Wednesday, October 21, 2015

Is there a better way to determine if Social Security benefits should increase?

Social Security recipients won’t be getting a cost of living increase in their benefits next year.

That’s led to some grumbling about how the price of everything seems to be going up but benefits aren’t going up.

It’s also led to a discussion about a better way to calculate cost of living adjustments (COLA) whether they should go up or not.

That discussion centers on the Consumer Price Index (the current calculation called CPI-W) vs. an index that also takes inflation trends into the equation (called CPI-E).

But, according to the good folks at the Center for Retirement Research at Boston College, using CPI-E over CPI-W would not have made a difference for 2016 and would not have made a difference in some past years.

As long as medical costs continue to slow in their rate of increase, Social Security recipients are better off with the current measure of consumer prices as an indicator of whether benefits should increase. The same is true for transportation costs, said the center, which have also stabilized.

“If the rate of medical inflation continues to be held in check, inflation of the elderly and non-elderly may look quite similar,” said the center in a recent study entitled Do We Need a Price Index for the Elderly? “On the other hand, if medical care costs start to rise more rapidly again, it may be time to construct and use an index designed specifically for older Americans.”

Since 2002, according to the report, average CPI-W and CPI-E inflation have been virtually identical due mainly to slower growth in health costs.

The Consumer Price Index measures changes in the price level of a market basket of consumer goods and services purchased by households.It has been used as the basis to calculate Social Security cost of living increases since the 1980s.

The knock on the index, according to the center, is that it uses a relatively small sample of households, prices may not be reflective of the store used by older people, samples used in the index might not be purchased by the elderly at all, and the availability of senior-citizen discounts is not reflected.

Hence the emergence of CPI-E, where the E stands for Elderly, which the U.S. Bureau of Labor Statistics says
“calculates an experimental price index for Americans 62 years of age or older.”

While use of the experimental index might have made a difference to benefits had it been used prior to 2002, the Center for Retirement Studies argues it wouldn’t have made a difference since then, primarily because of health costs.

“First, the rate of increase in the price of ‘medical care’ slowed from 5.6 percent in 1983-2002 to 3.5 percent in 2002-2015. Given that older Americans spend so much of their budget on this item relative to the population as a whole, the slowdown in cost growth substantially reduced the inflation they faced,” said the report.

“Second, prices for ‘transportation’ moved from rising slower than average in 1983-2002 to rising at the average rate in 2002-2015. Since older people spend relatively less on transportation, they were less affected than younger people when the relatively slower rate of increase in transportation costs disappeared.”

But prices of goods and cost of services can be cyclical and fluctuate, in particular as the care needs advance with the aging Baby Boomer population.

The center understands that, saying: “On the other hand, if medical care costs start to rise more rapidly again, it may be time to construct and use an index designed specifically for older Americans.”

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Wednesday, September 9, 2015

Some Grandparents Day advice for care givers

National Grandparents Day is Sunday, Sept. 13, and it will mean different things to different people, depending on your circumstances.

For some, it means taking care of a grandparent. Fernando Gutierrez, bioethicist and patient advocate of Ethics 4 Healthcare, has some tips on care he offered in a recent media release::

Take care of yourself
Being the care taker can be a truly gratifying experience, but in order for this to be the case, it is essential that you remember to take the time to maintain your own health and well-being.  You cannot help others if you do not help yourself.

Learn as much as you can

Learn about your loved one’s illness or disability. The more you know, the less anxiety you’ll feel when decision making. Remember, he said, education equals empowerment.

Create a team of elderly care specialists

Seniors are often treated for a wide array of medical conditions. Navigating through the various types of physicians best suited for grandparent(s) can seem like a daunting task, but a patient advocate is trained to help you navigate through the maze.

Know your local non-profit resources

Non-profits help seniors with technology skills, social clubs, and more. And legal services organizations can helps senior with legal questions, like determining if they’re being overbilled, or simply questions about finances.

