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| Public Policy |
While I often start with colors or shapes, with "Public Policy" I began with a story. Not my story, but a long and complicated story. I have a friend who is a social sciences public policy researcher, and prominently on her plate is a project about the problems of aging and how it will affect the county that she serves.
Aging? Really. People get old, get sick, and they die. If they are lucky, their kids don't start World War III by fighting over their stuff. What could be so complicated about that? I listened to her stories about the challenges she and her colleagues have just outlined for her county's leadership, and was struck by how everything links with everything else. Count (some of ) the ways:
Boomers will not retire in a tsunami: they are a slow-moving iceberg with a short front and a gigantic back end. My friend used this as an organizing principle for her presentation to her county's leadership. Knowing that the largest group of Boomers is as young as 46, gives everyone time to consider the issues around aging and to begin to plan. Time to get started!
Public Revenues and Taxes: Older people spend less, so sales tax revenue goes down. They earn less, so income tax revenue declines. Their property taxes generally stay level, notwithstanding the decline in property values. Government entities need to plan for a revised revenue stream.
In-Home Services: Boomers will probably want to "age in place," which means staying in their homes as long as possible. In-home medical services and personal care attendants will be needed by the thousands. Who will train them? Who will pay them? Who will supervise and monitor the care? Prosecutors report a startling increase in elder abuse by care-givers. This really matters.
Hospital Care: Optimistically assuming that you can pay for your healthcare either with public or private insurance, who will be there to speak for you when you are incoherent either from a specific medical condition or from dementia? Your children may be thousands of miles away, or you may have no children. A "Patient Advocate," a new health care job which links the patient, the family (if there is one), and the medical team will be an excellent resource. Where will these people come from? Who will train and certify them? Who or what will pay them?
Transportation (cars): As people age, their transportation needs and their ability to drive safely changes. How will you get to the doctor if you no longer drive? Who will do your grocery shopping? How will you be able to engage with friends and neighbors if you are housebound? Critically in Minnesota, how will you get the driveway shoveled out so that someone (not you, perhaps) can get to your car?
Transportation (public): If you have lived in a distant suburb all of your life, you have insulated yourself from public transportation. When you are reasonably mobile but can no longer drive, the fact that there is limited or no bus service to your neighborhood may rankle. Who are you going to look to for a solution to your new transportation problem?
Public Health & Safety: How do you plan for epidemics, pandemics, and evacuation when a significant portion of the population is not individually mobile?
Environment: Older people take a lot of medication which goes into the waste stream. When older people become incontinent, they use adult diapers. Most of the Baby Boomers were born before disposable diapers became the norm. They will have access to adult diapers, and these larger diapers will make a huge contribution to the waste stream.
Education: Just as important as providing for an aging population is the critical need to assure that the youngest citizens are getting appropriate and useful education. We no longer run one-room school houses where students were lucky if they each had a pencil and a tiny chalkboard. Education is a complicated and expensive operation with its own teaching, staffing, training, transportation, environmental, and public safety concerns. It is not a one-time expense.
Managing expectations for the next generations. Compared with Boomers and Millenials, there are realtively few Gen-Xers, but the Xers are waiting (often not patiently) for the Boomers to leave the stage. But with lagging-edge Boomers as young as 46, the generation shift may be a long time coming. Keeping eager Xers and Millennials engaged with their work will be a challenge.
This is just part of the growing list of policies relating to the issues and challenges of aging. The links between and among these problems inspired "Public Policy."
