As we are approaching the one-year anniversary of the pandemic, it is clear that businesses have struggled to manage the effects, including the disparate policies used with their workers. As referenced in my blog "Social Security: 85 Years of Lifting Seniors out of Poverty," the pandemic has caused less payroll tax to be collected, thereby decreasing revenue to Social Security and consequently decreasing the life of the Trust Fund. Furthermore, President Donald Trump over the summer signed an executive order impacting the solvency of the Trust Fund by deferring payroll taxes for the rest of the year and advocated for the cuts to be permanent. B’nai B’rith International expressed disappointment with the executive order because the payroll tax is a significant source of revenue for Social Security and any potential cuts will erode one of our nation’s most important programs for seniors. 

​With the White House transitioning from a Trump to Biden administration, it’s important to examine how President-elect Biden’s proposed policies could impact Social Security. First, over the summer Biden campaigned against cuts to the payroll tax. Despite the pandemic, at least Social Security shouldn’t see any further decreases to revenue by a payroll tax cut. 

Secondly, Biden proposed important changes to Social Security that could impact revenue and expenses, however, according to the Urban Institute does not solve Social Security’s long-term problem of being able to pay all of its obligations. Biden campaigned on increasing Social Security benefits for widows, people 78 to 82 years old and for certain low-income workers such as people who have worked more than 30 years. Former Senator Tom Harkin and Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, said in the Des Moines Register, "The nonpartisan Social Security Administration has projected that a single provision of the Biden plan — increasing the minimum benefit for low-income, lifetime workers — would lift more than one-half million seniors out of poverty by 2030."

Regarding the revenue to pay for these proposals, according to the Urban-Brookings Tax Policy Center Biden proposed a payroll tax increase for income above $400,000 a year that could generate $740 billion in revenue over ten years. It’s important to remember that people are only taxed on wages up to $137,700 for the purposes of Social Security. 

Another component of Biden’s plan would potentially allow people that serve as caregivers for family members who are young or have a disability to earn Social Security credits. This would reward family caregivers who are being unfairly punished for the purposes of earning Social Security at retirement. Similar to Biden’s other proposal referenced above, the plan would be funded by raising taxes on real estate investors whose incomes exceed $400,000 a year and, according to the campaign by, "taking steps to increase tax compliance for high-income earners." 

The original purpose of Social Security was to lift seniors out of poverty. By providing needed increases to Social Security benefits, and not raising taxes on middle and low-income individuals, Biden’s proposals should be given consideration by Congress. Unfortunately, we know that life in politics is never that simple. While I expect some possible bi-partisan cooperation in Congress around COVID-19 stimulus legislation, it remains unclear what other legislation can be signed into law. However, here is to hoping a bi-partisan agreement can be reached in Congress that benefits seniors throughout the country.

​At his 2017 Senate hearing to become a Supreme Court Justice, Neil Gorsuch was questioned by Sen. Dianne Feinstein (D-California) regarding physician assisted death (PAD). Feinstein and Gorsuch each articulated their position on this contentious issue, serving as a microcosm for our nation’s larger debate. Should doctors be allowed to prescribe end-of-life medication to terminally ill patients to ease their suffering?

In 1994, Oregon became the first state in our country to legalize PAD by passing the Death with Dignity Act. Since then, eight states and the District of Columbia have similar laws. Generally speaking, states require patients to have a terminal illness and have less than six months to live to be prescribed end-of-life medication.

Given the sensitive nature of this topic, people have strong feelings on either side. Opponents contend that a doctor’s prognosis is not a certainty and that these laws could lead to insurance companies weighing in on end of life matters. Additionally, the patients in question might be suffering from psychological distress.

Proponents of PAD advocate that people shouldn’t be forced to physically suffer and should have the right to choose to end terminal pain on their terms. Advocates say that with only a few months left to live nobody should be forced to needlessly suffer.

Data from around the country suggests that states which allow PAD have not been used in great numbers because this practice contributes to significantly less than a percentage point of deaths. Furthermore, Hawaii’s PAD law and a proposed PAD law in Massachusetts have a mental health consultation component. Plus, patients requesting PAD must be able to understand the nature of their decision to be given end-of-life medication.