Trust your instincts
Remember, you know your family member best. Don’t ignore what doctors and specialists tell you, but listen to your gut, too.

Hire the right people
As a caregiver, you are essentially a project manager and you cannot do everything. For this reason, it is important to do your homework when hiring institutions, attorneys, social workers, therapists, etc. Research reviews, contact references and take your time when making your decisions.

“As a caregiver, you’re likely to face a host of responsibilities, many of which are unfamiliar or intimidating. But despite the challenges, care giving can also be very rewarding,” Gutierrez said.

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Saturday, August 29, 2015

Expert warns that long-term care is great unfunded liability

Paul Forte, CEO of LTC Partners, is a
recognized expert on long-term care.
An internationally known expert on long-term care is sounding the warning that costs associated with that care -- in particular for aging Baby Boomers -- is “the single greatest unfunded liability most families will face.”

The warning comes from Paul Forte, chief executive officer of LTC Partners, headquartered in New Hampshire.

He knows of what he speaks.

Since 2002, he has headed up LTC Partners, a wholly owned subsidiary of John Hancock Life Insurance Co., which administers two major federal contracts, including the Federal Long Term Care Insurance Program (FLTCIP), the largest long term care insurance program in the country.

According to Forte, LTC Partners currently supports nearly four million customers and handles more than $2 billion in cash flows per year.

The other contract administers BENEFEDS, a secure website that enables federal employees and federal retirees to enroll in the Federal Employees Dental and Vision Insurance Program.

Recently, he was asked to speak in Washington, D.C., to a delegation from the Chinese government about the massive aging population in China.

“… long-term care is the single greatest unfunded liability for most families,” Forte said in his remarks to the Chinese. He advocated using the Federal Long Term Care Insurance Program (FLTCIP) his company administers as a model for use in the private sector.

Baby Boomers are turning 65 at a rate of 10,000 a day, and their long-term care needs will grow and grow and grow, putting an ever larger burden on their own finances, their families’ finances, and the government’s finances to cover the costs of long-term care.

“They are as scary, in their own way, as the cost of cancer,” said Forte. “You can pay a hundred grand for long-term care a year.”

Forte cited a number of questions to ask and factors to think about when considering long-term care:

How long might the care be required? It could be something short-term to recover from surgery that requires a stay in a rehabilitation facility, or it could be something more long term such as a chronic illness or dealing with someone who has Alzheimer’s.

Where is the care going to be provided? “Long-term care can be delivered virtually anywhere,” said Forte, noting skilled-nursing facilities, assisted living facilities, adult daycare, and care provided in the home.

Who is going to provide the care? This might be determined by where the care will be provided. Medical personnel will staff the nursing and assisted living facilities. Home care might include visits from volunteers from a community- or church-based group and in most cases includes a family member, which in itself can provide challenges for a family member who is a caregiver but who also has a full-time job, according to Forte. “You still have to have somebody in the family keeping an eye out and they have to be tethered to the home,” said Forte.

What is the care going to cost and how will it be paid for? The money to pay for the services – be they delivered at a facility or in a home – will come from the individual’s own pocket or savings, from Medicare or Medicaid, from family contributions, from a home equity loan or reverse mortgage payment, annuity payouts, and/or from long-term care insurance.

The need for long-term care insurance grew out of the realization that a federal program, such as Medicaid, didn’t provide enough for unexpected, long duration care costs.

Long-term care insurance is a stand-alone policy that covers care generally not covered by health insurance, Medicare, or Medicaid. Generally, individuals who require long-term care are not chronically ill. Instead, they are unable to perform the basic activities of daily living – called ADLs – that include such tasks as getting dressed, taking a bath, cooking and eating, going to the bathroom, walking or getting in and out of a bed or chair.

Age is not necessarily a determining factor in the need long-term care. Estimates are that about 70 percent of individuals over age 65 will require at least some type of long-term care services during their lifetime, but about 40 percent of those receiving long-term care today are between 18 and 64.

