NHPrimary.com: Health care tops seniors' concerns
By Carmela Zarcone/The Telegraph of Nashua, New Hampshire
January 24, 2000
Web posted at: 12:57 p.m. EST (1757 GMT)
NASHUA, New Hampshire (The Telegraph of Nashua) - On most days, the Senior Activity Center is bustling.
In one room, quilters make quick work of a pile of fabric scraps, deftly sorting by color and pattern the pieces worth salvaging.
Across the hallway, old men who have left behind their taste for bars but not for billiards hop off and on tall stools as they take their turns at a pool table.
Depending upon the time of day, the nearby cafeteria might be astir with aerobics enthusiasts, friends enjoying lunch together or avid bingo players.
But one attraction that seems to be drawing an ever-increasing crowd, according to Executive Director Pat Francis, is the volunteer who comes to the center once a week, trained to help seniors sort through their Medicare paperwork.
"They used to sit there, waiting for someone to finally come in with a shoe box full of papers," Francis recalls. "Now there's always a line."
And even otherwise occupied seniors have the topic on their minds.
"Health care is the big issue for me," Democrat Gene Spano, 75, cue stick in hand, says during a lull in a recent game. "What's happened with all these HMOs is horrible."
Conversations with more than two dozen elderly Republicans, Democrats and independents last week about the issues on their minds as they gear up for New Hampshire's Feb. 1 presidential primary suggest that this preoccupation with health care is nothing unique.
In fact, a Dartmouth College/Associated Press poll conducted earlier this month found that health care was the No. 1 policy priority among both Republicans and Democrats likely to vote in the primary.
While the poll didn't break down the results into age groups, Linda Fowler, a professor at Dartmouth who worked on the poll and serves as director of Dartmouth's Rockefeller Center for Public Policy and Civic Leadership, agrees that health care is a key issue for elderly voters.
"(It) has always been a salient issue for older voters," she says, which is not surprising, given the health problems many people face as they age.
Or as Albert Moore, a 71-year-old independent voter from Nashua, put it, voters find that "the older you get, parts wear out," and interest in the topic naturally grows.
Top elderly issues
The American Association of Retired Persons, which has mounted its largest ever nonpartisan voter-education initiative for this presidential election, reached the same conclusion when it polled its members nationwide last year.
The organization found that Medicare, long-term care and patient protection in managed care were three of the four most important election issues to its members. The fourth was Social Security.
As Fowler sees it, the long-term health care issues that always have been on the minds of older voters are now being joined by more immediate concerns, such as the skyrocketing costs of prescription drugs.
These price pressures are what Elaine Kulingoski, 63, a Democrat from Nashua, talked about when asked what she is looking for in a president.
"Somebody needs to put a ceiling on the prices of prescription drugs," she says. "I've called four or five pharmacies around town to get their prices on my prescriptions and found a $30 or $40 difference on what they charge for some drugs."
Many others told their own stories, often rattling off their monthly out-of-pocket prescription expenses more readily than their ages.
Although prescription-drug frustrations like these were on the minds of virtually everyone interviewed for this article, the evidence of the problem extends beyond anecdotes.
An October study by the U.S. House of Representatives bipartisan Prescription Drug Task Force cited a 306 percent increase in prescription drug prices from 1981 to 1999, while the consumer price index rose only 99 percent, according to the Bureau of Labor Statistics.
The same study reported that drug spending rose by more than 18 percent in the last year alone, fueled by both price inflation and increased use. The report noted that because Medicare's most basic benefits package does not include the cost of outpatient prescription drugs, some 15 million older Americans across the country must find another way to afford them.
The recent stampede by Medicare HMOs out of the unprofitable New Hampshire market is only serving to heighten seniors' health care anxieties and boost their insurance bills.
William Dempster, 67, an independent from Hudson, found himself stuck in this boat after being dropped by two HMOs during the past two years. His solution was to sign up for a new Medigap insurance policy, but he is anything but pleased with the price tag.
"Under the Medigap insurance, for two people, it's going to cost between $2,000 and $3,000 more a year," he sighs.
Such stories proved as common as talk of the prescription bus that transports seniors to Canada, where pharmaceutical companies market their drugs at much lower prices.
All of it suggests a preoccupation with health care on the part of seniors that has been rubbing off on at least some of the presidential candidates.
That's because when elderly voters say they want progress on a particular issue, emphasized Roland Stoodley, AARP's New Hampshire state president, candidates tend to take notice.
