July 28, 2015

How Much Good Could the WHCOA Do if the WHCOA Could Do Good?

A few weeks ago, I blogged about the upcoming White House Conference on Aging. This once-a-decade event took place last week. What, if anything, did it accomplish?

It was a modest affair, attended by a mere 200 invited delegates (though observed on line by 600 “watch parties”) that was more of a highly scripted performance than a platform for hashing out policy recommendations. This was no surprise, as Congress never allocated funds to support the event, so that it took place at all is something of a miracle. For all its limitations, it did accomplish something.  It was of symbolic significance, a way for the White House to affirm that the health and well-being of the older population are a concern for the entire society. It was also a forum for presenting recommendations for what people outside the federal government can do to address important public policy issues—given that Congress refuses to do so.

The Conference was of symbolic significance: it was hosted by the White House and the President actually made an appearance, addressing the attendees. And it turned to groups other than Congress to implement policy. In particular, it turned to state government, to the nursing home industry, and to the corporate world. State governments were exhorted to adopt 401K type savings plans for older people—a corresponding initiative, incidentally, failed in Congress. The nursing home industry will be charged with implementing a lengthy set of new rules proposed by the Centers for Medicare and Medicaid Services designed to improve quality of care in nursing homes. This means the nursing homes will have to pay for the enhanced training for nurses and nurses aides that the regulations would mandate as well as infection control committees to monitor antibiotic use and a host of other mandates. And corporations were given shining examples of creative technological approaches to the problems of aging: the ride-sharing service, Uber, detailed a new program that will offer older people discounted or free rides and training in using its smart phone app; Philips announced the creation of its “AgingWell Hub,” a collaboration with caregivers, older adults, academics, and companies  to identify new technologies and services that promote successful aging.

All in all, the Conference gave a boost to ongoing efforts in its four main topic areas: healthy aging, long term services and supports, elder justice, and retirement security. It was not an opportunity for brainstorming or for developing bold, radical new ideas. But it was a pragmatic approach to a pressing problem, undertaken with a paltry budget. And maybe, just maybe, Congress will be moved to do more in the coming years. After all, the average age of the current senators is 62, which means that before their term is over, the majority will be eligible for Medicare.

A longer version of this post appeared on the bmj blog

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