1

Quality of Health Care for Low-income Older Adults

Maribel Mateo

HLTHPOLS 304.01

California State University, Channel Islands

Dr. Ronald Berkowski

May 17, 2022

 2

Introduction

When it comes to aging, regular physical changes happen to the body, such as sore

muscles and body aches. However, there are also unpredictable serious issues such as terminal

diseases and severe injuries. Most low-income older adults try to stay away from visiting the

doctor's office simply because they cannot afford it. While there are programs to help older

adults pay for health care, such as Medicare, low-income individuals still have to pay out-of-

pocket costs. According to a report found on Dallas News, there is going to be a whole new

different population demographic by 2050 with the majority being older adults and ethnically

diverse youths (Angel & Torres-Gil, 2018). Not only are health care expenses threatening for

future generations, but it’s affecting older adults right now, especially low-income minorities

(Angel & Torres-Gil, 2018). Lawmakers must start prioritizing the quality of health care now to

prepare for the future of America’s older adults.

Selected Aging Issue

According to an annual study by the Insured Retirement Institute, only 25 percent of the

baby boomer population reported that they have enough savings to last them through retirement

(Angel & Torres-Gil, 2018). Forty-two percent of the boomer population reported that they have

no retirement savings at all (Angel & Torres-Gil, 2018). If the majority of baby boomers are

struggling to meet their financial needs, this creates a concern for the future generation of older

adults. This further increases the high demand for good quality health care that older adults need

to live a substantial healthy life. Although many Americans believe they are currently financially

secure, these studies have shown that most people do not have enough money once they retire.

Many factors play into this such as social determinants of health. These determinants based on

are environmental, societal, and economic conditions (Pooler et al., 2017). Social determinants
 3

of health are important to consider as they ultimately impact older adults’ ability to live healthy

and full lives (Pooler et al., 2017). This is an issue because older adults who encounter multiple

unmet social needs are faced with a higher risk of poor health outcomes (Pooler et al., 2017).

Low-income minorities struggle the most with covering health care expenses due to societal and

economic conditions. While there are programs to help older adults who are both of low-income

and racial minority, they do not always receive the best care. These older adults usually deal with

poor quality care from staff who oftentimes lack patience with their patients. Furthermore,

programs such as Medicare do not cover all health care expenses for older adults. This leaves

patients paying out of pocket or avoiding trips to hospitals overall, especially older adults who

are low-income minorities.

Chosen Policy

The Social Security Act of 1965 authorized Medicare and Medicaid programs to help

Americans cover health care expenses. Medicare is a health insurance program created to help

older adults who are 65 years of age and over (Kaiser Family Foundation, 2019). In 1972, the

program was expanded to cover those who are under the age of 65 with a long-term disability

(Kaiser Family Foundation, 2019). Although Medicare was created to assist older adults, it only

covers the cost of skilled nursing care, usually only up to 24 days (Overview of Medi-Cal for

Long Term Care -Fact Sheet - CANHR, 2019). Medicaid, on the other hand, is the federal-state

health insurance program created to provide health care coverage for low-income Americans

(Kaiser Family Foundation, 2019). Medi-Cal falls under Medicaid as it is a combined federal and

California State program designed to help cover medical expenses for those with a low income.

(Overview of Medi-Cal for Long Term Care -Fact Sheet - CANHR, 2019). Both Medicare and

Medicaid are funded through social security tax payments. Older adults with a low income can
 4

usually benefit from both health insurance programs through certain qualifications. Many rely on

both as Medicare only helps to cover nursing home expenses (Overview of Medi-Cal for Long

Term Care -Fact Sheet - CANHR, 2019). Older adults require more than just nursing homes.