Kaiser Health News reported about Charlie and Francie Emerick, married for 66 years, who each had terminal illness and availed themselves of Oregon’s Death with Dignity law. Charlie suffered from prostate cancer and Parkinson’s disease and Francie from a weakened heart after numerous heart attacks and cancer. “You keep going, Charlie, you’re going to get worse and worse and worse,” Charlie explained about his decision, “The other can’t be worse than this.” Before being prescribed end-of-life medication, Charlie and Francie both attested to their intentions and were examined by two different doctors who concluded they had less than six months to live. Ultimately, they decided they wanted to say goodbye on their own terms. Their story was recorded as a documentary to show how the process is carried out so people would understand more about PAD.

Traditionally, there is a widely held belief that PAD breaks with Jewish law, though there is a debate in the Jewish community about whether the issue should be revisited. Last year New Jersey legalized PAD, causing a debate among rabbis about whether to support the legislation. Rabbi Mark Mallach argued that the prevailing view in the conservative Jewish movement surrounding PAD should be reconsidered and told the New Jersey Jewish News (NJJN), “Jewish law has always been organic, responding to the needs of society in every generation,” and said, “Jewish law is not frozen.” However, Rabbi Elie Mischel took a different approach telling the NJJN, “Actively speeding one’s death is clearly forbidden under Jewish law (for both Jews and gentiles), and it is a rejection of the sanctity of every moment of life.” He also said, “Though we are not obligated to do everything humanly possible to prolong someone’s life (e.g., a very ill patient has the right to forgo a risky and painful surgery that has little chance to succeed), actively taking one’s own life is never permissible.”

As more states in our country debate PAD legislation, I expect these discussions to continue as people examine where they stand on this issue. Whichever side people come down on, I suspect this matter will generate intense debate in our national discourse.

Who reading this blog is tired of turning on the news and getting further depressed by stories regarding COVID-19? I imagine this feeling applies to most people in the country right now. No matter how you get your news, I can’t imagine it’s boosting your spirits. Consequently, let me provide uplifting stories of how businesses, government officials and ordinary citizens are trying to make the lives of seniors during this crisis just a little easier.

Although most of the country is under stay at home orders, too many people still have to go grocery shopping.  As most people are aware, seniors have to be extra cautious when dealing with the public because of COVID-19.  Consequently, trips to the grocery store can be problematic. Fortunately, stores like Walmart, Stop and Shop, Safeway, Albertsons, Whole Foods and Costco have all instituted dedicated shopping hours exclusively for seniors and other high-risk shoppers (ie. pregnant women and people with immune deficiencies). Hopefully, these hours have made it easier for people to social distance and buy groceries and other necessities. Also, some stores, like Walmart, are putting restrictions on the number of products you can buy in the areas of paper products, food and cleaning supplies. However, reports indicate that the system is far from perfect, with seniors still reporting large crowds during their designated shopping times.

In Nevada, CNN reported of a group called “Shopping Angels” led by a Jayde Powell, a pre-med student, that takes care of grocery shopping for seniors and disabled people. This is critical for older Americans who just can’t make it outside to get life’s essentials.  Furthermore, the group is coordinating fundraising efforts and working with local business to help those seniors that are financially limited. "We don't want money to be a deterrent," Powell explained to CNN. "If you cannot afford toilet paper or something like that, you're still to reach out to us." It’s also great to see this program catching on, with other people across the country offering to volunteer. Other older Americans, like my wife’s grandmother, have good Samaritans in their buildings knocking on seniors’ doors to see if they can do basic errands like grocery shopping, picking up medications and running to the post office.

In addition, in the beginning of 2020, Maryland started a free “Senior Call Check,” which has turned out to be particularly important given the COVID-19 crisis. The programs is a service for residents 65 years and older, which provides a daily check-in call to seniors and updates on the virus. If two calls are placed and not answered, the senior’s point of contact will be notified, and if that does not work, the authorities will conduct a welfare check. State Representative Ben Kramer, the sponsor of the program, would like to see it expand from a mere checkup to include information regarding the weather and senior scams. Kramer said, “So, this could give a notice that, 'Hey we want to give you the heads up, this impending storm is coming. You may want to make sure, if you're stuck in your home, that you've got enough food for several days, or your medications are filled to cover you for several days.”

