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An Aging Population, Health Care and Public Administration

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Wayne A. Jones
January 13, 2017

A new era in our country’s history begins Jan. 20, 2017 with the inauguration of Donald J. Trump as the 45th president of the United States. A change in administrations brings new leadership with different people in key positions with new ideas for many existing public problems. However, one thing that does not change is the responsibility government has to provide programs and services for its citizens.

What can change is the role the government plays in the delivery of these services. There may be a significant modification in the role the federal administration has regarding health care, and specifically health insurance, due to the reality of partisan politics.

What is the government’s role in public health? Writing in the New England Journal of Medicine, Dr. Thomas Frieden, director of the Center for Disease Control stated “law and public opinion recognize protection of health and safety as a core government function.” In this capacity, government “initiatives to promote free and open information to facilitate informed decision making, to protect individuals from preventable harm, to protect individuals from unhealthy environments, and to protect and promote health through population wide action.”

However, how our government creates and implements public health policies is controversial as it involves aspects of our society including individualism, economics, race, gender and politics. Politics, per Professor Harold Lasswell, are “who gets what, when and why.” The problem is with politics, the playing field is never level and with health care the implications involve life chances, quality of life, basic survival and longevity. A 1966 quote by Dr. Martin Luther King Jr. is very relevant: “Of all forms of inequality, injustice in healthcare is the most shocking and inhumane.”

There have been improvements in healthcare and public policy since Dr. King’s 1966 words. However, despite a diversity of health care options in the United States and an overall growth in life expectancy discrepancies remain. The 2012 National Vital Statistics Report reveals life expectancy differ by race, age and gender. Aging Population

People in America are living longer but problems remain and there is more to be done. One important question among many connected to health care, aging and public policy is: How can we as a society and as public administrators help to improve the life chances for all citizens?

Many factors contribute to an individual’s overall health. Increased access to health information and health insurance improves the likelihood for longevity. These are factors many take for granted.

An equally significant aspect is to also consider is along with living longer, a sizeable percentage of our society’s aging population is working longer. Most of these individuals can maintain their employer-provided health coverage as they continue to provide the benefit of their experience to the workplace and to junior employees. Then there are some who must continue to work past traditional retirement age just for basic survival, especially those in jobs that already do not include health insurance. What is their current health status and how will this impact their ability to continue working as they age without health coverage? How will this impact their quality of life in their later years?

Unfortunately, for some, living longer means dealing with health difficulties longer with the accompanying doctor visits, medications and hospitalizations. For people without insurance this can mean making choices about whether to purchase food or medicine. This is a troubling fact.

A major consideration then becomes how to address the problem with the significant percentage of Americans who do not have insurance. This is one of the concerns during the administration transition as the 115th Congress considers the possibility of repealing and replacing the Affordable Care Act.

What are the implications for public administration? Public administration and public administrators must remain neutral to the politics of the government’s involvement in health care. We cannot enter the fray of partisan politics.

In our capacity, as responsible citizens, there are things we can and should do:

  • Be cognizant of our health and work to maintain and improve it as we continue to age.
  • Be supportive of family, friends and colleagues in their efforts to become healthier.
  • Become knowledgeable as Congress begins deliberation on changes Obamacare and exercise our rights as voters to express our positions to our elected representatives.
  • Offer our support to the non-profit sector especially those agencies that provide health care for the uninsured.
  • Help to educate seniors in our communities about their health care needs and options

Public administration is about people — serving and helping people to have better lives.

Author: Wayne A. Jones is an assistant professor in the Department of Political Science and Public Administration at Virginia State University. He can be contacted at [email protected]

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