The question of whether to buy insurance to pay for long-term care is a difficult one for most people to answer, said Forte.

“Everybody has a different tolerance for risk,” said Forte.

You might live in reasonably good physical and mental health until your 95 and die in your sleep. Or at age 75, you might have trouble walking and getting in and out of a chair and you really can’t cook for yourself or clean house anymore.

Forte said there’s between a 40 and 50 percent chance that an individual might need some insurance against the cost of long-term care.

The younger you are, the less expensive a long-term care insurance premium will be: A 40-year-old will pay less per month than a 55-year-old.

And anyone who’s thinking about long-term care insurance has to be prepared that the premium is likely to go up, said Forte.

The policy that you bought at $2,500 a month when you were 50 could easily double by the time you’re 80 or 90. The fact that the rates rise the older you get can be a disincentive for people to buy the insurance.

“This is not perfect,” said Forte in explaining why premiums go up. “The problem with every insurer is that you’re trying to figure out the real cost of what claims will be 10, 20, 30 years into the future.”
In recent article he wrote for Contingencies, the magazine for the American Academy of Actuaries, Forte examined the need for long-term care insurance as “the best choice for uninsured millions looking to protect their retirement against the risk of needing long-term care services sometime before the end of their lives.”

He thinks the government long-term care program is a good one for all Americans.

“Since raising taxes to pay for a Medicare-like LTC insurance program is not seen as practical,” he said, “the FLTCIP offers the best value and may be replicated for all Americans. It has been our long-held belief that the public and private sectors should work together to address the LTC financing problem and to identify authentic solutions.”

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Wednesday, January 21, 2015

In love - and in hate - with my hearing aids

I am now wearing hearing aids. And I love them. And I hate them.

I love the fact that I can now hear and understand my wife Jane, a low talker, in the parlance of Jerry Seinfeld.

I love that I don’t have to crank the television volume up to astounding levels that frighten women and children and animals.

I love the fact that I can better understand the soft, sweet voice of my 3-year-old granddaughter.

My dislike for the hearing aids isn't of a vain nature. First off, you can barely see them in my ears, save for the fine wire that can be easily mistaken for one of my gray hairs.

After years of being hard of hearing -- and at times being  just plain deaf -- I accepted the fact that my quality of life had to improve and that when it came to hearing, wearing these devices was the only way.

So I’m okay with wearing the hearing aids.

What drives me crazy is the occasional discomfort. I’m highly if not overly tactile. If something doesn't feel right against my skin it drives me crazy. So the fact that I have something sticking in my ear -- constantly sticking in my ear -- is frequently disconcerting. I’m told, “You’ll get used to it.”

At almost 62 years old, I’m in the sweet spot of the Baby Boomer generation. I’ll be able to collect Social Security soon and I’m among the estimated three of every 10 people over the age of 60 who have hearing loss.

For the longest time, I pushed back at the need for hearing aids. The fact that I had moderate to severe hearing loss was no surprise when audiologist Dr. Samantha explained the audiogram chart that showed all of my hearing -- no matter the frequency or decibel level - was way below what’s normal.

And my speech audiometry -- the ability to distinguish the difference between, say, “sail” and “fail” wasn't very good, especially in the left ear.

I pushed back because, frankly, I didn't want to spend the money. These suckers are expensive, mitigated only slightly by the fact that my insurance will kick in $1,500. Most health insurance plans don’t cover anything when it comes to hearing aids.

But this became too important of a quality of life issue for me as I get older. I consider this an investment in my current and future emotional and mental health.

It’s true that hearing loss can have an effect on someone’s overall well being. I saw it happening to me. As understanding conversation became more difficult, particularly at a party or around a crowded dinner table or at a restaurant, it became more and more difficult to be a part of the conversation. The brain, working as a muscle, just tired from the work of trying to understand and interpret what was being said in that jumble of noise. So you withdraw, just a little, then a little more.

