measures, along with savings from unpaid retirement benefits, will further bloat corporate profits along with those of the private insurance companies and health care industry as a whole.

WSWS

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RIP Terry Pratchett: “AT LAST, SIR TERRY, WE MUST WALK TOGETHER”

The beloved fantasy author died at age 66 after a long battle with Alzheimer’s disease

RIP Terry Pratchett: "AT LAST, SIR TERRY, WE MUST WALK TOGETHER"
Terry Pratchett (Credit: AP/Kirsty Wigglesworth)

Prolific fantasy author Sir Terry Pratchett has passed away at the age of 66, after being diagnosed with early-onset Alzheimer’s disease in 2007. He continued to write throughout his illness, completing the 40th “Discworld” book last spring, which he did through the help of dictation and speech recognition software. He has often spoken publicly about his illness and became a staunch advocate for assisted death after his diagnosis (according to a source at the Telegraph, he died of natural causes).

Pratchett has written more than 70 books over his long career, including 41 books in the popular Discworld series, and has sold over 85-million books worldwide. He is the second most widely-read writer in the UK — and was, for a long time, the first, before being unseated by J.K. Rowling. He has many other accomplishments to his name, including the Carnegie Medal for his Discworld kids book “The Amazing Maurice and his Educated Rodents”, as well as the World Fantasy Award for Life Achievement and a Knighthood, not to mention enriching the lives of millions of readers across the globe.

Pratchett’s death was announced via a series of tweets from his Twitter account, describing an encounter with Pratchett and “Death,” who was a character in the Discworld novels.



“The world has lost one of its brightest, sharpest minds,” read a statement from Larry Finlay at Pratchett’s publishing company Transworld. “In over 70 books, Terry enriched the planet like few before him. As all who read him know, Discworld was his vehicle to satirize this world: He did so brilliantly, with great skill, enormous humour and constant invention. Terry faced his Alzheimer’s disease (an ‘embuggerance’, as he called it) publicly and bravely. Over the last few years, it was his writing that sustained him. His legacy will endure for decades to come.”

Anna Silman is Salon’s deputy entertainment editor. Follow her on Twitter:@annaesilman.

 

http://www.salon.com/2015/03/12/rip_terry_pratchett_at_last_sir_terry_we_must_walk_together/?source=newsletter

“Alive Inside”: Music may be the best medicine for dementia

A heartbreaking new film explores the breakthrough that can help severely disabled seniors: It’s called the iPod VIDEO

"Alive Inside": Music may be the best medicine for dementia

One physician who works with the elderly tells Michael Rossato-Bennett’s camera, in the documentary “Alive Inside,” that he can write prescriptions for $1,000 a month in medications for older people under his care, without anyone in the healthcare bureaucracy batting an eye. Somebody will pay for it (ultimately that somebody is you and me, I suppose) even though the powerful pharmaceutical cocktails served up in nursing homes do little or nothing for people with dementia, except keep them docile and manageable. But if he wants to give those older folks $40 iPods loaded up with music they remember – which both research and empirical evidence suggest will improve their lives immensely — well, you can hardly imagine the dense fog of bureaucratic hostility that descends upon the whole enterprise.

“Alive Inside” is straightforward advocacy cinema, but it won the audience award at Sundance this year because it will completely slay you, and it has the greatest advantages any such movie can have: Its cause is easy to understand, and requires no massive social change or investment. Furthermore, once you see the electrifying evidence, it becomes nearly impossible to oppose. This isn’t fracking or climate change or drones; I see no possible way for conservatives to turn the question of music therapy for senior citizens into some kind of sinister left-wing plot. (“Next up on Fox News: Will Elton John turn our seniors gay?”) All the same, social worker Dan Cohen’s crusade to bring music into nursing homes could be the leading edge of a monumental change in the way we approach the care and treatment of older people, especially the 5 million or so Americans living with dementia disorders.

You may already have seen a clip from “Alive Inside,” which became a YouTube hit not long ago: An African-American man in his 90s named Henry, who spends his waking hours in a semi-dormant state, curled inward like a fetus with his eyes closed, is given an iPod loaded with the gospel music he grew up with. The effect seems almost impossible and literally miraculous: Within seconds his eyes are open, he’s singing and humming along, and he’s fully present in the room, talking to the people around him. It turns out Henry prefers the scat-singing of Cab Calloway to gospel, and a brief Calloway imitation leads him into memories of a job delivering groceries on his bicycle, sometime in the 1930s.



Of course Henry is still an elderly and infirm person who is near the end of his life. But the key word in that sentence is “person”; we become startlingly and heartbreakingly aware that an entire person’s life experience is still in there, locked inside Henry’s dementia and isolation and overmedication. As Oliver Sacks put it, drawing on a word from the King James Bible, Henry has been “quickened,” or returned to life, without the intervention of supernatural forces. It’s not like there’s just one such moment of tear-jerking revelation in “Alive Inside.” There might be a dozen. I’m telling you, one of those little pocket packs of tissue is not gonna cut it. Bring the box.

