December 2007
Nevada's early caucuses give us leverage to ask the tough questions
With both major political parties holding caucuses in Nevada on January 19, our state will exert far more influence in the next presidential election than it ever has before.
The caucuses will also be an opportunity for elder voters to flex some added muscle. Note: You do not have to be a registered member of the Democratic Party or even a registered voter to participate in the Democratic caucus; same day registration is permitted. With the Republicans, the rule is you have to be a registered party member 30 days in advance of the caucus, so Dec. 20 would be the cutoff.
Most candidates know that older adults are a reliable presence at the polls. In the 2004 election, 72 percent of people 55 and older voted, compared with only 47 percent of 18-to- 24-year-olds, according to U.S. Census Bureau data. Consider also that at the Iowa caucus in 2004, 64 percent of participants were 55 or older. In other words, older adults were the majority voice in the first balloting (which is often the trendsetter) of the last presidential election. Iowa is still first in line to vote this year with Nevada currently scheduled fourth, after primaries in New Hampshire (January 8) and Michigan (January 15). And if senior turnout runs according to form, it could give a big boost to candidates who emphasize senior issues.
What are those issues? According to polls, the war in Iraq remains high on almost every voter's list, seniors included. The other top issues for seniors aren't hard to guess. Surveys of AARP members in early-voting states like Nevada have found that 9 in 10 consider Social Security and pension protection to be their top issue and 8 in10 are concerned about health care.
Health care is a major concern at the Sanford Center for Aging, too, especially as it relates to prevention and to older adults with chronic conditions. People 65 and older make as many doctor's office visits as all younger adults combined.
With that in mind, here are some questions you might ask the presidential candidates when they come calling for your vote.
Why don't we have universal health care?
The United States routinely extends medical care to prisoners and to victims of natural disasters around the world, yet we have the largest uninsured population, 45 million people, of any industrialized country. Last September Consumer Reports said that 29 percent of insured persons surveyed said their coverage was so meager that they often postponed medical care.
How will you make prescription drugs more affordable?
Medicare Part D, which went into effect in 2006, subsidizes the costs of prescription drugs, but the deductibles still leave thousands in out-of-pocked costs and consumers have to sort through hundreds of different plans to find the ones that best match their needs. Why does it have to be so complicated? And why do people in other countries pay less for the same drugs?
What will you do to help people with chronic conditions?
Our medical system and healthcare insurance industry are geared to responding to acute ailments like heart attacks and broken bones. The typical older adult has to cope with multiple chronic conditions like arthritis and diabetes. Health insurance or Medicare typically doesn't cover those chronic conditions. Why not?
What will you do to reduce the cost of medical care?
Americans spend more on health care per capita than any other advanced industrialized country. Despite all that spending, we rank only 42nd in life expectancy (down from 11th place 20 years ago).
What will you do to improve the quality of medical care for seniors?
Less than one percent of doctors, nurses and other health-care workers today are board-certified in geriatrics, and no state except California requires specialized training for professionals who treat older adults. There are no federal mandates either.
Will you pledge to fix the system?
AARP, the Business Roundtable, the Service Employees International Union and the National Federation of Independent Business have joined forces to launch a campaign called Divided We Fail. It aims to focus attention on health care and financial security issues this election year. The campaign has asked members of Congress to sign a pledge to “provide every American with access to quality, affordable health care” as well as address issues related to lifetime financial security. As of this past Thanksgiving, only 168 of the 530 members of Congress (House and Senate) had signed the pledge. There were two from Nevada: Reps. Shelley Berkley and Jon C. Porter. We can do better, so ask the questions.
(Lawrence J. Weiss, Ph.D., is director of the University of Nevada, Reno Sanford Center for Aging and an adjunct associate professor of medicine. He welcomes your comments on this column. Write to him at weisslj@unr.edu or c/o Sanford Center for Aging, Mail Stop 146, Reno, NV 89557-0146.)