Baby boomers are the generation that invented staying forever young — and that means never losing any of their mental sharpness. As they reach retirement age, however, that belief seems increasingly hard to sustain. Patricia Marx, a regular contributor to The New Yorker who specializes in funny, first-person journalism, decided to take this problem on. In her latest book, Let's Be Less Stupid, she investigates the proliferation of mind-sharpening techniques, including having her brain electrically zapped, learning Cherokee, and playing piano scales for hours. And the results were…mixed.

Kurt Andersen: There are so many different products and schemes to help you keep your wits. How did you decide which ones you were going to do?

Patricia Marx: I made a list of as many as I could, and they ranged from things like "learn a language" to "eat sensibly" to "take naps" to "turn all the photos on your desk upside down." I did as many as I could tolerate. I didn’t eat legumes, and I didn’t take naps…boy, science likes naps. I’m really sorry, because I have not slept my whole life and it turns out to be a bad thing.

Of all these things you did, how effective did they seem?

I’m not a scientist, so I really have no idea. Before and after, I had my IQ taken and I had my brain imaged. They were very gleeful about how much my brain had improved and how much bigger certain areas were. I told my boyfriend, very proudly, that my brain was 33 percent bigger in many areas, and he said, "If that was so, then your brain would be oozing out of your nose, eyes, and ears" — and you can see that it’s not. The thing about MRI and fMRI is they lead us to believe they know a lot more about the brain than they do.

You started out doing humor at the Harvard Lampoon, and you were the first woman elected to the Lampoon. How much of your experience was a gendered thing?

It wasn’t, and I felt that it shouldn’t be. It’s just not the primary way I identify myself. I didn’t really know there weren’t girls on the Lampoon before. I just knocked on the door and said I’d like to sign up.

You went on to be a writer at Saturday Night Live for a couple of seasons. Did that feel more like a boys’ club?

It just felt like overnight camp. Even though people were complaining, as they do at a comedy job, I was thinking, “Please make us work on Sunday.” Just the fact that they had pizza and Diet Coke at three in the morning was so much fun to me. And, like at the Lampoon, people were just hilarious. Maybe that’s why I tend to write funny. I came to think that being funny was the most important thing in the world.

More than 4,000 of you took us up on testing your hearing with the Mimi Hearing Test app — which is remarkable, considering the national stigma surrounding hearing loss. That may be why many American adults have not been tested. 

But mobile technology like Mimi has increasingly made it possible for people to find out about their hearing ability. The challenge is that we can now access a form of health data without a medical professional to help interpret it. 

So we brought some questions you've raised about your hearing results to Dr. Lawrence Lustig, professor and chair at Columbia University Medical Center's Department of Otolaryngology. You might remember him from our episode on deaf composer Jay Zimmerman.

How much hearing loss is natural and nothing to worry about? Average adults will naturally be unable to hear very high pitched sounds (above 8000 Hz) that young children can. Is there a good rule of thumb?

That is a tough question. There's no absolute or bright line. If you were a military veteran and were exposed to loud explosives, you probably have experienced some amount of hearing loss and the cause was clearly identifiable. It’s not that the hearing loss can be ignored, but one can be reasonably certain it doesn’t represent something like a tumor or infection causing the hearing loss. 

But if you're young, under 40, and notice hearing loss affecting your day-to-day, that should be checked out as soon as possible. 

Hearing loss above 8000 Hz is not a huge deal since a majority of the speech frequencies are between 500 and 2000 Hz. In general, high tones are lost first, and female and children's voices are higher pitched, and thus these are the voices that people with hearing loss generally have a harder time hearing.

For a lot of people, a moderate loss is manageable, if all they have to do is turn up the volume on the TV. However, those same people could have difficulty in a noisy background, at a restaurant, dinner table with family, or in a meeting at work. In the end, any hearing loss that affects your day-to-day life should be evaluated by a professional.

What are the risks of leaving your hearing loss untreated?

There is no inherent 'risk' of leaving your hearing untreated, barring such instances such as getting hit by a car or bus because you didn't hear it coming and you weren't paying attention!

But keep in mind that hearing loss is a form of brain deprivation, at least for someone who had hearing for most of their adult life (for the born-deaf, their other senses are amplified). If you wait too long, say decades, it becomes harder to address because the parts of your brain that would process that sound don't work as well.