There’s the apologetic old lady who claims to remember nothing about her girlhood, until Louis Armstrong singing “When the Saints Go Marching In” brings back a flood of specific memories. (Her mom was religious, and Armstrong’s profane music was taboo. She had to sneak off to someone else’s house to hear his records.) There’s the woman with multiple psychiatric disorders and a late-stage cancer diagnosis, who ditches the wheelchair and the walker and starts salsa dancing. There’s the Army veteran who lost all his hair in the Los Alamos A-bomb test and has difficulty recognizing a picture of his younger self, abruptly busting out his striking baritone to sing along with big-band numbers. “It makes me feel like I got a girl,” he says. “I’m gonna hold her tight.” There’s the sweet, angular lady in late middle age, a boomer grandma who can’t reliably find the elevator in her building, or tell the up button from the down, boogieing around the room to the Beach Boys’ “I Get Around,” as if transformed into someone 20 years younger. The music cannot get away from her, she says, as so much else has done.

There’s a bit of hard science in “Alive Inside” (supplied by Sacks in fascinating detail) and also the beginnings of an immensely important social and cultural debate about the tragic failures of our elder-care system and how the Western world will deal with its rapidly aging population. As Sacks makes clear, music is a cultural invention that appears to access areas of the brain that evolved for other reasons, and those areas remain relatively unaffected by the cognitive decline that goes with Alzheimer’s and other dementia disorders. While the “quickening” effect observed in someone like Henry is not well understood, it appears that stimulating those undamaged areas of the brain with beloved and familiar signals – and what will we ever love more than the hit songs of our youth? — can unlock other things at least temporarily, including memory, verbal ability, and emotion. Sacks doesn’t address this, but the effects appear physical as well: Everyone we see in the film becomes visibly more active, even the man with late-stage multiple sclerosis and the semi-comatose woman who never speaks.

Dementia is a genuine medical phenomenon, as anyone who has spent time around older people can attest, and one that’s likely to exert growing psychic and economic stress on our society as the population of people over 65 continues to grow. But you can’t help wondering whether our social practice of isolating so many old people in anonymous, characterless facilities that are entirely separated from the rhythms of ordinary social life has made the problem considerably worse. As one physician observes in the film, the modern-day Medicare-funded nursing home is like a toxic combination of the poorhouse and the hospital, and the social stigma attached to those places is as strong as the smell of disinfectant and overcooked Salisbury steak. Our culture is devoted to the glamour of youth and the consumption power of adulthood; we want to think about old age as little as possible, even though many of us will live one-quarter to one-third of our lives as senior citizens.

Rossato-Bennett keeps the focus of “Alive Inside” on Dan Cohen’s iPod crusade (run through a nonprofit called Music & Memory), which is simple, effective and has achievable goals. The two of them tread more lightly on the bigger philosophical questions, but those are definitely here. Restoring Schubert or Motown to people with dementia or severe disabilities can be a life-changing moment, but it’s also something of a metaphor, and the lives that really need changing are our own. Instead of treating older people as a medical and financial problem to be managed and contained, could we have a society that valued, nurtured and revered them, as most societies did before the coming of industrial modernism? Oh, and if you’re planning to visit me in 30 or 40 years, with whatever invisible gadget then exists, please take note: No matter how far gone I am, you’ll get me back with “Some Girls,” Roxy Music’s “Siren” and Otto Klemperer’s 1964 recording of “The Magic Flute.”

“Alive Inside” opens this week at the Sunshine Cinema in New York. It opens July 25 in Huntington, N.Y., Toronto and Washington; Aug. 1 in Asbury Park, N.J., Boston, Los Angeles and Philadelphia; Aug. 8 in Chicago, Martha’s Vineyard, Mass., Palm Springs, Calif., San Diego, San Francisco, San Jose, Calif., and Vancouver, Canada; Aug. 15 in Denver, Minneapolis and Phoenix; and Aug. 22 in Atlanta, Dallas, Harrisburg, Pa., Portland, Ore., Santa Fe, N.M., Seattle and Spokane, Wash., with more cities and home video to follow.

http://www.salon.com/2014/07/15/alive_inside_music_may_be_the_best_medicine_for_dementia/?source=newsletter

Bringing Dementia Patients to Life

 

1K The Atlantic by Richard Gunderman
 

 

We know a lot about Alzheimer’s disease. For example, we know that it is the sixth-leading cause of death in the United States. We know that one in three seniors dies with some form of dementia. And we know that over 5 million Americans are currently living with Alzheimer’s. But there are some important things we don’t know—and I am not referring simply to the still-elusive cure for the disease. I am also talking about new insights familiar to experts in dementia care, which have not yet reached many of the 15 million Americans caring for a loved one with the disease. In dementia care, what we don’t know can really hurt us.