B’nai B’rith, as a sponsor of affordable senior housing across the country is certainly no stranger to people helping their neighbors throughout the crisis. For example, at Strauss Manor in Tucson, Arizona, and Sam J. Stone Covenant Apartments in Peoria, Illinois, staff members, volunteers and residents are pulling together to make masks for people who live in the buildings and their caregivers. At B’nai B’rith House in Claymont, Delaware, Jewish Family Services (JFS) donated food boxes for the residents even before the crisis. However, with help from the United Way, JFS has started to include essentials for residents (shampoo, toothpaste, etc.) so they don’t have to leave their homes. Naturally, these deliveries have been accomplished with social distancing in mind.
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It’s always nice to hear stories about people going above and beyond, especially during times of crisis.  Hopefully, the pandemic will recede soon, but in the meantime it’s nice to hear stories of communities rallying around each other for the betterment of everyone. 

When my grandfather was 91, my parents sat him down and broached the idea of him giving up his car keys.  As you can imagine, that idea was not met with a lot of enthusiasm.  However, my parents felt that because of his physical limitations, safety required him to stop driving.  After a long discussion and a lot of convincing, he handed over the keys. I bring this story up because I recently learned our country arguably has more safeguards in place that govern who can drive a vehicle than those that govern who can own a firearm. Obviously, the purpose of this blog is not to advocate for the confiscation of guns from all people, but to discuss when conditions like dementia make gun ownership amongst our older American population a deadly problem.

So, how much of an issue is firearm ownership amongst seniors around the country? The Pew Research Center reported 45 percent of seniors live in a household with a firearm, and the United States Census Bureau indicated that 4.3 million seniors have dementia.  Also, the Center for Disease Control and Prevention stated that in 2016, about 8,200 older Americans (65+) committed suicide. Furthermore, according to the New York Times, amongst men in this age group who committed suicide, three quarters of them used a gun.  Dr. Yeates Conwell, a psychiatrist and director of the Office for Aging at the University of Rochester School of Medicine, said, “Suicide risk is elevated in people with dementia.”

In 2018, Kaiser Health News and PBS NewsHour studied aging Americans, dementia and gun ownership. While there is no formal office which keeps records on this matter, the investigation was able to study over 100 instances in the United States since 2012, where someone with dementia killed themselves or someone else with assistance of a firearm. Often, the shooter suffered from confusion, paranoia, delusion or aggression, frequently associated with dementia. Regrettably, their victims were the people closest to them, including caretakers, spouses and children.

For instance, according to the report, Larry Dillon of West Virginia, upon turning 65, started exhibiting several signs of concerning behavior such as being frightened of intruders entering and burning down his house. In addition, Dillon went to bed at night with a 9 mm semiautomatic Glock pistol in his nightstand.  Consequently, Dillon’s daughter made an appointment with a neurologist. However, it was unfortunately too late. One night, Dillon heard what he thought were people breaking into the house, so he took his Glock and fired bullets into the room where his wife and granddaughter were watching television. Sadly, his wife died, and his granddaughter has experienced horrific trauma witnessing the event. After a medical examination, a diagnosis revealed that Dillon had Lewy body dementia, which manifested itself in warning signs like vivid visual hallucinations.

Statistics and stories like these have caused the American Medication Association to declare gun violence a public health crisis! They have called for common sense reforms like banning assault style weapons and removing guns from those people who pose a high risk for violence.

Fortunately, seventeen states have passed red flag laws, which allow the government to be more proactive to ensure that firearms are not in the possession of individuals who are determined by the court to be a risk to themselves or other people. Many times, the court is alerted to concerning behavior because of friends or family of the individual. Recently, red flag laws having been gaining traction throughout the country, with 12 states having passed legislation since the tragic shooting at Marjory Stoneman Douglas High School in Florida. Obviously, further action is desperately required.  Presently, Senators Richard Blumenthal (D-Conn.) and Lindsey Graham (R-S.C.) have advocated for a federal red flag law that would provide financial resources to states that choose to implement the policy.  However, predictably, this legislation, along with countless other gun control efforts, has stalled, with the White House and too many members of Congress woefully neglecting their responsibilities by failing to pass common sense gun violence laws.  Until the federal government can govern on this matter, I hope the remaining 33 states pass their own red flag statutes to curb the epidemic of gun violence.   
What makes the federal government’s inaction on this matter even more disappointing is that there is overwhelming public support.  In 2017, the Pew Research Center indicated that 89 percent of the United States supports regulating firearm purchases to people with mental illnesses. Politically, this sounds like a slam dunk. However, to the surprise of nobody, we still don’t have red flag laws on the books that govern the entire country. 