Older adults with hearing loss are more likely than peers with normal hearing to require hospitalization and suffer from periods of inactivity and depression, according to a study at Johns Hopkins.

So now I’m in control again, helped my hearing aids that I can adjust through a smartphone app. I can take a phone call directly into my hearing aids, for example.

Dr. Samantha is bringing me along carefully, methodically. When fitted with the hearing aids she didn't give me the full 100 percent of hearing. It would be too overwhelming, she said. And she’s right. All that sound -- even the sound of my fingers on the keyboard -- can be overwhelming at times.

My health is important to me. For my sake and in particular for the people I love, I want to stay in good physical, emotional and mental health. Hearings aids have become part of what I've decided to invest in myself to make that happen.

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Monday, August 11, 2014

Wired up and ready to go

FitBit and Timex Ironman on my left, Road ID and Polar
heart strap readout on my right. Hmmm, clowns to the left
of me, jokers to the right, here I am, stuck in the middle with you.
When I prepared to go for a run this morning, I strapped a heart monitor around my chest, the heart monitor readout and a Road ID bracelet on my right wrist, a Timex Ironman watch and a FitBit Flex on my left wrist.

The heart monitor strap/readout (a birthday gift from my sister) displays my heart rate and keeps track of calories burned, highest heart rate and average heart rate. The Timex records the time it took to take my run and the split times if I know where my mile marks are. The FitBit Flex (a birthday gift from my son and daughter) records steps as well as route taken, number of miles, active minutes and calories burned.

And the Road ID bracelet helps identify me - and find my wife - if I drop dead during my workout. (Seriously, during a vacation a few years ago in Delaware, a vulture followed me around during one of my runs.)

Being so wired up enables me to gather a lot of data about my workouts. And I’m a geek in that regard. That’s what happens after years of working as an operations director for a newspaper company where measurement of performance of various pre-press, press, and post-press  functions is an important part of the job.

It all begs the question: Why?

In my effort to keep this body of mine functioning for as long as possible, I use the data to gauge how all my 61-year-old original equipment - back, knees, hips, shoulders, etc. - is doing relative to fitness, weight, and assorted aches and pains.

I can gauge what kind of workout to have on a particular day - light, medium or heavy - based on the kinds of workouts I had the previous days. And I can calculate when I might be able to cheat on my calorie intake with an extra beer or two, or maybe a bowl of ice cream, or even a plate of Buffalo wings.

There is some question as to the effectiveness of some of this technology, however. Being wired up and ready to go doesn’t necessarily get you anywhere when it comes to overall health..

NBC’s Today Show, for example, had a report recently that FitBit users were gaining weight.

The problem is one of false positives. My FitBit tells me how many calories I’ve burned and how many calories I can afford to eat with an eye toward losing weight. But if you’re eating the wrong kinds of calories, you’re going to gain, not lose, weight.

So for today, I’ve had a Greek yogurt and fresh blueberries - coming in at about 100 calories. With the 1,492 calories I’ve burned thus far, according to FitBit, I have 2,113 calories left in my bank to consume for lunch, dinner, snacks, etc.

The Today Show report said: “Weight loss is more an art than a science. While we might like to think it’s a simple calculation of calories in and calories burned, most of us have numerous, fluctuating variables in our personal weight-loss equation.”

If a consume 1,000 of my banked calories with high salt, high fat, high sugar food, I’ll be on the wrong side of all this technology.

Could I live without all these gadgets? Sure. But it’s helpful that the data tells me where I’ve been (literally, the GPS unit on the FitBit maps where I’ve been) and gives me a good idea of where I need to go.

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Sunday, July 20, 2014

My history of PDS: Public Displays of Singing

I freely admit to PDA -- Public Displays of Affection -- with my wife Jane.

