samuel moyn op-ed

Offering Simplistic Solutions to Real Problems of an Aging Society

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With the headline “Older Americans Are Hoarding America’s Potential,” a recent New York Times piece by Yale professor Samuel Moyn has, understandably, attracted a lot of attention in my networks.

Much of the attention is critical, and I share some of those criticisms. But let’s recognize that Moyn identifies real problems.

He writes, for example, that older Americans deserve a better-funded long-term care system. I agree. Our long-term care and healthcare systems (or lack of systems) incentivize older people to hold on to wealth in fear that a medical emergency could wipe them out financially.

Unfortunately, Moyn’s piece offers simplistic solutions to the problems he identifies. For example:

➡️Voting: He writes that older Americans are overrepresented in elections, and they contribute a disproportionate amount of campaign donations.

I agree that younger Americans should have more influence in politics. Moyn focuses on reducing the impact of older voters and the older politicians they often vote for.

Instead, we should fix a political landscape that leaves younger voters feeling like it’s not worth voting at all.

➡️ Housing: Moyn suggests “a progressive tax on older homeowners to incentivize them to downsize rather than retain.”

I think many older adults would downsize without a nudge — if there was somewhere to go.

But we’re building the wrong type of housing. Very little new stock is all-age accessible. We build tall townhouses with no elevators because developers claim they’re too expensive. New housing for young adults often includes large HOA fees.

In the end, the options for older adults who want to move are impractical or unaffordable — or both.

➡️ Workforce: Citing a lack of opportunity for young and middle-aged workers, Moyn suggests we reinstitute mandatory retirement.

But forcing out older adults who want to work makes no sense given current demographic realities.

Immigration levels are falling dramatically. The number of 18-year-olds is plummeting as well. Even if the government incentivizes larger families, that won’t make a difference for 20 years, if at all.

Given these trends, we should be asking “Where will the workers come from?” The answer is older adults. We need to expand, not reduce, the age range of our workforce.

I also have an issue with the piece more broadly: using the word “gerontocracy.” It’s sensationalist, fanning the flames of ageist ideas which will not solve the real problems Moyn outlines.

His piece sends the message — perhaps not intentionally — that our problem is too many old people with too much influence. Too many old people at work, too many old people in single-family homes, and too many old people in the political process, from voters to elected leaders.

He doesn’t go so far as to ask, “How can we reduce the number of old people in society?”

But his line of reasoning may lead others there. And that’s alarming.

co-housing Casa Verde Commons

4 Reasons Cohousing Has Serious Growth Potential as a Senior Housing Option

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If you’re trying to understand what Boomers and older Gen Xers really want in senior housing, this piece by Adrienne Matei in the Guardian is not a bad place to start.

I would quibble with one assumption the piece makes: That there are essentially two options in today’s senior housing world: living alone and becoming lonely or moving into an institutional setting. There’s already far more available than these two unattractive extremes.

But cohousing — multigenerational or senior-specific communities where people live, interact with and care for their neighbors — has real potential to grow. The Guardian piece provides four good reasons why:

👉 Older Adults Value Their Independence and Agency.

One subject of Matei’s piece says she chose cohousing in part because “institutions ‘take away the ability to decide what your day is going to look like,’ offering scheduled activities and mealtimes that reduce individual agency.”

In cohousing, residents set their own schedules. And they do most things for themselves.

It avoids instilling what I call the “learned helplessness” that grows in some other settings.

As retired gerontologist Anne P. Glass says in the piece, “Contrary to what society may believe, older people are really quite competent.”

👉 Older Adults Want Community.

This piece makes it clear that older adults long for community and a sense of connection.

Angela Maddamma, 72, talked about the visits she received from new neighbors the day she moved into her cohousing community. She’s on a community committee and enjoys spontaneous connections with neighbors — but she can go home and “veg out” whenever she desires, too.

That’s a key aspect of community within cohousing: Having ample opportunity to connect with others, but on your own terms.

👉 A Trend From the 1960s Makes a Comeback.

The idea of living with a group of like-minded people and collaborating to support each other might sound familiar. In the 1960s and ’70s, these living arrangements were called communes.

Communes and cohousing are both centered around community, not care.

These alternative arrangements are not for everyone, and they’re difficult to scale, but they still are attractive to a significant number of older adults.

👉 A Market Gap Has Opened Up.

Thanks to increased longevity, markedly different segments make up what we used to simply call “senior citizens.”

There are many adults in their 60s, 70s and 80s who are seeking a housing lifestyle option, and others in their 80s or 90s who have care-driven needs.

It’s not surprising that the former group wants something different.

Because of this growing segment, I hope and think you’ll see cohousing grow.

