PLANK AUGUST 17, 2012
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In an earlier post I repeated an observation by Yale’s Ted Marmor that nearly 30 percent of all Medicare recipients are cognitively impaired, which would leave them ill-equipped to make already-difficult consumer decisions about which option to choose under Paul Ryan’s voucherized Medicare program. A friend wrote in to object: Surely those cognitively-impaired senior citizens wouldn’t be making such consumer decisions in the first place. They’d be letting their children or some court-appointed trustee handle that. I replied that there’s no obvious bright line between cognitive impairment and non-impairment; rather, there was a continuum, and a lot of elderly people are a little foggy without being so incapacitated that they must turn decision-making over to someone else. Indeed, it’s my impression that adult children are quite reluctant to tell their elderly parents what to do, where to live, whether to drive, etc., and that they typically don't step in until their parents are pretty far gone. Who wants to tell someone they love that their existence as an autonomous person is over? I was preposterously indulgent with my late wife during the late stages of her illness as her cognition dwindled, because I knew she would really hate being told that she could no longer help herself to medication, slice herself a grapefruit, sign a check, or walk downstairs unobserved. And so she did, when I finally told her, about a week before she died.
It is well-established that the elderly are considered ripe targets by con artists. Researchers at the University of Iowa recently identified one reason why: the ventromedial prefrontal cortex, “an oval-shaped lobe about the size of a softball lodged in the front of the human head, right above the eyes.” Apparently it starts to go after you turn 60. Not to go all David Brooks on you, but this apparently is where human skepticism resides (“the cognitive seesaw between belief and doubt”). The UI researchers gathered patients with damage to the ventromedial prefrontal cortex, damage elsewhere in the brain, and no brain damage at all. Then they showed them some ads modeled on pitches that the Federal Trade Commission had identified as fraudulent. Sure enough, the patients with damage to the ventromedial prefrontal cortex were twice as likely as the others to get suckered.
The gullibility of the elderly is not the principal reason to oppose Ryancare. But it’s worth considering.
9 comments
I've long feared that financial abuse will become rampant in the coming decades, simply due to the expected increase in the number of predators that follows an increase in the number of prey. In comparison to their parents, fewer affluent boomers will have defined benefit pensions, and the miserable performance of their defined contribution plans will make them reluctant to annuitize their savings. People with a good sum of money, desperate for more. The perfect marks.
- kpidcoc
August 17, 2012 at 11:15am
It's the same part of the brain that is involved in judgment and impulse control, and researchers have found that it develops more slowly in boys than girls. Indeed, for boys it doesn't fully develop until they are well into their twenties. There are many reasons not to give junior the keys to the car, this is a good medical reason. If that part of the brain is impaired in old age, then so is judgment and impulse control. I suspect everybody would agree that boys shouldn't be making potentially life altering decisions. For the same reason, neither should seniors.
- rayward
August 17, 2012 at 11:49am
So - people with no kids? Are they going to appoint government trustees or something? Who will pay THEM? This is going to fix the deficit? Plus kids get fed up and argue among themselves. They have lives TOO, which is one of the great blessings of SS, Medicare and Medicaid - even with those, elder care in the US doesn't approach the German model for example. Plus, without supplemental insurance those are not really sufficient - people's assets can go in a flash - to get on Medicaid for long term care, assets must be pretty much depleted. Well I guess those lazy grandparents need to go out a work! Cast OFF those chains of government dependency! Meanwhile, fog - oh yeah. Especially if one is taking drugs. Plus, you know what, after a certain point people, count me among them, REALLY get tired of spending precious time on B*******. Our patience is at an end. I don't want to work for corporate masters any more and that includes insurance companies who are making a profit from my illnesses, drug companies, doctors etc, ditto; and navigating the insurance industry shark tank, dealing with paperwork x ten and arguing with nasty insurance company "customer service representatives" is work at best and torture at worst, and oh ps, death panels???? The stress is enough to kill you, I've had encounters with insurance company people which have left me furious, frightened and shaking. It's so bad. Speaking of making people do their work for them - the local drugstore has installed do-it-yourself checkout kiosks which are baffling. They confuse college students let alone #1 Big Chief Woolgatherer, me. I wish they'd stop standing around, open the dang drawers and let us pay for our stuff like a civilized person! and stop trying to train us to work for them while they fire people who used to have cashier jobs. News! "Health care" companies (among others) have begun thinking that we work for them and not the other way around, maximizing THEIR profits on our time and effort. Enough. Really, it's enough. PS I'm becoming a real curmedgeon. If that's what you call a really, really mean female. Probably not but you know, I'm trying to be proper here. LOL.
- Sophia
August 17, 2012 at 1:01pm
If one's ventromedial prefrontal cortex does "starts to go after you turn 60 ", that explains a lot about our dysfunctional Congress. Anyway, my LongTermCare insurance premium just increased 45% - a 60th birthday present from MetLife? 45% in one year made me very skeptical of the value going forward. When the LTC program was dropped from Obamacare, I learned that only 3% of Americans have such policies. Mine was the sole portable benefit from my corporate career when first offered when I was 40, and I wanted to avoid having to defraud Medicaid someday. Hmm, I really thought my skepticism was due to logic - why should I keep paying for something that makes me one of the minority who prefers staying honest. What part of the brain imprints honesty? Is that what is missing from most humans? No honesty brain lobe?
- K2K
August 17, 2012 at 1:26pm
I have learned that many of my mother's fellow "independent-living" inmates at the "continuing care" facility get little cognitive or emotional assistance from their children. The children may be just plain mean, under a lot of pressure from their other family and work responsibilities at middle age, or not terribly competent themselves. My mother and her friends consult with each other, hopefully pick the best available doctors, and juggle the meds properly. Ryancare would, of course, add to the worries of vulnerable old people. What a schmuck!
- amidut
August 17, 2012 at 3:40pm
The nuns, bless them, are beating him up pretty good. Go nuns! On FOX yet:)
- Sophia
August 17, 2012 at 5:52pm
You go, grrrls! Nuns sure are different than they were in my youth. Good for the new generation. The old generation was a bit, well, strict.
- magboy47.
August 17, 2012 at 8:39pm
This is one of the most serious issues with the 'voucherize Medicare' proposal; unfortunately, it's one that is also very difficult to broach without being accused of ageism. And you are right that offspring are reluctant to intervene until things are really going to hell - my husband and his siblings did not move to take charge of my father-in-law's affairs until he was found wandering on the highway in his underwear in the mddle of the night.
- bustedboom
August 17, 2012 at 8:45pm
From a Puget Sound broadcast network [guerilla war by the 99% against the 1%?]: "When you mention the name Cratsenberg in Federal Way [suburb of Seattle], locals will know exactly who and what you're talking about. Over decades, the family patriarch built a million dollar business with commercial properties throughout the region. "'It's a very prominent family that is very well known in the city of Federal Way,' said Cathy Schrock of the Federal Way Police Department. "Over the past few years, prosecutors allege Juliana Min Cratsenberg took advantage of the 86-year-old family patriarch, who suffers from dementia. She's accused of moving into his home, marrying him and ultimately stealing from him." Don't anybody try this on me. One of my chickens has a very strong peck, and I feed her well.
- skahn
August 19, 2012 at 11:18pm