Abstract:

Seven major turning points in the evolution of U.S. aging policy over the past 50 years are identified & reviewed: (1) the Social Security Act, (2) the Great Society, (3) the federalization of Old Age Assistance, (4) the enactment of comprhensive social services, (5) Social Security improvements, (6) New Federalism, & (7) medical cost-containment policies under Medicare & Medicaid. In the 1980s, significant & growing problems of uninsurance & underinsurance for health care have re-emerged. Simultaneously, state Medicaid programs are characterized by their increasing variation & inequities, while there has been a decline in access for the poor. The future of aging policy will be decided in the context of four sociodemographic realities: (1) population aging, (2) trends in mortality & morbidity, (3) the relationship between income & health, & (4) aging as a woman's issue. A call is made for a recommitment to the public interest & to public solutions which affirm that health care is an inalienable right.