U.S. Senate Candidate Al Franken Talks Aging and Long-Term Care

Al Franken has lived a fascinating life. Many know him from his Saturday Night Live days. But he’s put comedy aside (hopefully not for good - we all need some humor) to run for the United States Senate in Minnesota. He is the Democratic-endorsed candidate.

Changing Aging recently sat down with Senate Candidate Al Franken to discuss his views on aging and aging services. Thank you for taking time from the campaign trail to talk with our readers Al:

[NOTE TO READERS: We've also sought an interview with current U.S. Senator Norm Coleman and hope to hear back from him soon. We will post that interview as soon as it's done.]

How do you see life for you in your 90s? What’s your vision for growing old?
I hope to be healthy and active when I am in my 90’s. I think my 100’s will be more of a problem. I want my wife Franni and I to be able to stay at home and spend time with our children, grandchildren and great grandchildren. My parents each lived to be 85. I am planning on Franni and I surpassing that. Just a few months ago, my uncle Erwin passed away. When my cousin called to tell me the news, he said, “He died of being 97, that’s it.” I want it to be that way for Franni and me.

Your mother, I believe, lived in assisted living or a nursing home . . . how was that experience from your perspective?
My mother lived out her days at Jones Harrison–near where I grew up in St. Louis Park, Minn. She received wonderful care. The skilled nurses and doctors at Jones Harrison were able to meet her needs, something that Franni and I were not able to do. We came to visit often, but we were not able to care for her on our own. My brother and I were glad that she could be taken care of so close to home and that her friends could easily visit her. It also meant a lot to her to be close to places she was familiar with and her friends. Ideally she would have been able to be at home, like my father was when he passed away, but she needed more specialized care.

Most Minnesotans and Americans say they want to live at home when they grow old, yet in this country most government dollars go to institutional based services, would you work on changing that?
Our Minnesota seniors deserve to live out their lives where they are most comfortable. In most cases this means finding ways for them to stay in their own homes and in the communities they have lived for years - where their friends and family are. Right now, a large portion of our federal dollars spent on health care for seniors is through Medicare or Medicaid - the latter of which goes to pay for nursing home care when a person no longer can pay with his or her own dollars. Numerous studies show that institutional care is more expensive and less efficient than home care.

Strengthening home care options will also address the concerns of rural Minnesotans who struggle to find access to providers. Rural Minnesotans are less likely to find nursing homes in their communities, and those that exist are struggling financially. Our seniors deserve to live out their days where they choose - and most often that would be remaining at or close to home, with family and friends.

Minnesota congressional members have supported on a bi-partisan basis legislation that would bring more technology into aging services and enhance seniors’ life quality and independence. It’s connecting American technology to aging. If you were to be elected to Congress, would aging and enhancing the future of aging be a large priority for you?

When we invest in developing technologies, health care quality improves. Every senior will benefit when we’re able to implement interoperable electronic medical records and tele-health technologies. With these tools, we’ll improve the quality of care our seniors receive, making it more efficient and more cost effective. As a nation, we are making progress on many 21^st century fronts. Technology that already exists can be adapted to meet the needs of seniors and individuals with disabilities to improve not only their quality of care, but also their quality of life. And we can make sure that these exciting new innovations also address the privacy and security concerns that Minnesotans have about protecting private health and treatment information.

It’s absolutely crucial that we invest in research to find treatments and cures for diseases like Alzheimer’s and Parkinson’s, which our seniors face with increasing numbers. I am a strong supporter of the National Institutes of Health and their in-depth research capabilities. I want change in Washington - and that means leaders who don’t shy away from science and scientific breakthroughs.

America has long been the world leader in health and treatment capabilities. I want that to continue, not only for the benefit of our seniors, but for the American economy as well. We should be a leader in the global market when it comes to health technology, just like Minnesota leads the national market with the Mayo Clinic in Rochester.