In addition, there are some causes of hearing loss that need to be investigated to be sure there is not an underlying condition causing the loss, such as a tumor at the base of the brain, an infection, or other disease. Thus all forms of hearing loss should really be evaluated by a professional to be sure there are no underlying causes that need to be treated. In particular, hearing loss in only one ear, definitely needs to be looked at because it could be the result of a treatable infection. Similarly, sudden cases of hearing loss should be evaluated as soon as possible.

What can be done about tinnitus?

There's no magic pill to make it go away. Usually people have tinnitus in association with hearing loss, but they don't necessarily go together. We have only a crude understanding of the cause of tinnitus. There's some evidence that it starts in the ear and sets up in the brain stem. The lack of animal models is the part of the challenge in addressing the condition. You can't ask a lab mouse, do you have tinnitus?

We have some anatomical correlates of brain scans of what tinnitus looks like, but we're not 100% sure those relationships are accurate. That being said, there are a number of treatments, each with varying degrees of success, depending on the individual, including the use of tinnitus maskers, use of hearing aids for those that already have hearing loss, and retraining therapy with sound. 

A few people have written to us about bad experiences with hearing aids - they were expensive and didn't work in all environments. Is that changing?

Hearing aids are getting better all the time. They are still not perfect: they cause trouble with feedback, with the 'occlusion effect' (sensation of something plugging the ear), and the challenges of amplifying not just what you want to hear but also what you don't want to hear. However, newer processing algorithms and directional microphones are making them better for amplifying what you want amplified while suppressing background noises. Smaller devices and better ear inserts are also improving the cosmetics and ear-plugging factor, and some now even come with tinnitus suppression software. Advances will continue to occur in the industry.

For less serious hearing loss there are many cheaper options such as smartphone apps or Bluetooth devices that can amplify voices in challenging environments, like noisy restaurants.  

If you suspect that someone you know has hearing loss, what are some strategies for getting that person to seek help?

The best thing is to be upfront and non-judgmental. We tell people if we think they are losing weight, or look pale, or have vision troubles, and most are thankful for that feedback (well, maybe not the weight comment). If you think someone has hearing loss, let them know it's affecting their ability to interact, and also let them know the field is advancing and there are many new treatment options available that were not available even a couple years ago. In the end, the most important thing is to get people hearing again and not feel ashamed they have a hearing loss. For some reason, no one is embarrassed or ashamed to wear glasses! So why is there a stigma associated with hearing aids? There shouldn't be. We should all be accepting of this like any other medical condition. 

Roger Angell, a senior editor and staff writer, has contributed to The New Yorker since 1944 and was inducted into the Baseball Hall of Fame last year, for his writing on the sport. This year, he won a National Magazine Award for his essay “This Old Man,” about aging, loss, and love. Angell spoke with David Remnick about writing in his tenth decade.

Produced by Jill Du Boff. 

While we sweat it out at spin class in the name of good health, the world’s oldest people drink whiskey, eat bacon, and chug Miller High Lifes with a side of Johnny Walker Blue.

At least those are the life secrets we love to hear when we talk about supercentenarians — the exclusive group of people who live to be at least 110 years old. But the science is not that simple, and the lives of these super-survivors are proof.

The oldest person recorded in history, a French woman named Jeanne Calment, lived to be 122 years old. Calment, who was born in 1875, lived a fairly easy, stress-free existence, according to Jean-Marie Robine, a French demographer who met her and studied the last years of her life.

But the more significant marker of her longevity, he believes, is her direct ancestors who lived, on average, 22 years longer than expected. “So definitely, the gene pool [was] exceptional,” he said.

Tom Perls, a physician and researcher who runs the New England Centenarian Study, has studied about 150 supercentenarians. He agrees: living an extremely long life probably has to do more with your DNA than what you drink.

“It’s many complicated pathways that feed into what determines your rate of aging and your risk for age related diseases,” Perls said.

Today, the oldest known living person in the world is a woman in Brooklyn, New York, and lives a fairly quiet life. At 116 years old, Susannah Mushatt Jones has watched the world go form streetcars to hoverboards; from President William McKinley to President Barack Obama, who is framed in a picture on her wall.

Last July, she celebrated her birthday in style with the Brooklyn Nets, local politicians and a gigantic cake topped with (frosting) bacon, a food she eats every day because her doctor says, “why not?”

But she doesn’t talk as much as she used to, and spends most of her days with caretakers and family in Brooklyn — waking up to a big plate of grits, eggs and bacon every morning.

