By Ann Moline
Thursday, February 8, 2001
Any efforts to reform Medicare, to address the prescription drug and long-term care needs of seniors must be measured by their impact on women. Quite simply, if reform doesn't work for women, it just doesn't work.
WASHINGTON (WOMENSENEWS)--Older women today live in poverty at almost twice the rate of their male counterparts, spending 20 percent of their income on medical care and 30 percent on housing. They survive on half the income of their retired male counterparts, whom they outlive by an average of six years. The situation is stark and disturbing.
"Older women are the most vulnerable among us," said Eula Ossofsky, president of the Older Women's League, at a press conference announcing a new report, "The State of Older Women in America." It highlights the problems faced by the average older American women and the causes.
And the situation will not improve for their young and middle aged sisters without sweeping policy reform, says the league, a 20-year-old Washington-based advocacy and watchdog group.
Difficulties in retirement do not necessarily stem from a lifetime of poverty, said League Executive Director Deborah Briceland-Betts, emphasizing that all women, not just the currently poor, need to pay attention to their retirement. The spiral downward into elderly poverty can be traced directly to the country's continuing wage gap, she said.
"Even 35 years after passage of the Equal Pay Act, women still earn substantially less than men," she said, adding that working women also earn less because they also care for young children and elderly parents.
The average U.S. woman earns 73 cents for every dollar a man earns, African American women earn 63 cents and Latinas earn 53 cents.
Because women earn less, and often have greater caretaking responsibilities, they save less for retirement, resulting in an average retirement income that is less than half of what men can expect. "When seven in 10 women in America earn $25,000 or less a year, it can be awfully hard to put anything away," Briceland-Betts said. A lower earnings rate translates into lower social security benefits.
Pension plan structure works against women as well. Part-time workers, many of whom are women, usually do not receive such benefits. In most plans, workers must remain with a company for a certain number of years in order to become vested and take the plan's accrued savings with them when they leave. Since women often represent a more fluid part of the work force due to family demands, they lose out on a legitimately earned benefit, one that could make a huge difference in their old age.
The average woman leaves the workforce for 11.5 years--not always all at once--further complicating the vesting situation. "First, they care for small children. Then, they care for elderly parents. And finally, they care for a chronically ill spouse. While we may embrace these roles as the right thing to do for the family, women are simply paying too high a price," Briceland-Betts added.
At age 85, women constitute 71 percent of the Medicare population, according to the Older Women's League report. Jeanette Takamura, former assistant secretary of aging with the Department of Labor, said that lack of access to adequate health care contributes to an unstable retirement. Because women live longer than men do, they will be more prone to chronic illness.
"Women are quite literally the face of Medicare," said Takamura, a league board member. "This report shows. . .that we are disproportionately affected by the program's most obvious gaps in coverage." Among the most glaring: lack of prescription drug coverage and affordable long-term care options.
Many elderly women must chose between paying for medications and paying for other essentials. Indeed, the brutally cold weather currently gripping the nation's midsection and the rising cost of heating fuel means that even greater numbers of women must make some wrenching decisions. Many of them never before had to worry about such things. Should they decide to forego medicine, the impact is profound.
"They will need more and longer hospitalizations that Medicare may not cover. They need more care they cannot afford," falling further into the grip of poverty, explained Briceland-Betts.
Takamura emphasized that the need for prescription drug coverage is not just an issue for the poor. "Middle class women who have achieved a measure of financial security can find that high drug costs quickly undermine the retirement security they have worked so hard to achieve," she said. Drug plan proposals targeting only low-income women will do nothing to alleviate this problem. She called for far reaching reform that would include everyone, regardless of income.
"There is no other way to say it: We need a prescription drug benefit," Takamura said, a package that is voluntary, comprehensive and universally available to beneficiaries, with affordable co-payments and deductibles.
Medicare does not cover long term care, in most situations. And, according to the league's report, female residents of nursing homes aged 75 and older outnumber male patients by four to one. Long-term care is, therefore, a women's issue. Takamura pointed out that while women may be in need of such care, they also serve as caretakers, increasing the emotional, physical and financial stresses in their lives.
She called on policy makers to intensify their efforts to overhaul a crucial safety net in order to improve the lives of elderly American women.
"Any efforts to reform Medicare to better address the prescription drug and long-term care needs of seniors must be measured by their impact on women. Quite simply, if reform doesn't work for women, it just doesn't work," she said.
The needs of the most vulnerable must be immediately addressed through programs and supports, the report said. The reforms that can be accomplished now include universal prescription care coverage, expanded access to Medicare coverage and improving access to Medicare low-income programs, it said.
But the more compelling issue is also more complicated--fixing the problems that forced so many of today's elderly women to live in reduced circumstances.
"We don't want more safety nets and poverty programs. We want equity so we can care for ourselves," said Briceland-Betts. She called for equal pay for equal work, equitable pension and Social Security, an overhaul of the health care system and access to affordable housing. Without high level policy reform in these areas, today's young and middle-aged women will also face a tenuous future.
Ann Moline is a free-lance writer based in Washington.