Many people save nothing for long-term care expenses. It ends up costing the country billions in Medicaid costs. This issue seems tailor-made for bi-partisanship (we’re all aging). One idea non-profit senior service providers, including Ecumen, have put forth, is a framework for a national insurance trust Disability in old age (or young age) should be an insurable event. What’s your reaction to this framework?

Every Minnesotan deserves access to long-term care. For most of us, this isn’t a concern until we are much older; but for some, an accident or an illness causes us to need long- term care starting at a younger age. I strongly support the goal of Medicare to provide for the basic health care needs of our seniors. Medicaid needs to be strong to step in to provide asafety net when someone younger is disabled or unable to provide for themselves due to economic hardship.

Federal programs must provide the basic services, however not all needs can be met this way. I am intrigued by the framework put together by non-profit aging service providers around the country. We have to ensure that seniors can live where they most want to live while preserving safety nets for those most in need. I do not support the privatization of programs that provide for the basic needs of Minnesotans. Government has pledged to be there for seniors. We need to ensure that government programs are strong for Minnesotans and Americans in need of long-term care.

Another issue that the country and Minnesota is wrestling with is family caregiving. Most people over age 65 rely on family caregivers, most of whom already have full-time jobs. Do you have any ideas for supporting family caregivers?

Minnesotans take tremendous pride in their families - I know I do. And we take pride in the sense of community that comes from being able to take care of those we love. The 65 and over population is currently the fastest growing age group in this state. Between 2000 and 2030, the 65 and over population will roughly double from 12 percent to 24 percent of the total state population. In addition, the group most likely to need long-term care - Minnesotans 85 and older - will nearly triple statewide from 90,000 in 2000 to 250,000 in 2050. More and more Minnesotans are providing long-term care for elderly family members. As we get older we lean on our family members more. And that’s the way it should be - we are happy to help family. But the aging of the state’s population has created a “sandwich generation” of Minnesotans who are caring for both their parents and their children. More than ninety percent of all long-term care in Minnesota is provided informally, usually by spouses or adult children. The average out-of-pocket costs facing family caregivers amount to roughly $5,500 per year - more than most families spend on health care.

As Senator, I’ll create a $2,000 Caregiver Credit for any individual with substantial long-term needs - that would cover more than a third of the average costs to caregivers. To insure that those most pressed for time and resources would be able to access the credit, I would not require families to engage in any complicated accounting of their out-of-pocket costs. The credit would simply be phased out for families earning more than $150,000. This new credit would help more than 100,000 Minnesota residents and families do what they do best - take care of eachother.

Soon we’re going to see something in this country we haven’t seen: Millions of people over age 85, and the fewest amount of people under 50 to care for them. Any ideas?

Baby boomers are not only patients, but doctors and nurses as well. As a result, we are already facing a workforce shortage of providers and caregivers. Currently there are not nearly enough doctors are willing to see Medicare patients. In addition to an aging workforce that isn’t being replaced, there are insufficient numbers of primary care physicians as well as those who specialize in geriatrics. I propose providing financial and academic resources, as well as incentives, for doctors and nurses who pledge to dedicate their skills to our aging Minnesotans.

I believe that all seniors should be guaranteed health care coverage-and not just seniors, all Americans. We need to go to universal health care. A single-payer system would be the most effective in terms of reducing administrative costs, and I would be thrilled to support such a system. However, I believe that today’s political environment requires a creative and flexible approach to covering every American. Under my plan for universal healthcare, I would require every state to cover every one of its citizens, and the federal government to provide funding to fulfill that requirement. Each individual state would be free to offer a variety of options, as long as they add up to universal coverage, giving us 51 laboratories (if you count DC) to develop a system which works best.

Additionally, as the baby-boomer generation ages, the needs of our communities change. Beyond healthcare, many retirees want to be active participants in their communities. I support community organizations who are dedicated to engaging seniors in a myriad of ways. Community centers are a common gathering place for seniors. Many of these facilities provide hot lunches in addition to classes, peer level support and basic healthcare such as providing flu shots to those most in need. I will work to make sure these kinds of organizations remain viable.