And she knows better than to credit the bacon for her extraordinary life.

“I have no secret,” she said in a video two years ago. “I just live with my family. My family makes me happy.”

Before journalist Lesley Stahl joined 60 Minutes, she became the first woman to serve as CBS News' White House Correspondent. Her coverage of news, political leaders and stories has taken her around the globe. Her latest investigation looks into the science of grandparenting. In  Becoming Grandma: The Joys and the Science of the New Grandparenting Stahl reflects on her own experiences as a grandmother, and interviews friends and experts to understand how grandmotherhood affects women. 

Event: Lesley Stahl will be in conversation with Tom Brokaw at the 92nd Y (Lexington Avenue at 92nd Street) on Wednesday, April 13th at 7:30 p.m. She'll be signing books after the discussion. 

Check our Lesley Stahl's Guest Picks!

What have you read or seen over the past year that moved or surprised you?

I’m just finishing Anna Quindlen’s new novel, Miller’s Village– a novel that seeps into your pores, gorgeously written. Wise. Addictive.

What are you listening to right now?

 Wait, Wait... Don’t Tell Me!

What’s the last great book you read?

I loved Jon Meacham’s book on George Bush the first. I’ve thought for a while that he was due for some revisionism.

What’s one thing you’re a fan of that people might not expect?

Banjos!

What’s your favorite comfort food?

French fries – Ketchup! Extra salt!

Dana Spiotta joins Deborah Treisman to read and discuss Joy Williams’s “Chicken Hill,” from a 2015 issue of the magazine.

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JUDY WOODRUFF: A new report due out later this week from the National Institute on Early Education Research finds that a number of states are struggling to find ways to improve access to high quality pre-kindergarten.

Tonight, we look at a unique approach taken by a preschool in Seattle, Washington. It’s giving children life lessons that go beyond the classroom, and providing a unique opportunity to seniors.

Special correspondent Cat Wise has our report. It’s part of our Making the Grade series on education that airs every Tuesdays.

MARY MCGOVERN, Resident, Providence Mount St. Vincent: What do you see?

CHILD: A brown bear.

CHILD: A brown bear.

CAT WISE: Mary McGovern is 95 years old, and one of her favorite things to do is read to toddlers.

MARY MCGOVERN: And what is that? A bird.

CHILD: A bird.

MARY MCGOVERN: A bird. What color is the bird?

CHILDREN: Red.

MARY MCGOVERN: Red. Everybody knows that.

CAT WISE: Luckily for Mary, she doesn’t need to go any further than down the hall to find her young friends.

MARY MCGOVERN: Oh, see, look in here is the little kids in there.

CAT WISE: Oh, yes.

McGovern lives at Providence Mount St. Vincent, a nursing home in Seattle, Washington, that also houses a day care for children up to 5 years of age.

WOMAN: Thank you, honey. Thank you. There you go. Thank you very much.

CAT WISE: Every weekday, 500 residents are joined by 125 children in the facility affectionately called The Mount.

MAN: Peekaboo.

WOMAN: Peekaboo.

MAN: I see you.

Administrator Charlene Boyd:

CHARLENE BOYD, Administrator, Providence Mount St. Vincent: We wanted to create a place for people to come to live, and not come to die.

CAT WISE: So, in 1991, Boyd and other administrators added a high-quality preschool to the nursing home and created an intergenerational learning center, a community for the very old and very young.

Why is there is this railing here?

CHARLENE BOYD: This railing is here not for the kids, but it’s here for residents. And it’s a safety piece for a resident in a wheelchair to push themselves up and to hold on and to bring themselves to a standing position and watch the children through the window.

CAT WISE: So, they can stand here and look in?

CHARLENE BOYD: They can stand here and look in.

It’s putting high-quality child care in a setting that link old and young together, making the magic between these two ages together, bringing joy to the residents and joy to those young children. It’s just like this magical formula that happens every day.

WOMAN: Can I get a high-five? There. He knows how to do a high-five.

MARY MCGOVERN: Most of them, they’re curious about me. Why are you here? I tell them I’m here because, when I was living in my house, when I got too old, I wasn’t always walking straight, and sometimes I would fall. And if fell, I had to have some help to get up, because I couldn’t get off the floor.

I want to hug your baby doll.

MAUREEN MCGOVERN, Mary McGovern’s Daughter: I think there are things that both parties take away from the interactions. It’s not like a lifelong relationship, but just for that moment in time, they’re both enjoying each other’s company, and getting something out of their relationship with that person in that moment.