Will it ever house millions? I don’t think so. But I expect to see all sorts of alternative lifestyle options develop for Boomers and Gen X. There’s certainly a desire for new options.

demand for senior housing

How Will We Meet Rising Demand for Senior Housing? We Have to Innovate.

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In the senior housing and care industry’s current state, supply is not going to meet demand any time soon.

The need for our services is growing quickly, fueled by the demographics of an aging society. The cost of building new communities and providing the services is growing quickly, too, as construction remains expensive and labor scarce. The product is unaffordable for many now, and unlikely to become more affordable as-is.

It’s easy to look at the situation and get discouraged when it comes to how we will meet escalating demand.

Instead, I like to point out that this moment is made-to-order for innovation. It’s the perfect time to figure out new ways of delivering our services and trying new models.

Tim Regan’s recent piece in Senior Housing News did a good job of explaining why we’re where we are now. By 2030, the youngest Baby Boomers will be 65 years old. We don’t have enough senior housing now, and to meet the need in five years, a lot of construction needs to start now.

“While the cost of capital has improved slightly since last year, many projects still don’t pencil out,” NIC Senior Principal Omar Zahraoui told Regan, “and the floodgates for new development are unlikely to open in the next 12 months.”

Regan’s piece touches on tariffs, too, which could increase costs further, as well as the large number of promised deportations, which could make labor harder to find and more expensive.

It’s clear that we can’t just sit and wait for conditions to improve. We’ve got to innovate, figuring out new ways of delivering more for less. The needs are too great and the costs are too high to just stick with one fixed model.

Instead, we need models that are scalable, in several different categories:

👉 Middle-market models that wrap around supportive services.
👉 “Active adult” models that focus on lifestyle, wellness and health span.
👉 Community-based models organized around wellness clubs, membership programs and “PACE-like” services.
👉 Models in which our services are delivered into the home.

For the senior housing and care industry to meet the needs of a rapidly growing population of older adults, it has to morph into something beyond just a bricks-and-mortar solution.

The companies that figure out more innovative ways of reaching more people with the services they need — and in ways that they can both access them and afford them — are going to be huge winners in the future. To the extent the industry does not seize this opportunity, outside disruptors and innovators surely will.

stingy economist headline

What the Economist Got Wrong In Its ‘Stingy Boomers’ Piece

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You may have seen the article — or at least the headline — already. The Economist labels Baby Boomers as “loaded” and asks “Why are they so stingy?”

That ageist language is enough to warrant an entire post. But when you add in the assumptions this piece makes about the behavior of adults over age 65 and their housing decisions, you have a report that totally misses the realities of aging today.

That’s not to say that there isn’t substance in this piece. I wrote another post that looks at what the Economist got right.

But beyond the weaponized ageist language use — which pits one generation against others — this piece makes two other major mistakes.

1. The “Over 65” Grouping

Most of the research cited in this piece looks at the behavior of adults ages 65 and older in aggregate. That’s a problem — considering the entire 65-plus population as a single cohort doesn’t reflect today’s reality.

Boomers view their 60s and 70s differently than previous generations. They expect to live longer, and they plan to work longer, too — because they need the money, or because they want to and can.

The Boomers who are working to save money have seen their parents experience unexpected longevity and struggle to pay for care. And they have seen the cost of that care continue to rise.

Other Boomers feel financially secure but find a sense of purpose, enjoyment or engagement in a job.

The piece’s “over 65” mistake extends to citing an investment index that tracks “share prices of firms which do well when oldies spend big.” This index “includes companies that provide treatments for age-related diseases, leisure and tourism, and anti-ageing skincare products.”

There are millions of Boomers in their mid to late 60s (and older) who aren’t interested in retirement cruises, nor in anti-aging products. Assuming they are is another example of ageism.

2. Home Ownership Assumptions

The piece notes that “Few boomers are downsizing to smaller homes.” That’s true — but it misses some important facts.

First, high interest rates are making it harder to sell and less appealing to buy a new home.

Second, and more important, where are older adults going to go?

I’m not referring to retirement homes. I’m talking about homes that make sense for someone at age 70, 75 or 80. Less than 4% of current U.S. housing offers accessibility for older adults. And builders are not creating much more.

In total, this piece’s assumptions simply don’t account for the needs of today’s diverse society. Adults over 65 are not a monolith. They’re different from each other, and different from previous generations.

Many of the decisions Boomers are making are efforts to align their wealth span, health span and life span. That’s not being “stingy.” That’s being prudent.

Older couple at home

Boomers, Millennials and the American Housing Crisis

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“Millennials Have the Children, but Boomers Have the Houses”

“Aging in Place, or Stuck in Place?”

These are two recent New York Times headlines on stories that ostensibly document different problems.

The first article explains that a large number of Millennials would love to buy a big house for their young families, but there aren’t many available. The reason: “Baby boomer households with no children in the home — own 28% of the nation’s large homes (those with three or more bedrooms).”

