Closing the Expectation Gap

Next year, health insurance premiums for aging adults who use the ACA marketplace could jump 40 to 50 percent. Within six years, the consequences of actions taken by this current Administration may force a reduction in monthly benefits for those of us on Social Security.   

I am a solo ager, living on a fixed income, and I do not have room to absorb increases or decreases like that. Neither do a lot of people I know.

Like many of my generation, I have an expectation that these benefits are going to be there for me, and that I will be taken care of in my old age. But evidence strongly points to a different reality: the widening gap between what I expect and what I am actually going to get. That gap is worth looking at, because expectations have consequences in terms of psychological impact and ability to adjust or accommodate to change.

Where Expectations Come From

My expectations are rooted in two different sources: past experience, and promises I believe have been made to me. That distinction matters. When an expectation isn’t met, I may feel disappointed or taken advantage of. When a promise isn’t kept, I make decisions about whether I will continue to trust the promise maker.

My expectation that I will receive a monthly Social Security check comes from a promise made back in 1935. The promise that I will have access to quality healthcare was made in 1965. In both these cases, I have had positive experiences with my medical bills being paid and my monthly benefits check being deposited in my bank account since I turned 65.

So imagine how I am feeling now that both these programs are being threatened! I am feeling scared, disappointed, and a bit helpless that my elected officials haven’t figured out a way to preserve Social Security and Medicare. That was the promise they made to me when I voted for them.

Awareness of Shifting Expectations

Remember when we used to wait for the Sears Catalogue to come out and once orders were placed, it took weeks for the merchandise to be delivered?  Now our expectation is that we’ll search, point, click, buy, and have whatever we want tomorrow! Remember when we used to talk to one another, face to face?  Now we text to see if we’re available first.

We were aware of these shifts happening, and our expectations adapted accordingly. We didn’t have to “like” the changes, but we learned to go with the flow. This is how expectations shift over time.

Psychologically, once a pattern or routine is established, we expect it to continue. We rely on it always being that way. And when it does change, there is a period of adjustment, and then that becomes the new way of doing things. Up until this Administration, we have been able to rely on Social Security and Medicare doing what they are charged with. But now different shifts are happening and the time available to adjust has shrunk.

Promises Made, Kept, or Broken

Too many of us aren’t paying attention to what is going on with our Social Security and Medicare. Admittedly, these are complex policy areas and frankly, not the most exciting stuff to read about. But the changes on the horizon are sure to be a surprise to many who have expectations of receiving monthly benefits and being able to see a doctor.

Right now, both of these programs provide essential services and benefits to between 68 and 75 million Americans. Changes are being considered that will impact what many of these people, myself among them, have come to expect. And I am afraid that too many will feel like they have been taken advantage of or that the change has happened out of the blue, leaving them unprepared.

It Isn’t Fair!

This past week, Nancy LeaMond of AARP provided testimony to the U. S. Senate Finance Committee on the necessity of keeping Social Security solvent. The irony, not lost on me, is that, of 27 members of this Committee, all but eight are currently receiving Social Security benefits. You would think they would be better stewards of this program out of self-interest alone!

In her testimony, LeaMond noted that Social Security is becoming more central than ever to Americans’ retirement security.

“Private pensions have mostly vanished, and around half of our workforce has no employer-sponsored retirement plan,” she told lawmakers. “Forty-two percent of Americans age 50 plus who are not yet retired have less than $50,000 in retirement savings. All of this means Social Security will remain essential for many years to come.”

Kick the Can

Unfortunately, this issue has been the proverbial “kick the can down the road” for too many years. Congress has put off addressing the very real underlying issue of having to collect more money in order to keep the bank account full. But it can do this no longer.

I fear too many of us don’t want to accept this reality and are crossing our fingers or relying on promises made that “everything will be all right.” This leaves us vulnerable to having that expectation not be met and worse, not having sufficient time to adjust and work out alternatives.

Getting Old Costs Money

Healthcare is another bogeyman. I have an expectation that I will have a doctor who I can see when I need to, that I will be able to obtain the medicine I need to keep me going, that if I need it, there will be a hospital close by to handle my emergency. And, that all of these things will be paid for because I have Medicare coverage.

The paradox is that we are living in an era of unprecedented medical achievements. We now manage illness, and have discovered and brought to production life-changing pharmaceuticals. We have made advances in managing chronic disease resulting in extending our lifespan. Yet we are currently watching the intentional and systematic dismemberment of the only healthcare plan available to the majority of older Americans and younger Americans with disabilities. It makes me want to cry.

Financing Healthcare for All

We have yet to come to terms with how to equitably finance healthcare. The systems put in place back in the 1960s did not envision healthcare as it is available today. Politicians are heavily lobbied to protect profits and tax benefits for insurance companies, not ensure quality healthcare for patients.

As a solo ager on a fixed income, I cannot absorb a 40 or 50 percent premium increase that is currently under consideration. That increase has been put before Congress by lobbyists from the healthcare giants, hospital organizations and the AMA, not patient groups.

I will be left doing my best to stay healthy, and like too many Americans, cutting back on medicines or forgoing treatment altogether until it becomes an emergency. This is not keeping the promise made to me. My expectations are not being met.

What I’m Doing with That

Expectations only become problematic when they cause us to feel like we’ve been taken advantage of or when something “changes out of the blue.” Of course, both of those experiences depend on how you are impacted (if at all) by changes!  There is no excuse for any of us to think that changes to Social Security and Medicare are coming out of the blue.  That leaves us with the uncomfortable reality that these changes are happening because we are being taken advantage of.

What I am doing with this is taking a hard look at my own expectations, especially for the next two to five years, because those years will decide whether I can live with dignity, continue to receive adequate healthcare coverage, and have a reasonable expectation of paying for affordable housing.

The Uncomfortable Situtation

The Declaration of Independence boldly claims that “All men are created equal.” That government has a duty to secure and guarantee certain rights, including life, liberty and the pursuit of happiness.

It follows that benefits offered by our government should be available to each and every one of us. Healthcare, however, is not a Constitutional guarantee, nor is Social Security. This leaves us with the uncomfortable situation of having to argue for something that we have come to take for granted.

If we are not proactive, we will lose this argument and suffer the consequences, unless sufficient numbers of us can come together and demand that these promises be kept and our expectations met.  That starts in the mid-terms and continues in every election that follows.