MARY MCGOVERN: Give me a hug. Come on.

CHARLENE BOYD: All of us have common needs to be recognized. All of us have common needs to be loved, and all of us have common needs to share life together. And so these children bring life and vibrancy and normalcy. It’s a gift. It’s a gift in exposing young families to positive aspects of aging, and it’s a gift of also having children seeing frailty, normalcy and that’s part of that full circle of life.

(SINGING)

CAT WISE: Intergenerational activities can be spontaneous or planned, like this sing-a-long.

MARIE HOOVER, Intergenerational Learning Center: There’s 36 visit possible each week, so each classroom, six classrooms, has at least three visits, up to six visits.

CAT WISE: The director of the center, Marie Hoover, says children become comfortable with elderly residents at an early age.

MARIE HOOVER: Whether they’re in a wheelchair, or in a walker, or maybe they’re hard to understand, or you have to speak louder, it is just about who that individual is, and they adjust. The kids just don’t — they really don’t blink an eye. This is normal. This is just who this resident is.

CAT WISE: Ninety-three-year-old Harriet Thompson joined this sing-a-long on her way to the dining hall.

HARRIET THOMPSON, Resident, Providence Mount St. Vincent: I usually like to go sit down for a while before dinner, but I heard them singing, so in, we went.

CAT WISE: What do you experience internally when you’re around these children?

HARRIET THOMPSON: Happiness, just plain old happiness. You know, yes, it beats anything else. Beats television.

CHARLENE BOYD: Boredom and loneliness at sort of the plagues of older adults. There’s nothing more delightful than seeing young children with noise, with laughter. You see the residents, and they hear the sound of the kids coming down the hall, and it’s as though sunlight just came through the window.

HARRIET THOMPSON: I’m a great-great-grandmother, but they’re in another town. I can’t hold my own little girl because she’s far away. And so this is what makes me happy. You get to know them, and watch them, and act silly with them. And it’s good to feel like you’re 3 years old again.

CAT WISE: Teachers see similarities in the ways these two very different age groups communicate.

MARIE HOOVER: The brain of a toddler, and as somebody is beginning to have, you know, some signs of dementia, the brains are similar, and their development, or their decline, is similar.

CAT WISE: That was apparent in this art class, where resident John Goss, a retired surgeon, and 5-year-old William Kraynek (ph) teamed up as painting partners.

JOHN GOSS, Resident, Providence Mount St. Vincent: This is a junk brush?

CHILD: A giant.

JOHN GOSS: Giant, yes.

He’s operating on my plain, and I’m operating on his plain, and so we have an attachment. He helped me, and we were working together.

CHILD: I used blue, and he used blue, and I used green, and he used green.

JOHN GOSS: It’s wonderfully fun, because things come out of your hand, rather than your mouth.

MARIE HOOVER: The kids are certainly of that age where this there isn’t this sense of, oh, that’s weird or something to be scared of, and I think that’s happening on both sides of the age.

CHILD: What’s your name?

ANNIE CARTER, Resident, Providence Mount St. Vincent: Annie Carter.

CAT WISE: Later the same day, William Kraynek visited the skilled nursing section of The Mount to help make sandwiches for the homeless.

CHILD: I had three sandwiches.

ANNIE CARTER: Oh, I see.

CAT WISE: Here, William partnered with 92-year-old Annie Carter.

ANNIE CARTER: We just talk about our work, just like anybody else on a job. That’s our job, so we have to do the right thing.

WOMAN: This is Alex.

Hi, Alex.

MAN: How you doing?

WOMAN: Hi.

CAT WISE: How do the children deal with difficult situations, like a resident that might be declining or even death? How do the children deal with those situations?

MARIE HOOVER: Developmentally, it’s not really something they can conceptualize. Even our oldest kids, at 5, kids don’t quite get that whole death concept.

If the kids bring that up to the teachers, then the teacher’s response is going to be, I miss Mary too. What’s your favorite memory about what she did?

And those are the kinds of things they’re going to focus in on, as opposed to somebody died. They’re just not quite ready to get that concept.

CAT WISE: Child care at The Mount is competitively priced with similar high quality preschools in the area. Currently, 400 families are on the wait list.

Administrators believe The Mount’s model can be replicated across the country, and they expect interest to peak this summer, when a documentary featuring their work called “Present Perfect” is released.

For the “PBS NewsHour,” I’m Cat Wise in Seattle.

