What lies ahead

By the time you read this, the Presidential campaign—that agonizing, frustrating, marathon ordeal—will have less than a month to go. By then we’ll all be very clear on how the candidates stand on long-term care policy, won’t we? You can rest assured—we won’t.

Neither of the candidates is being very clear about any of the issues that matter. I write this at the time of the “lipstick on a pig” controversy, for example. But surely the most obscure of all pressing issues has to be long-term care policy. This, despite the surging number of Baby Boomers confronting the issue—not for themselves, but for their parents.

Set aside your provider’s hat for the moment. Think about your personal life, your acquaintances, and friends. I’m willing to bet you know of someone in long-term care, if not a relative, then the relative of a friend. I personally know very few middle-aged folks who don’t have some direct connection with the long-term care system these days. This fact alone is impacting the field, fueling the culture change movement, increasing the variety and quality of long-term care services, and energizing a positive approach to healthy aging.

But will it go further? Will it translate into policy creating a long-term care system that makes sense, offering people choice and dignity at an affordable price? Maybe this is a question that only the “Big Thinkers” can address these days—and this issue of Long-Term Living offers two such thinkers on full display. Robert H. Binstock, PhD, Professor of Aging, Health and Society at Cleveland’s Case Western Reserve University and author of the recently published Aging Nation (Johns Hopkins University Press), offers his perspective on the post-election possibilities in an interview with Executive Editor Maureen Hrehocik. Dr. Binstock is notable for a much more measured view of the so-called Social Security “crisis” than is fashionable in today’s media: He thinks it’s overblown and easily fixed with modest program changes. He sees bigger problems with Medicare—or, more accurately, with the healthcare system in general and the political challenges that any “fix” will entail. He looks to those aforementioned Baby Boomers as a potential force for change.

Also featured is Stephen A. Moses, president of the Center for Long-Term Care Reform and a long-time advocate for change who is virtually unique in his public prominence in this area. You don’t have to agree totally with his views, which are private long-term care insurance-oriented, to be impressed by his commitment and drive in spreading the word to the public at large. Indeed, in his case, “drive” is the operative word. He has dedicated himself this year to completing a one-year, 35,000-mile tour of the nation in a self-driven Airstream bus, engaging grassroots Americans at all levels of society to raise consciousness and focus attention on the need for new policy. His bus has been dubbed “The Silver Bullet,” aptly enough, since Moses has been described in this magazine as the Lone Ranger of Long-Term Care.

Both Binstock and Moses are provocative. However, neither pretends to hold a crystal ball or offer a final answer on how policy will evolve. Taken together, though, they do illuminate the issue, providing a clear focus and a sense of direction for the path toward progress.

Richard L. Peck, Editor-in-Chief

To send your comments to the editors, e-mail peck1008@iadvanceseniorcare.com.

Long-Term Living 2008 October;57(10):10

Richard Peck

Richard L. Peck was editor in chief of I Advance Senior Care / Long-Term Living for 18 years. For eight years previous to that, he served as editor of the clinical magazine Geriatrics. He has written extensively on developments in the field of senior care and housing.