So what’s the holdup?  For starters, gun advocate groups have been a major roadblock to responsible gun safety legislation.  These groups argue that red flag laws allow the government to take away firearms from citizens who have yet to commit a crime. Kaiser Health News and PBS NewsHour reported that Dr. Arthur Przebinda from the group Doctors for Responsible Gun Ownership “balks at any formal assessment of firearm use among people with dementia, saying it could lead to “a totalitarian system that decides when you can have rights and when you cannot.”

Dr. Przebinda is taking an absolutist stance on a law which could save lives.  Exactly what is his argument? Everyone can own a gun? I hope everyone accepts that young children shouldn’t own guns because they don’t have the appropriate cognitive abilities. So why would we accept adults with limited cognitive abilities be allowed to own a gun?  It’s absurd to argue that we should wait for people to die before taking proactive measures regarding an individual’s firearms, if they show clear signs of dangerous behavior. Let me be clear, I am not arguing for the confiscation of everyone’s guns. I am advocating for a process which respects due process and gets firearms out of the hands of someone the government believes doesn’t have the mental capacity to own a gun. Is that such an unreasonable position? Taken one step further, I can’t falsely yell “fire” in a crowded theatre because it puts people’s safety into danger, so why should someone who exhibits behavior that threatens themselves or other people be allowed to own a gun? I will take my chances we won’t spiral into a totalitarian government.

Florida is one of the states which has enacted red flag laws and Kendra Parris, a local attorney, has represented individuals in court who are at risk of losing their guns.  Parris told the Pew Charitable Trust in regard to due process and red flag laws,  “Rather than find clear and convincing evidence, [courts are] basically saying, ‘Better safe than sorry.”  I find Parris’ observations fantastic news! No gun owner should lose their property without due process. However, let’s neutralize any potential danger, and then the court can rule on the matter. Around 40,000 people die a year from gun violence. I can sleep at night having the court securing everyone’s safety and applying due process second.  

Organizations like the National Rifle Association (NRA) have argued that households that have firearms and people with dementia can safely secure their gun with trigger locks and gun safes.  However, the Alzheimer’s Association believes the NRA’s recommendations don’t go far enough, because people with dementia will still believe they are in danger and look for ways to crack safety precautions. The organization suggests the best way to protect your family is to not have the gun in your home.

So in the absence of further laws, what can people do? Well, the good news is that there is momentum in the medical community to help stop gun deaths.  In 2017, after the Las Vegas shooting that left 58 people dead, over 1,300 health care providers promised to start talking with their patients about guns when certain risk factors are identified. In addition, the Veterans Health Administration and Alzheimer’s Association both suggest asking about firearms when evaluating a patient for dementia. However, the medical community has been too limited for years because the Center for Disease Control (CDC) was basically unable to do gun violence research. Regarding the past twenty years, Giffords: The Courage to Fight Gun Violence’s (an organization led by former Congresswoman Gabby Giffords) website states, “In 1996 Congress took away dedicated federal funding for gun violence research from the CDC. For more than 20 years, federal investment in gun violence research has remained virtually absent at the nation’s primary health protection agency, despite gun deaths increasing for the past three years in a row to levels not seen in decades.” Fortunately, Congress, in the last government spending bill, finally appropriated $25 million to study gun violence.
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As we look to the future, the University of Colorado School of Medicine predicts by 2050,  8 to 12 million people will live in the U.S. who suffer from dementia and own a gun. As a country, we can’t be afraid to pass basic common sense gun violence legislation that could save countless lives. Congress and the White House must find the political courage to stand up to outside influences that believe common sense gun reform legislation is by definition against the Second Amendment. Until that day, hopefully, the individual states can lead the charge to ensure a safer America.