PBS NewsHour education coverage is part of American Graduate: Let’s Make it Happen, a public media initiative made possible by the Corporation for Public Broadcasting.

The post What happens when a nursing home and a day care center share a roof? appeared first on PBS NewsHour.

Pulitzer Prize-winning author and physician Siddhartha Mukherjee traces the history of genetics and heredity in his new book The Gene: An Intimate History. Former New York Times Magazine editor Gerald Mazorati details his journey to compete on the national circuit as age 60 in Late to the Ball. New Yorker staff writer and Harvard historian Jill Lepore embarked on a quest to uncover the truth behind the eccentric modernist writer Joe Gould in her new book Joe Gould's Teeth. 

Former New York Times Magazine editor Gerald Marzorati took up tennis in his mid-50s. In Late to the Ball: Age. Learn. Fight. Love. Play Tennis. Win., he details his journey to compete on the national circuit at age 60. Finding himself in a difficult spot in life — past middle-aged, but still not “old”— he explains why he set this goal and how he set off to make it a reality. 

Event: Gerald Marzorati will be signing, reading from his book and in conversation with Roger Angell at The Corner Bookstore (1313 Madison Avenue and 93rd) on Tuesday, May 17th at 6 p.m.  

Click on the 'Listen' button above to hear this interview.

Yesterday in Chicago, Vice President Joe Biden spoke to one of the largest annual meetings of cancer researchers in the world, and he urged them to work together.

"You're spending hundreds of millions of dollars. Imagine, imagine if it was coordinated,” the vice president said.

That is the mission that President Obama gave the vice president in January, when he announced the cancer "moonshot." Biden was in Chicago to promote a new database of genomic and clinical cancer patient data that will allow researchers to access more data than ever before. The hope is to identify patterns in how patients with different cancers respond to treatments to tailor future interventions more precisely.

But whether it is cancer or heart disease, a stroke or diabetes, the greatest risk factor for the developed world's most deadly diseases is age. So researchers like Matt Kaeberlein, who is co-director of the University of Washington's Nathan Shock Center of Excellence in the Basic Biology of Aging, are trying to slow down the aging process itself.

Here, The Takeaway speaks to Dr. Kaeberlein about his recent study that found certain drugs delayed aging in lab animals.

86-year-old Joy Bergman is struggling to keep her life under control. She’s single-handedly caring for her husband who’s suffering from Alzheimer’s – plus she’s trying to hang onto her job as a museum conservator despite her bewilderment with modern technology – and, above all, she’s hiding the severity of her problems so that her adult children won’t worry about her – or worse – try to take control. Joy is the heroine of the 10th novel by Cathleen Schine, They May Not Mean To, But They Do. 

Event: Cathleen Schine will be giving a reading at the Barnes and Nobles, Upper West Side (82nd & Broadway) at 7:00 p.m. She will also be in conversation with Meg Wolitzer.

Aging has evolved over millions of years to prevent an ecological crisis. In Cracking the Aging Code: The New Science of Growing Old-And What It Means for Staying Young  theoretical biologist Josh Mitteldorf reveals the newly discovered complexity behind evolution and aging, and why aging and death are crucial to the survival of the human race.

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JUDY WOODRUFF: The American middle class is shrinking and struggling. The six-year-long economic recovery is showing some signs of slowing. And the pronounced wealth divide in the U.S. may get worse without bigger steps.

That warning was part of a new report issued today about the U.S. economy by the International Monetary Fund.

I sat down with its managing director, Christine Lagarde, at IMF headquarters here in Washington earlier today to hear more of her concerns about what’s happening to the middle class and the poor, and what could be done about it.

Managing Director Christine Lagarde, thank you for talking with us.

CHRISTINE LAGARDE, Managing Director, International Monetary Fund: Pleasure.

JUDY WOODRUFF: So, this latest report from the IMF looks at the American economy, says it is in good shape overall, shows resiliency, but then it goes on to point out a number of factors that provide concern for the future.

And one of them has to do with the shrinkage of the American middle class. What do you and your colleagues see, and what concerns you?

CHRISTINE LAGARDE: We are seeing a shrinking of the middle class.

If you look at the size of the middle class in 1975, it was roughly 60 percent of total population. If you look at the middle class today, it is about 50 percent. So, that’s a significant decline of the middle class. And it is an economic issue, because the middle class has always been the consumption force of this nation.

