San Francisco – A Gathering of Hope
I had the honor last week to attend the American Society on Aging’s yearly conference in San Francisco where I renewed friendships with old (I mean previous) friends and had the opportunity to meet and make friends with the new champions of America’s older population. Before I get into what I saw and learned at the conference, I feel obligated to say something about San Francisco.
Almost without exception everyone that I told where I was going, immediately asked me if I was worried about my safety. They all had heard, in one way or another, stories about the rampant crime in the city. The conference was held in a hotel adjacent to the Tenderloin district that seems to be the center of the crime problems. This area has been the focus of a suit brought by the citizens of the Tenderloin district accusing the government of using the area as a containment zone for illegal drug use and other vices. I have to admit I was cautious, and in my short three block walk from the BART station to the hotel, I observed tents and other indications of homelessness and groups of people gathered in various doorways. I didn’t venture out during the conference because I didn’t feel safe. I bring this up because many older people living in urban areas have begun to feel unsafe and have found that health services are becoming scarce in their area. When an In-N-Out (a famous hamburger place in the west) in the San Francisco area gets closed because of crime, then you know that the seniors in that area must be fearful when they travel to the doctor or the pharmacy, if there is even a drug store that is close to them. Access to services was a big focus at the conference. The situation in San Francisco might be a warning of a growing problem in other urban areas.
This conference is always a great source of information on how older Americans are being served and what the future holds for our healthcare. There were classes, panels and presentations dealing with every aspect of serving older Americans. From my point of view, there were two themes that seemed to permeate the conference – access and artificial intelligence (AI).
Ensuring access to healthcare is certainly not a new subject, but there have been some recent changes that could have an impact on how easy seniors can get acceptable healthcare. On the plus side, we have the continuation of no co-pays for vaccinations, and an out-of-pocket cap this year of between $3,300 and $3,800 on the Medicare Part D prescription drug program, with the cap dropping to $2,000 in 2025. The importance of renewing the Older Americans Act (OOA) was also discussed. One of the presenters reminded us that the OOA was focused on the 90% of seniors who were not in government programs with the express goal of keeping them from falling into that category. I’m always interested in promoting an ounce of prevention. On the downside, we have the ending of the telehealth benefits that were instituted during the pandemic and the continuing shrinkage of healthcare workers, especially doctors, that support seniors. People were also concerned that there is legislation that some states are passing (or revoking existing laws) that is perceived as raising barriers in front of minorities and those in the LGBTQ community. I heard many presenters talk about the embedded prejudice in many parts of our healthcare system. I sensed that many attendees were feeling that some of the strides forward in providing equal access to all were being threatened. It is evident that there are changes happening in how we provide healthcare. While our government tries to find ways to reduce the financial barriers there are often geographic, educational, and prejudicial barriers that also have an impact on the most vulnerable among us. It was a common undertone of the presentations that I attended. The good news is that there were many ideas put forth to improve access. I only hope that these ideas get to the providers, the insurers, and to our government.
The other theme that seemed to pop up was where AI would fit in to healthcare. It seemed that attendees were both excited and weary of its power. It seemed it could be a part of the solution to the shortage in healthcare workers. It was recognized that it might help reduce some of our doctors’ administration burden so they can spend more time focused on us. One of the classes I attended got into a detailed discussion on how AI could assist a person as they tried to ascertain which government programs were available to them. It was pointed out that AI could use the patient’s specific personal information and situation to decide which programs they would be eligible for and would be helpful for their specific needs. The discussion then went to the protection of personal information. It is precisely what our government is wrestling with right now: How we reap the benefits of this powerful tool without losing control of it and how we ensure we protect our personal information. It was mentioned more than once that patients don’t want AI coming between them and their doctor. They want their doctor to make the final decisions. I’m sure there will be a lot more to say about AI.
The conference was a great success and was an invaluable source of information about where we are and where we are going with our healthcare for older Americans.
Best, Thair