A Time for Everything

I am the mother of two young children and the primary care physician of a thousand or so aging patients. Twenty-four hours a day I am either “on-call” for or providing care directly to needy, dependent little people. And about ten hours a day plus some nights and weekends, I am caring for needy, ailing older adults. Whether at work or at home, the nature of the care I provide often feels very much the same. Both my children and patients have come to me frightened, hungry, exhausted, and in need of reassurance. Both have sought advice and both have needed help with their activities of daily living such as grooming or toileting. Both ask that perpetual question, “Why?” Continue reading…


Living and Learning: The Academy of Aging

I entered the Academy of Aging – an informal but ancient and rigorous school – the easy way, reading and writing about it. I was drawn to the subject in my mid-50’s by working on the future of Medicare and its predictable economic crisis in the years ahead. I gained a good academic knowledge of the economic and social problems of getting old, and some insight into its psychological and physical meaning for aging individuals. But I never much worried about getting old myself, tending in fact to laugh a bit at those who had fits about it all, some as early at age 30, others at 40, still others at 60. Not me, even at 70. Continue reading…


Myths about Medicare, the Deficit, and Consumer Choice

Before Medicare began in 1965, many American senior citizens – and their children – struggled to pay for their doctor bills. Ever since, Medicare’s been an American success story. Why, then, do so many Beltway pundits and members of Congress – including Mitt Romney’s running mate, Rep. Paul Ryan,  – go after it?

Some of its critics claim that slashing Medicare is the only way to control the deficit. Like most attacks on Medicare, this assertion is based on ideology, not evidence. Continue reading…


Medicare Losses Today and Tomorrow

The single largest transfer payment that the government makes is to the Medicare program. For the calendar year of 2011, the Medicare premium and interest receipts were $306.7 billion, while the expenditures were $549.1 billion, requiring a draw on the general funds of the government of $242.4 billion. Continue reading…


Our Children, Our Caregivers?

In a Huffington Post blog Ann Brenoff asked, “Is childlessness felt more when you hit middle age?” Her premise was that many childless people (i.e., women) worry that by having chosen not to have children in their 20s and 30s, they closed off the possibility of having a caregiver in their old age. Earlier Jane Gross, in a post on the New York Times “New Old Age” blog, had described the situation, rather more dramatically, as “Single, Childless and ‘Downright Terrified.’”

When I first read Brenoff’s blog, I laughed at the implication that those of us who had children in our 20s and 30s considered them a form of long-term care insurance. Continue reading…


Old versus Young in Japan

If you read about a country with economic problems where “already indecisive leaders [are] loath to upset retirees from the baby boom who make up more than a quarter of the population and tend to vote in high numbers,” you might guess that the article was about the U.S. and Medicare.

It’s not. It’s about Japan and the value of the yen. Continue reading…


A New Voice by and for the Medicare Population

Welcome to Over 65! This is a blog by and for those in the Medicare population (along with a few younger contributors) who want a stronger voice in decisions made about and for us–and for the younger generations that we created. It’s an idea created by a bioethicist (Daniel Callahan), a psychiatrist (Jim Sabin) and a surgeon (Sherwin Nuland). All of us are well over 65, have worked on issues about aging and end-of-life care for much of our careers, and feel there is major work that remains to be done.

Continue reading…