The second article describes how many older Americans are ready to downsize, but they can’t find a suitable home to buy.

These are not separate problems. They are connected, and it’s high time that we consider holistic housing policies to address these issues.

It should start with addressing the needs of older Americans. The second story I mentioned above, by Paula Span, begins by telling the story of a couple in their 70s who want to sell their four-bedroom house and move into a two-bedroom, single-level condominium.

That’s harder than it sounds. As Span writes, “Local developers are putting up four-level townhouses with even more stairs. The few suitable one-floor homes available get instantly snapped up. City dwellers fleeing Covid helped pump up housing prices.”

The Harvard Joint Center for Housing Studies issued a report last year that dives more deeply into this problem: Fewer than 4% of U.S. homes offer the three key features most older Americans need for accessibility – single-floor living, no-step entries, and wide hallways and doorways.

Add it together, and it’s not that older adults don’t want to move — with no viable options, they feel trapped.

Meanwhile, as the first story reports, Millennial households with children own just 14% of the nation’s large homes. It’s not enough.

We don’t have housing policy in this country, both in terms of what’s being built and also the financing mechanisms that encourage it, that facilitates needed movement and fluidity in the market. And it needs to start at the local level, where planning and zoning laws can start to change things.

Change is definitely needed. Housing supply and demand are out of whack. It doesn’t reflect today’s realities — people are living longer, that changes housing needs, and everyone is feeling the results: Millennials, Gen X, Boomers and more.

The Forgotten Middle

Why ‘One Size Fits All’ Solutions Won’t Fit the Forgotten Middle

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One of the best things about this New York Times piece is that it shines a light on something many don’t appreciate: There are multiple layers to the “forgotten middle” challenge looming over housing and healthcare for older adults. Grasping that fact is vital to solving the problem.

Paula Span’s Times piece was well-timed. It was published a few days before the Milken Institute released a report — sponsored by the National Investment Center for Seniors Housing & Care (NIC) and CVS Health — examining innovative financing models to scale affordable housing and care solutions for this same group.

Both the Times and Milken make it clear that the forgotten middle is a very broad cohort. And because of that, there will never be a one-size-fits-all solution for this group’s housing and long-term care needs.

Instead, solutions will have to be tailored to the income and resources, as well as the healthcare needs, of those being served.

(All of this, of course, builds off the seminal Forgotten Middle study published in Health Affairs, authored by Caroline Pearson and the research team at NORC at the University of Chicago and underwritten by NIC. See link at the bottom of this post.)

The Times piece paints a vivid picture: There are two very different markets for healthcare and housing among older adults in the American middle class. The upper half has, in many instances, seen their financial situation, health and longevity all improve over the last two decades.

Meantime, the lower half of the forgotten middle has not seen those gains. In fact, many have lost ground — both financially and in terms of their health and longevity.

The lower middle class tends to be sicker with more chronic conditions and less financial stability. They’re often one fall or other health incident away from falling into poverty and qualifying for Medicaid.

We need to understand those differences if we’re going to be able to craft programs that meet all of the forgotten middle’s needs — making long-term care and housing affordable and accessible for all.

I applaud the leadership of NIC which, through its case studies, research and programming at its conferences, not only first brought attention to this issue, but now is focusing on the variety of strategies and models needed to serve this huge demographic cohort. It’s a segment of the population that will total nearly 16 million in less than a decade — so the time to act is now!

Milken Future of Health Summit

Future of Health Summit: Reimagining Senior Housing and Integrated Care

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As the baby boom generation ages, expanding affordable housing and integrated long-term care options for our nation’s diverse older adult population has become increasingly urgent.

According to a National Investment Center for Seniors Housing and Care-funded study conducted by NORC at the University of Chicago, more than half of middle-income Americans aged 75 or older will not have the financial resources to access housing and care by 2029. Meeting the needs of this “Forgotten Middle”—an income group too wealthy to qualify for means-tested programs yet unable to afford private-pay senior living options—will require coordination from public and private sector stakeholders.

Recognizing the challenges of promoting and incentivizing innovation across sectors, this session hosted by the Milken Institute features industry leaders, providers, and policy experts discussing scalable housing and care solutions for this growing segment of the population.

Moderator:

  • Caitlin MacLean, Senior Director, Innovative Finance, Milken Institute

Speakers:

  • Lynne Katzmann, President and CEO, Juniper Communities
  • Bob Kramer, Co-Founder and Strategic Advisor, National Investment Center; Founder and Fellow, Nexus Insights
  • Nirav Shah, Senior Scholar, Stanford University
  • Elizabeth White, Founder, NUUage Coliving

Watch the recording: https://milkeninstitute.org/panel/14999/reimagining-senior-housing-and-integrated-care

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