I am more prone, however, to PDS -- Public Displays of Singing.

Sometimes I wonder in my third act of careers (currently I’m in Act II as a freelance writer after a long Act I career in newspapers) whether to perform as a singer at whatever local bars and restaurants would have me and my band, which consists of Martha, my 46-year-old acoustic guitar.

Lord knows I do enough singing in public as it is now, why not get paid for it?

I have a lot of music in my head and often it just starts coming out of my mouth - and it doesn’t really matter where me and my mouth happens to be.

Partly it’s genetic.

My Dad was a PDSer. He was a U.S. Air Force officer teaching at the U.S. Air Force Academy back in the 1960s and the story goes that he walked into class singing the Beach Boys version of “The Little Old Lady from Pasadena”.

He sang: “It’s the Little Old Lady from Pasadena” and the cadets returned with “Go granny, go granny, go granny go.”

My first introduction to my wife Jane came from a PDS moment.

The company I worked for in 1998 was in the process of buying the newspaper in Portsmouth, N.H.,where Jane worked. During one of many transition meetings I led that and that Jane was part of, I walked into the conference room singing the Barenaked Ladies’ song “If I Had a Million Dollars”.

Public Displays of Singing don’t count in the places where it’s perfectly OK to sing out loud -- like home or at church.

My most frequent PSD are at the gym, where I try to ease the rigor of exercise with music via earbuds from a first generation iPod.

All my favorite music - 1,545 songs - is on my iPod. That’s 4.3 days of singing that I could do since i know the words to each of those songs.

So it’s pretty easy for me while I’m at the gym to get lost in the music. And once that happens there may be a little air guitar, there might be some air drumming, and there will certainly be out-loud singing, not arena-volume singing but loud enough to get the occasional stare or wry smile from someone nearby.

I’m beyond the age of embarrassment. Music, to me, is one of the great gifts that humankind has given itself. I’m not ashamed to celebrate that  with my PDS.

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Friday, June 27, 2014

61 as a number, not an age

Here’s the thing about turning 61: It’s an age that either defines you or you define it.

I’m trying my best to define it, so I consider it a number, not a state of mind.

It doesn’t matter that I’m a year from being able to collect Social Security. It doesn’t matter that I’m a year closer to being eligible for Medicare. It doesn’t matter that I’m inching so much closer to that “senior citizen” euphemism: 61 won’t define me in those terms.

Sure, there are days when I feel every year, every month, every week, every day, every hour, every minute, every second of being 61. My knees remind me. My back reminds me.

And there are reminders from my doctor about the tests and routine procedures normally associated with being a 60-plusser. Oh, and the fact that I CAN’T HEAR YOU very well anymore.

But those are the exceptions of who I am these days, not the rule because I’ve sworn to myself that as I get older, I won’t let the years age me.

I help myself by keeping myself engaged: Engaged in my freelance work, engaged with the people I love, engaged with the world around me.

I feel the need to be on the move - physically, mentally, emotionally.

Sit too long and the corrosives will into your joints, into your synapses. What did Neil Young sing? “It’s better to burn out than fade away...” Rust never sleeps.

Some of the engagement comes from the fact that I’m on the move between two homes - one in South Bend, Indiana, where my wife Jane works for the University of Notre Dame, and one in Durham, N.H., where I work as a freelancer for a couple of online and print news and information outlets.

I can work from pretty much anywhere because of my fully equipped “office in a bag”. I can set up anywhere and be immediately productive.

I’m given to looking more deeply into 61 than I did 60. Any age that ends in a 0 - 10, 20, 30, 40, 50, 60, 70, 80, 90, 100 - is a big deal because it’s an easily identifiable mile marker on the interstate of life.

61 is the beginning of the outlier years. Hardly anyone notices, and you just go about your business.

That’s why I’m making more of an effort to remain engaged in this life I live. Those outlier years will begin to pile up. You live it, or it lives you.

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