Document Type
Article
Publication Title
Elder Law Journal
Abstract
I examine how the United States finances elder care, arguing that the legal processes structuring elder care tend to widen economic inequality and divide the interests of lower-income people against each other along generational, gendered, and racialized lines. I begin with two case narratives drawn from my practice experience as a poverty lawyer for older adults. One narrative involves an elder homeowner, while the other involves an elder renter. Both face crises of unmet care needs, the threat of homelessness, and ultimately the outcome that many older people dread most: institutionalization in a nursing home. I use these narratives as a jumping off point to explain how lower-income elders become, effectively, commodities for health care and housing entities to extract profit from.
I argue these stories are not exceptional, but typical, because they play out the logic of legal processes governing elder care. I examine the increasing privatization of Medicare, especially focusing on how Medicare Advantage plans convert age-related subsidies into profit, at an unjustifiable cost to elders, their caregivers, and taxpayers. Regarding elder homeowners in particular, I show how Medicaid law sets up a race between for-profit actors in the long-term care industry, on the one hand, and elders’ potential heirs, on the other, to see who can seize elders’ home equity before the other does. And regarding elder renters, I examine how even older people without assets present valuable age-related revenue streams for the housing and long-term care industries to extract.
Lastly, I consider proposed legal reforms and find none of them satisfying, arguing the crisis of elder care in our increasingly unequal society requires transformation of underlying social conditions, rather than superficial reforms. However, using the framework of “non-reformist reforms,” I ultimately argue for a strategy of struggling for incremental reforms to help build solidarity and power among oppressed classes and point the way toward an end goal of decommodified housing and health care.
Publication Date
2-2025
Recommended Citation
Andrew Milne, Silver Tsunami or Silver Rush? Extracting Value from Elders, Forthcoming, Elder Law Journal.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
