Older people and voting participation: past and future.

Contemporary politicians and their advisors focus on older voters as a pivotal segment of the American electorate. Some analysts predict that this preoccupation will intensify in the years ahead and the demands of older persons will dominate American politics. One reason for this focus on older voters is that they constitute a substantial proportion of voters today, largely because of age-group differences in voting turnout rates, and they will be a considerably larger proportion in the future because of the aging of the baby boom cohort. This article examines the voting participation of age groups in past presidential elections and explores what the voting participation of older persons could be like when the baby boom cohort reaches old age. The political significance of older persons being a large percentage of voters is considered with respect to both the past and the future.

Elderly immigrants and the saga of welfare reform.

In 1996 Congress enacted legislation which, among other things, substantially cut off Supplemental Security Income payments and food stamps for present and future legal alien residents of the United States, and made it much harder for them to qualify for Medicaid. For low-income elderly immigrants, who constituted more than two-thirds of aliens on SSI, the adverse and potential impacts were substantial in terms of economic hardship and access to health care. In the months that followed, their plight received significant attention from the media and state and local politicians who now had greater economic and social responsibilities thrust upon them. One year later, Congress restored SSI benefits only for aliens who been receiving them before August 22, 1996 and made it easier for them to qualify for Medicaid. Food stamp benefits, however, were not restored. The limited scope of this restoration of benefits means that many of today's older immigrants, as well as those in the future, will be faced with serious problems in meeting their basic income and health care needs.

The clinical introduction of genetic testing for Alzheimer disease. An ethical perspective.

OBJECTIVE: Primary caregivers should be aware of recent progress in the genetics of Alzheimer disease (AD) and of the clinical and ethical considerations raised regarding the introduction of genetic testing for purposes of disease prediction and susceptibility (risk) analysis in asymptomatic individuals and diagnosis in patients who present clinically with dementia. This statement addresses arguments for and against clinical genetic testing. PARTICIPANTS: The 20 participants were selected by the investigators (S.G.P., T.H.M., A.B.Z., and P.J.W.) to achieve balance in the areas of genetics, counseling, ethics, and public policy, and to include leadership from related consensus projects. The consensus group met twice in closed meetings and carried on extensive correspondence over 2 years (1995-1997). The project was supported by the National Human Genome Research Institute of the National Institutes of Health. EVIDENCE: All 4 involved chromosomes were discussed in group meetings against a background of information from several focus group sessions with AD-affected families. The focus groups comprised volunteers identified by the Cleveland Area Chapter of the Alzheimer's Disease and Related Disorders Association and represented a variety of ethnic populations. CONSENSUS PROCESS: The first draft was written in April 1996 by the principal investigator (S.G.P.) after the consensus group had met twice. The draft was mailed to all consensus group members 3 times over 6 months for extensive response and redrafting by the principal investigator until all members were satisfied. CONCLUSIONS: Except for autosomal dominant early-onset families, genetic testing in asymptomatic individuals is unwarranted. Use of APOE genetic testing as a diagnostic adjunct in patients already presenting with dementia may prove useful but it remains under investigation. The premature introduction of genetic testing and possible adverse consequences are to be avoided.

The 1996 election: older voters and implications for policies on aging.

Aggregate national exit poll data from the 1996 presidential election suggest that voters aged 60 and older were not influenced by age-related policy issues, such as Medicare, any more than younger voters were. Yet, state-level data provide a basis for conjecture (although not a conclusion) that such issues may have influenced the voting decisions of some older voters in 14 states. If so, however, the impact was in Clinton's favor in some states and Dole's favor in others. Now that the election is over, the short-term problem of Medicare Part A will be dealt with swiftly, but a bipartisan commission to deal with the program's long-term issues is problematic. The establishment of such a commission on Social Security is more likely. The President's response to the push by governors and congressional Republicans to turn Medicaid into a block grant program will indicate whether he will move at all to the left of the centrist political position that he assumed throughout 1996.

Changing criteria in old-age programs: the introduction of economic status and need for services.

For more than a decade, incremental changes have gradually eroded the traditional approach in many policies that have relied primarily on specific old-age categories to determine eligibility for public benefits and the amount of those benefits. These changes, and other recent policy proposals, have introduced need-based criteria as well as the principle of asking wealthier older persons to pay greater taxes or share more heavily in financing services and benefits than those older people who have less income and accumulated wealth. This discussion of such modifications in policies on aging begins with a depiction of the political context in which they have emerged. It then reviews the emergence of the new approaches, and concludes with commentary on the political viability of these and other possible changes in the mixture of criteria used in old-age benefit programs.

Older voters and the 1992 presidential election.

At the core of the so-called "generational equity" construct is the notion that older persons exercise self-interested political power. This article examines what we know about one element of the politics of aging--the voting behavior of older persons in recent presidential elections--and suggests areas of research on the 1992 election that may tell us something about how far, and how soon, proponents of generational equity will be able to move toward dismantling policies that benefit older people.

Health care for older populations: society's responsibility.

Current and projected costs of health care for the elderly are fluctuating. Federal policy makers bent on containing Medicare and Medicaid costs have a major effect on this economic health care issue. The challenges of financing and providing both acute and long-term care for older persons are intertwined with society's moral and ethical attitudes toward the elderly in general. New approaches to old services as well as innovative financing options for funding or subsidizing health care costs for the elderly are described and analyzed.

The oldest old: a fresh perspective or compassionate ageism revisited?

A focus on persons aged 85 and over is a timely measure for better understanding the implications of population aging. Yet, it may generate inaccurate stereotypes that reinforce anxieties about conflicts between age groups in the allocation of health and social welfare resources. Alternative constructs enable consideration of a variety of options that differ from unnecessary extrapolations from existing public policies. These range from market initiatives, through state and local government actions, to federal intervention for meeting the challenges of becoming "an aging society."