Susan Jacoby -- Never Say Die: The Myth and Marketing of the New Old Age
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I did not find this book as depressing as I expected to.  Perhaps
that is because I'm still in reasonably good health and can at least
tell myself that I can look forward to a reasonable number on "good"
years.

That's the emotional, and personal side.  But, on the the practical
side, Jacoby's book has implications to policy decisions that have
serious consequences in our society.  This is as much a book about
public policy, specifically health care policy, as it is about old
age.

The myths and illusions that Jacoby attacks, have practical
consequences, for example: (1) As a counter to government deficits,
we are considering cost saving actions such as reduced assistance to
the elderly and the sick and increasing the age for eligibility for
Social Security benefits.  (2) To prevent the financial crash of
2008 from becoming a truly catastrophic crisis, our government has
driven interest rates so low that those of us who were fortunate
enough be be able to save for old age get almost no earnings from
our savings. (That, by the way, is a huge transfer of wealth away
from those with savings to those in the financial industry.)

These policies, Jacoby argues, are made to seem reasonable by the
overly optimistic beliefs and illusions that most all of us will
have an old age in which we can work and take care of ourselves and
be financial self-reliant.  These beliefs are wrong, and the
consequences of policies based on them are bound to be both
significant and disastrous, especially since the Baby Boom
generation will be causing a expansion of the size of the elderly
cohort in population in the U.S.

Jacoby's specialty is to take on and puncture irrational thinking
and foolish idea.  Her previous book, "The age of American
unreason", was a bit of an equal opportunity lambaste that targeted
foolishness on a range of topics.  This book ("Never say die") is
more focused and specific to our thoughts and feelings about old
age.  If you want to improve your abilities in the way of critical
thinking, Jacoby's reasoning is an excellent example to follow.

Financial reality -- Jacoby works hard to destroy our myths and
delusions about finances in old age: (1) In contrast to our beliefs,
most of us in the U.S. cannot or will not save enough during our
working lives to support our retirement.  Jacoby asks: Would you
even *want* parents to say to their children that there is no money
for college tuition and expenses because they (the parents) are
saving for retirement? (2) Many if not most Americans enter
retirement with very little in the way or savings.  (3) That means
that many in the early years of retirement need to work in order to
support themselves.  (4) But, there are few jobs available for many
of these in the early retirement years, and if the elderly do find
work, they are actually taking jobs away from younger workers.  We
have a job shortage even without sending the elderly back into to
workforce. (5) Social Security benefits alone are not enough to
support an acceptable life, and we are talking about cutting that
back even more.  (6) We have a drastic reduction in the number of
workers who are and will be covered by defined-benefit retirement
plans, those who are are covered by defined-benefit plans are having
their benefits cut, and those who have attempted to provide for
themselves, e.g. through 401K investment plans and the like, have
seen those savings and investments trashed severely by the recent
financial crash.  (7) We, in the U.S. and our representatives in
Washington, D.C. do not have the political will face the reality and
costs of caring for the elderly.  And, even if we did, we likely
would not be willing to tax ourselves to pay for that care and
support.  The U.S. is a hard, mean society that is not willing to
take care of those who are unable to take care of themselves.

Part of our problem is that we all want instant gratification and
lower taxes.  We do not want enforced savings (for example, Social
Security taxes) and we are not able or willing to save for
ourselves.

If we are to move toward medical care for everyone, it should be
baby-boom generation who lead the way and do the pushing.  But,
health care for everyone is likely to mean less for some, in
particular, the elderly may see a reduction in their Medicare
benefits.  Rather than lead us toward a united effort at reform of
health care in the U.S., that is likely to lead us to an
inter-generational conflict, according to Jacoby, as seniors refuse
to give up what they already have.  Instead, we are likely to see a
tendency toward "I've got mine; don't try to take it away in order
to pay for yours" mentality.

Moral questions -- Should we be trying so hard to extend life, if we
are not willing to pay for the support and care for those whose
lives are being extended.  And, if those in old age deserve support
and care, if that is a human right for the elderly, why not for
everybody?  Certainly for children.  And, do the non-elderly who
cannot find a job with medical benefits *not* deserve care?

We, in the U.S., are proving the inadequacy of solutions based on
individual will, responsibility, and action.  For example, we cannot
count on individuals in general to save enough to provide for their
retirement expenses and their medical care, especially medical care
during the very last years of life, which are likely to be high.
And, a belief in these myths of individual solutions and individual
independence for health care leaves us unable to confront these
issues and to support the policies we need as replacements.

In the last chapters of this book, Jacoby shows herself to be a
liberal who is sympathetic, even envious, of European and Canadian
social solutions to medical care problems.  Her arguments are the
kind intelligent discussion that we should have had during the
recent efforts to pass health care reform.

Jacoby is hopeful that we in the U.S. will face reality when
conditions for many of us become bad enough.  I'm skeptical that we
will do that.  I worry that conditions will need to become
unbearably terrible before we do.  And, I believe that the
wealthy in the U.S. have the political power to block reform.

This is not a cheerful book.  But, it has the value of encouraging
us to think about these issues in a clear and un-illusioned way.  We
and our elders can expect a lot of grief and unpleasantness if we
fail to do so.

03/31/2011

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