I recently spoke with Theresa Klein, an occupational therapist at Augustana Emerald Crest Assisted Living in Minneapolis, who has been caring for people with dementia for 23 years. Theresa and her colleagues have known and cared for hundreds of patients, and this wealth of experience has provided insight on how to craft a better life for both patients and caregivers. First and foremost is the realization that a dementia diagnosis is not the medical equivalent of falling off a cliff. If we stay hopeful and focus on what matters most, she says, we can do a lot to help patients reach their peak every day.

To provide the best possible care for dementia patients, we need to get past some important misconceptions about the disease. One is that Alzheimer’s, which accounts for about 80 percent of dementias, is strictly a disorder of memory. In fact, it usually involves many mental processes, including the abilities to focus attention, organize thoughts, and make sound judgments. Another is the notion that Alzheimer’s is strictly a disease of cognition. In reality, it can affect emotions and personality, as well. But perhaps the biggest misconceptions Theresa encounters regards a dementia diagnosis as the end.

Naturally, being diagnosed with dementia represents an important change in life, but it is certainly not a death sentence. Some patients diagnosed with Alzheimer’s disease will live another 15 and even 20 more years, though others will progress more quickly. Nor does it represent the end of all that is good in life. Theresa and her colleagues have learned a crucial lesson that needs to be disseminated to caregivers everywhere: “We should dwell less on lamenting what dementia patients are incapable of and focus more on bringing out and celebrating what they are capable of doing.”

Like anything else in medicine, helping someone suffering from dementia requires understanding, compassion, and dedication. Care needs to be tailored to each patient’s personality, life history, and stage in the development of the disease. When this is done well, new possibilities open up. What might have been an atmosphere of regret and hopelessness centered on the disease’s relentless progress can be transformed into an upbeat outlook that celebrates abilities, rejoices in moments of recognition, and looks to the future with hope.

Perhaps Theresa’s most important insight into dementia care concerns the power of ritual, and it came from the care of her own grandfather. As his dementia progressed, he became less alert and more confused. A devout Catholic, however, he kept attending weekly Mass. Though Theresa’s father was nearly mute much of the time, at services he happily recited familiar prayers and joined in the hymns. Each time the service began, he would become calmer and less agitated, less confused and more focused. The ritual seemed not only to evoke special memories and feelings–it brought him back, as well.

Theresa and her colleagues now invite patients to participate in such rituals on a regular basis. One of the key words here is “participate.” They do not passively sit back and watch or listen as someone else recites prayers and sings hymns. They are invited and encouraged to join in the service. Some, typically those in the early stages of their disease, are able to participate fully, even engaging in discussions about the meaning of what they are doing. For others at later stages, participation may mean singing, ringing bells, or simply tapping feet and clapping hands.

One recent case demonstrated the power of such rituals to bring out the best in a person. Martha was a silver-haired, 82-year-old dementia patient whose adult daughter visited her in her memory care facility every day. Usually, Martha spent most of her day asleep in bed, and when she sat in a chair, she tended to slump to one side, seemingly oblivious of her surroundings. But within a few minutes of the start of a service, she would sit straight up, look at her daughter, and join enthusiastically in the prayers and hymns. On more than one occasion she even told her daughter that she loved her.

The implicit expectation that dementia patients will somehow withdraw and shrivel up can become a self-fulfilling prophecy. Martha had been in and out of hospice three times. Three times her daughter had prepared to say goodbye to her for the last time. The key in such cases is to avoid the mentality that the most anyone can hope is that patients will simply keep quiet and leave everyone alone. As Theresa says, “We need to avoid treating the Marthas of the world as just patients we do things to. We must never forget that they are also human beings we can do things with.”

A physician friend recently told me a similar story. He and a colleague had just emerged from a very difficult conversation with a young cancer patient whose disease had progressed so far that she understood very little of their conversation. They had gone out into the nursing station to write notes in her chart when he noticed an elderly gentleman sitting in the hall in a wheelchair. Clearly in the advanced stages of dementia, he slumped to his side, oblivious to what was going on around him, held upright only by a restraining belt clutching him to the chair.

To everyone’s amazement, just as they were sitting down, the old man burst forth in song. Everyone immediately stopped what they were doing, amazed and transfixed. Inexplicably, he was intoning in a clear, sonorous tenor voice two verses of an old Baptist hymn, “God Will Take Care of You.” Every eye within earshot welled with tears each time he launched into the refrain:

God will take care of you,

Through every day, o’er all the way;

He will take care of you,

God will take care of you.

Ritual–in this case, as in others, a familiar hymn–had transformed an otherwise hopeless recipient of care into someone quite different. At least for those few minutes, he had become a human being capable of reaching out and caring for others, a beacon of light and joy to everyone.

We simply do not know what is transpiring in the mind of another person. It is all too easy to place all the blame on the dementia patient, lamenting and even despising their disability. But were we to do so, we would be letting ourselves off the hook a bit too soon. Awareness, understanding, and affection are not merely the outputs of some inner dynamo. They also emerge in response to what others do, say, and feel. In some cases, unresponsiveness may say less about a patient’s disability than a failure on our part to offer something worth responding to.