The upper class doesn’t spend as much. The lower class doesn’t have as much to spend. So, the maximum impact in terms of consumption is generated by the middle class.

JUDY WOODRUFF: What’s happening here? You also write in the report your concern about the so-called labor force participation rate, the number of people who are actually working.

And we know that there is concern about the number of men and women who are able to find a job. What do you see there?

CHRISTINE LAGARDE: What we are seeing is something that affects us all, which is aging.

The U.S. population is aging, like in other economies of the world, and, as a result, the participation of active workers in the economy is declining. Now, we cannot stop the course of time, but what policies can do is encourage people who are not joining the workplace, the job market, to actually do so.

And I would point to a couple of policies. One is support given to women. And, by that, I mean maternity leave policy that would help them face the decision of, do I stay or do I go? Second, child care support, and not just child actually, but the kind of support that would help families look after a child or look after an elderly, because, with aging, we will have to support more parents or grandparents.

JUDY WOODRUFF: And you’re describing a real squeeze on the middle class in this country.

CHRISTINE LAGARDE: Yes, there is that squeeze. And that’s where you head in the directions of people feeling insecure, people not wanting to move from one job to the other, people not spending as much as they would otherwise do.

Those behaviors, those decisions have an economic impact on our growth.

JUDY WOODRUFF: Help us understand, what’s the connection with the overall economy?

CHRISTINE LAGARDE: Well, the major engine for growth in this country and in quite a few advanced economies as well is typically consumption.

When the U.S. consumer consumes, there is demand, more demand, and, therefore, the U.S. manufacturers must manufacture more. If they have to manufacture more, they have to create more jobs. It’s a fairly simple virtuous circle that is generally initiated by consumption.

JUDY WOODRUFF: A number of remedies you lay out would cost money. They would require action by the Congress at a time when this country is very politically polarized. How realistic do you think your recommendations are at a time like this?

CHRISTINE LAGARDE: I see one area where there is some agreement.

And that’s on the Earned Income Tax Credit, which, if combined with the minimum wage increase, would certainly bring people up and would boost consumption. So, on the Earned Income Tax Credit, there seems to be common ground.

I hope we can find many of those small-ticket items which will push the envelope further and increase growth in the U.S.

JUDY WOODRUFF: And if these remedies that you lay out are not enacted, what’s your concern for the future of the economy?

CHRISTINE LAGARDE: You know, if those issues such as low participation in the labor force, increased poverty, reduced productivity and polarization in terms of income are not addressed, then the U.S. economy will face what I have called this new mediocre, where potential growth is lower, there is growth, there is a degree of recovery, but not sufficiently to bring people out of those poverty levels that we talked about, not enough to increase the middle class, and not enough to address the unemployment of those who are still looking for jobs.

But those forces, poverty, participation, productivity, and polarization of income, are there to stay unless they are addressed.

JUDY WOODRUFF: Finally, a different question.

Voters go to the polls tomorrow in Great Britain to say one way or another whether their country should leave the European Union. You have been clear. You have made public statements about how you think this, if it happens, would be harmful to Great Britain, to other parts of the world.

How do you see the effect on the United States if there is a vote to leave, Brexit, to leave the European Union?

CHRISTINE LAGARDE: Well, if the U.K. decided to leave the European Union, there would be some effect on the U.S. economy. How big that effect would be, difficult to say.

There are two channels of communication of uncertainty and lack of demand. One is through trade, less trade between the U.S. and the U.K. most likely. But it’s not a huge volume. So that impact would be relatively low.

However, on the financial front, because of the role played by London as a financial center, because of the potential impact on volatility, on the anxiety of people who then sort of fly to — fly their money to safe havens, then there could be a significant impact on the U.S. economy.

JUDY WOODRUFF: So, Americans should be watching closely?

CHRISTINE LAGARDE: I think we should all be watching closely, yes. And I hope the right decision is made, but it’s for the U.K. people to decide.

JUDY WOODRUFF: Christine Lagarde, the managing director of the IMF, thank you very much.

CHRISTINE LAGARDE: Thank you, Judy.

The post Sobering IMF report on U.S. economy cites dwindling middle class, growing income equality appeared first on PBS NewsHour.

Medicare is prevented by law from negotiating with drug companies over their prices. In recent years, the price tag for people who must take expensive new drugs has risen at an alarming rate, writes aging expert Phil Moeller. Credit: Flickr user ep_jhu

Editor’s Note: Journalist Philip Moeller, who writes widely on aging and retirement, is here to provide the answers you need in “Ask Phil.” Send your questions to Phil.