"The candidates are listening to the seniors because they know they are the voters," Stoodley says, pointing to voting patterns as proof.
In the last presidential election, he offers, 60 percent of New Hampshire's registered voters aged 65 and older voted.
"That's about double the number for those in the 18-to-25 age group," he says.
Nationwide, voters 65 and older represent the only age group whose voting rate has increased over the past 25 years.
Such devotion is hardly lost on politicians, who also have watched Granite State seniors turn out by the hundreds to get a closer look at them at AARP-sponsored candidate forums.
"This has really paid off," Stoodley says, now that the presidential candidates seem to be talking about the issues that matter most to seniors. "Many of the (political) commercials you see on TV start out with Medicare or Social Security."
Although many seniors spoke only of health care when asked about the primary, a few offered the topic as only one of several on their minds.
Albert Moore, for instance, is as eager to see reform for the tax system as he is for managed care.
"The tax issue doesn't seem to bother the younger person as much," says Moore, 71, who describes himself as a Republican-leaning independent.
But when the retired engineer from Nashua decided to take a tax-preparation course with the thought that he might pick up some part-time work in that field, he says the experience only strengthened his belief that there must be a better way.
"I studied harder in that 13-week course than I did in college," he says.
And with this subject on his mind, flat-tax proponent "Steve Forbes is the one I'm strongly in favor of," Moore says.
Other voters say their choice of candidate in the primary will depend, at least in part, on their assessment of the candidate's character.
That's not surprising to Dartmouth's Fowler.
"For some seniors, the whole question of moral values and family values is important in part because the world is so unrecognizable to them," she says. "I think they've been profoundly disturbed by what went on in the White House a year ago, and there's some concern about the overall direction of the country."
The Clinton-Lewinsky scandal was certainly enough to move the "usually independent" Dick Bonati firmly into the Republican camp for this election.
"I can't stand the Democrats anymore," says Bonati, 76, of Hollis. "I think we should have somebody as president that we can look up to."
Ollie Noel, meanwhile, says it's not just Al Gore's ideas on health care, but also his character that's made her decide to vote for him.
"I like Gore because he's a good family man," says Noel, 76. "The fact that he decided to sit out the presidential election after his son was in an accident tells me that his family comes first."
Some spoke about more basic concerns when asked what they would like a president to do for them.
"There's not enough public transportation," laments Democrat Charlean Douglas of Amherst.
Major urban areas may be well served, she says. But Douglas, 58, who is blind, spoke of how difficult it can be for people like her to get around a place like Greater Nashua unless they are willing and able to fork out considerable sums to travel by taxi.
"I would like to be able to come to the senior center more, but I can't," she says. "To have a well-balanced life, you need to be able to do social things like this."
Most voters interviewed say, in keeping with Stoodley's statistics, that they will be sure to vote on Election Day.
But many of them, too, spoke with a decided distaste for the process that seems to have come with years of hearing the same political promises made and broken as well as a frustration with the glacial progress that comes with Capitol Hill gridlock.
"If I sound bitter, it's because I am," says Dorothy Holden, 75, a Nashua independent. "They all talk a good story, but the problem is that it doesn't really matter which one gets elected."
Take the issue of health care, she suggests.
"Whoever gets elected can say, ‘I want universal health care,' the way Bill Clinton said it. He still has 435 members of the House and 100 members of the Senate to get through."
As one of Nashua's resident experts on government programs for the aging, Thomas Hooker would agree.
A regional administrator for the U.S. Administration on Aging until his retirement in 1998, Hooker, 67, says he spent years anxiously watching the stage being set for the current health care crisis, as HMOs aggressively courted seniors they would later cut loose.
Politicians had nothing to say then, he says. And today, the tendency by the primary candidates to offer "30-second, sound-bite" suggestions for helping seniors ignores larger issues in public policy.
Hooker would like to hear the candidates' thoughts, for example, on what can be done about the continued stalling by Capitol Hill lawmakers on reauthorization of the Older Americans Act. He believes that this legislation, in limbo for years, would set the stage for a more strategic, grass-roots approach to federal programs for the elderly.
The problem, he says, is that no candidates are talking about such big-picture issues, something that irritates him not just as a retired advocate for the elderly but also as an independent voter.
"In these primaries, everyone is simply trying not to make a mistake," he says. "I haven't heard anybody advocating for the rights of older people in a broad sense."