At a time when political friction is great and resources are not, expecting miraculous breakthrough solutions to our problems is not only unrealistic but counterproductive. Instead, the best way to "think big" may just be to "go small," by focusing on specific and relatively affordable changes.
Here are 10 improvements that would clearly improve the quality of life for millions and millions of older Americans. They do not cost a fortune and, in fact, can help reduce the expense burden on seniors and stressed-out government budgets. Unfortunately, with one or two exceptions, these improvements are not part of any widespread public or election-year debates about the country's future needs. They should be.
1. Dependable and fair Social Security. There is no excuse for our continued failure to adjust Social Security's funding and benefit programs. This is not a big-money fix but a relatively modest process to incrementally restore the program's financial soundness. Restoring the system's historic progressivity would be a good start. Longevity gains support raising the retirement age for healthy seniors. But many lower-income workers are not living longer lives, and they need continued early-retirement and disability protection.
2. Bring back traditional pensions. It's clear from decades of experience with 401(k)s and IRAs that individuals are not very good at making long-term investment decisions. We may not be able to afford the good old days of secure company pensions. But we can certainly reorient defined-contribution retirement plans toward annuities and the payout of guaranteed retirement income.
3. Higher interest rates. Annuities and other age-appropriate investment vehicles require higher interest rates to support acceptable payouts of retirement income. The Federal Reserve needs to let interest rates rise slowly over the next few years, and can do so with little risk of either dampening demand for capital or adding to inflationary pressure.
Aging in Place. By consistent nine-to-one margins, people want to stay in their homes and age in place in their later years. Here are three must-haves for this to happen.
4. Good public transportation. Governments at all levels need to develop long-term plans to shift their emphasis, and their public dollars, from the private automobile to better mass-transit solutions. For decades, this argument was supported by energy conservation and climate-change needs. These have only grown more dramatic. And now they're supported by practical needs of a rising senior population and increased demand for urban living.
5. Walkable neighborhoods. Being able to walk to grocery stores, shops, medical offices, the gym, and other places is essential to satisfying aging-in-place for most seniors. Beyond the ease of access to needed resources, walkable neighborhoods also promote better physical health and mental well-being by reducing isolation and encouraging more sociable living environments.
6. Universal design. Wider hallways, more accessible switches and outlets, and wheelchair-accessible bathrooms and home entrances are among the more prominent needs to enable seniors to live safely and comfortably in their homes as they age. Not nearly enough progress is being made to incorporate these standards into new homes and adapt older homes.
7. Home-based healthcare. This is one of our most promising win-win opportunities. Institutional care is expensive and often unappealing to seniors. Technology can enable delivery of high-quality care to people in their homes, producing healthier outcomes and lower healthcare costs. Big changes are needed among healthcare providers and in the institutional mindset that drives many providers of senior support services.
8. More geriatricians. Providing health insurance to 30 million more Americans under Obamacare is expected to worsen what is already a serious shortage of general physicians. But the situation is already dire when it comes to producing more geriatricians and other professionals trained to help older people. This will be a very hard fix to make unless we direct more resources toward geriatric medicine.
9. Self-driving cars. Led by some amazing gains by Google, the prospect of self-driving cars is no longer the stuff of Jetsons-like science fiction. While seniors need mass transit, they also need other tools to extend their independent years as much as possible. Being able to continue using their vehicles would be an enormous old-age benefit.
10. Intuitive technology products. OK, maybe this one is impossible. But if seniors are to avoid isolation as they age, they must be able to use technology to participate in mainstream social activities. They need common platforms, simpler user interfaces, and technology tools that do not require user manuals.