They are entitled to receiving proper well-qualified health care just like everyone else. According

to research findings provided by Kaiser, Medicaid not only provides coverage to low-income

individuals, but it can also serve as supplemental coverage for traditional Medicare older adults

with low incomes (Kaiser Family Foundation, 2019). In 2016, studies showed that Medicaid

assisted more than 1 in 5 (22%, or 7.0 million) older adults cover for expenses that Medicare did

not (Kaiser Family Foundation, 2019). However, this did not include the 3.5 million

beneficiaries who were enrolled in both Medicare Advantage and Medicaid programs (Kaiser

Family Foundation, 2019). Nevertheless, without social security providing these health insurance

programs, older adults would be left with no financial assistance once they are ready for

retirement. Many older adults in America rely on social security for more than half of their

income once they are retired, especially those with a low income (Angel & Torres-Gil, 2018).

Barriers

Although the Social Security Act helps to provide programs such as Medicare and

Medicaid, there are still many older adults who struggle to meet their needs such as paying for

health care costs. There are many barriers preventing the needs of older adults from being met.

This leads to their needs not being prioritized and thus receiving poor-quality health care.

Reasons behind this issue are gaps in understanding between experts and the public. According

to a gauging aging report, one of the key factors behind the gap in their understanding is

classified as Ecological vs. Individualist (Lindland et al., 2015). The ecological aspect derives

from the experts’ point of view in recognizing the role of contextual, social, and systemic factors
 5

in shaping the process and experience of aging (Lindland et al., 2015). The individualist aspect,

on the other hand, pertains to the public’s point of view as individuals. The individualist aspect

highlights people’s will and decision-making as being responsible for determining the shape and

outcomes of their life course (Lindland et al., 2015). Both these points of view can help to

explain the contrast in opinions about older adults. Since clearly there is a need in strengthening

social security and the quality of health care for older adults, this can also cause a divide between

prioritizing the needs of older adults and that of the younger population. According to an article

found in Dallas News, changes in demographics will create political competition between older

white adults and younger racial and ethnic groups (Angel & Torres-Gil, 2018). This can also

cause an increase in insufficient public resources such as taxes to maintain Social Security and

reinvesting in public education (Angel & Torres-Gil, 2018). Additional issues that could arise

from this may include taxes going up or even raising the retirement age, which is not good for

anyone.

Conclusion

Health and care for older adults must be prioritized as they are an essential part of the

population, regardless of the negative connotations and judgments that may arise in society.

Older adults should be well respected as they have the most experience and knowledge about

life. They provide so much to future generations. This is one of the many reasons why

lawmakers must work to protect and strengthen Medicare and Social Security, as these are the

foundations of health and retirement income security (Angel & Torres-Gil, 2018). With changing

demographics concluding major population changes by 2050, the quality of healthcare for older

adults must not be targeted for future cuts. Lawmakers must start prioritizing the quality of

health care now to prepare for America’s future older adults.

 6

References

Angel, J.L., & Torres-Gil, J.F. (2018, October 7). Minorities and aging Americans must find

common political ground. Dallas News.

https://www.dallasnews.com/opinion/commentary/2018/10/07/minorities-and-aging-

americans-must-find-common-political-ground/

Kaiser Family Foundation. (2019, February 13). An Overview of Medicare. The Henry J. Kaiser

Family Foundation. https://www.kff.org/medicare/issue-brief/an-overview-of-medicare/

Overview of Medi-Cal for Long Term Care -Fact Sheet - CANHR. (2019). Canhr.org.

http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_overview.htm

Lindland, E., Fond, M., Haydon, A., & Kendall-Taylor, N. (2015). Gauging Aging: Mapping the

Gaps Between Expert and Public Understandings of Aging in America.

https://www.frameworksinstitute.org/wp-content/uploads/2020/03/aging_mtg.pdf

Pooler, J., Liu, S., & Roberts, A. (2017). Older Adults and Unmet Social Needs. AARP.

https://endseniorhunger.aarp.org/wp-content/uploads/2017/11/SDOH-among-older-

adults-2017_IssueBrief_COR-Final.pdf