Marcy – Ill.: Is there anything I can do about prohibitively expensive medications I will need to take for the rest of my life?  I take three medicines with no generic alternative. My doctor told me that they were “covered” by Medicare. Now, I’ve come to find out that even on the most comprehensive and expensive drug plans, I will pay more than $1,000 a month just for the drugs, not for the premiums or any other Medicare expenses. I have some resources, but this will deplete them in a few years.  I am not poor enough to qualify for assistance, but soon will be. I know now I should have done more research on what my doctor told me and perhaps worked until I died or was fired, so I could stay on employer insurance, but that bridge is burned, and I surely will never get another job with benefits. Is there any relief for astronomical drug costs?

Phil Moeller: Marcy, I’m so sorry to learn that you have been victim of another of Medicare’s major gotchas. Medicare is prevented by law from negotiating with drug companies over their prices. This was a pro-business feature of the 2003 law that created Medicare’s Part D prescription drug insurance program. We have been paying for it ever since, and the price tag has risen at an alarming rate in recent years for people who must take expensive new drugs. Miracles or not, they can devastate personal and family finances. Even the prices of some generics have soared.

READ MORE: Medicare’s catastrophic drug insurance can be a catastrophe for consumers

Having said this, I wonder if you’ve factored in the effect of Part D’s coverage of drugs in the so-called “catastrophic” tier of the program? Once you and your Medicare insurer have paid a total of $3,310 for drugs this year, you will enter the so-called donut hole and will need to shoulder a greater share of drug expenses until your out-of-pocket spending has hit $4,850. At this point, you will have entered the catastrophic tier of your coverage. In this tier, you need to pay only a few dollars for each prescription or 5 percent, whichever amount is greater. Now, 5 percent of a big number can still be a hefty amount. But I doubt that it will total $1,000 a month.

If you need help calculating your Part D costs, get in touch with the State Health Insurance Assistance Program or the Medicare Rights Center. Please let me know how things turn out. If your costs are still going to average $1,000 a month, there may be some other private prescription support programs available to you. Let me know, and I’ll provide information about them.

Mary – Ill.: I am turning 66 in August. Several months after I turned 65, I discovered I “had to” file for Medicare Part A at age 65. So I did about six months after I turned 65. But since I was still working and had no plans to retire until I was 66, I continued my health savings account contributions. Now, I find out what I did was illegal, and I am liable for tax fines on the HSA contributions. Our human resources manager never mentioned this conflict, which annoys me. Can I rescind this or fix it? I have since retired, two months prior to reaching my full retirement age of 66. But I have not filed for Social Security or any other part of Medicare. If I can’t rescind or fix this, can my penalty only be for the months after I filed and not retroactive to August 2015? I read you can withdraw from Part A, but also read that that could jeopardize my Medicare and benefits for life. HELP!

Phil Moeller: Mary, you have been ensnared in a nasty Medicare gotcha. First off, there was no requirement that you file for Part A when you turned 65. Whoever told you this was wrong. So long as you have active health insurance from your employer, you did not have to file for any part of Medicare at age 65 (or at any older age, for that matter). Now, I advise folks without an HSA that getting Part A at 65 is a good idea. Anyone with enough earnings to qualify for Social Security (either directly or as a spouse or even former spouse of a qualified person) can get Part A without paying any premium. Should they need hospital care, which is what Part A covers, some expenses their private health insurance does not fully cover can be picked up by Part A. It thus can help and should never cost the person more money than not having the coverage.

However, as prior Ask Phil pieces have explained, having Part A is regarded as being on Medicare, and folks on Medicare are disqualified from participating in a tax-favored HSA plan. Continuing to make such contributions is, as you note, not only disallowed, but can also expose you to tax penalties. In fact, in a rule only a crystal ball seer could love, you must stop such contributions six months before your HSA eligibility expires!

In theory, you could rescind your Part A election and continue participating in the HSA. But since you have retired, I fear getting the timing right would be a nightmare. You would need to suspend Part A up to but no later than your effective Medicare coverage date. You have several months to enroll in Medicare following your retirement and the end of your employer health insurance. But timing this too closely risks having no health insurance at all for a short period, so I think people should enroll in Medicare as soon as they need to and not risk exposing themselves to an uninsured health event.

READ MORE: Should you stay on your employer health insurance or get Medicare?

I’d call a Medicare counselor, at the State Health Insurance Assistance Program or the Medicare Rights Center. See if someone can help you. However, while I believe you have the right to avoid an IRS penalty here, I’m afraid that in the real world you might be better off just paying the penalty and moving on. I know. I’m never supposed to admit defeat and should always argue that consumers need to stand up for their rights. Sadly, you are dealing with Social Security, Medicare and the IRS here. Don Quixote’s task was simple by comparison. Good luck, and please let me know how you fare.

Anonymous – Fla.: I live on my Social Security retirement income and am now getting $555 a month. That’s the only income I have. My medical coverage now is through the city of Jacksonville, since I live below the poverty level. I get Medicare next year when I reach 65. Will I have to pay anything out of my Social Security payments to Medicare?

Phil Moeller: You should call a SHIP counselor in Florida and find out how Medicare’s lower-income support programs for your area compare with the help you now get from Jacksonville. My first take is that you should not have to pay for Medicare if your only income is that monthly $555 Social Security payment. But you are smart to plan ahead, and counselors should be able to help you.

Sue – Pa.: I am 64 and will be 65 in January. My husband carries medical insurance for us through his work. My husband is 62. Do I have to sign up for Medicare? Would it be advantageous to do so? How would I sign up if I had to? Thank you. This is all very confusing.  My home mailbox is always getting Medicare notices.

Phil Moeller: Yes, it certainly can be confusing. When a friend of mine was nearing his 65th birthday, his mail from Medicare insurers literally filed up a grocery bag! Look at my answer above to Mary’s question. You need not sign up for Medicare at 65 if you’re still covered by your husband’s health plan. But you might want to get premium-free Part A of Medicare if his health plan does not include a health savings account.

FOLLOWING UP

Nancy – N.J.: I am a New Jersey SHIP (State Health Insurance Assistance Program) counselor and have encountered basically the same problem as the person you wrote about in “Getting trapped in the regulatory morass of Social Security and Medicare.” Our client collected on her ex-husband’s Social Security record. She switched to her own retirement benefit at age 70 and encountered a changed Medicare number, just as in your earlier example. Usually, Medicare will see both numbers, and there will be no problem. But in this case, Social Security somehow cancelled her previous Medicare coverage. Her Medicare Advantage plan thus has been cancelled and this insurer is trying to recover earlier insured payments that it made to providers. She has been working to solve this mistake for nearly five months, including communications with her Medicare Advantage plan, Medicare, the Social Security Administration and her U.S. senator’s office. They say it will be a while longer before matters can be addressed. I am told only the Social Security Administration can fix this and not Medicare. As a SHIP counselor, I have no standing with the Social Security Administration. Your earlier column asked readers to stay tuned for the next chapter of this situation, so I am staying tuned and wonder if you have any solution or ideas?

READ MORE: Getting trapped in the regulatory morass of Social Security and Medicare

Phil Moeller: Nancy is among an understandably large percentage of the human race that does not read and memorize every word that I write. Imagine that! As it turns out, I did provide an update to this situation in a later column. While I do love to drive up my online traffic numbers, I will save Nancy the trouble of searching for this item, which is reproduced here:

I wrote about a financial adviser whose client and her husband had run afoul of both Social Security and Medicare. The government linked their Social Security numbers and the woman’s effort to file and suspend her Social Security somehow led to her losing her Medicare coverage! As the old Ripley’s “Believe It or Not” stories used to say, we can’t make this stuff up, folks.

Her adviser reports that the women’s situation is being straightened out, but that she is still exposed to nearly a month-long period when she will have no Medicare. Let’s pray she remains in good health until her insurance coverage resumes. In the meantime, a Social Security spokeswoman reports that it is not uncommon for two spouses’ Social Security numbers to become linked. Here is what she writes:

In your message, you state that her Medicare is now under her spouse’s Social Security number (SSN). I can confirm this change occurs when a Medicare only entitlement on a SSN converts to a monthly benefit entitlement on a different SSN. However, the start date of entitlement to the Medicare coverage on the old record does not change when it converts to the new SSN.

Additionally, a new health insurance card is issued when an individual status changes. For the card issuance policy and corroboration, see HI 00901.045: Health Insurance Card – Policy and HI 00901.065: Health Insurance Card Issuance.

I include this explanation in full, because A) Social Security has on occasion quibbled with how its comments are translated, and B) you need to see how clearly the agency explains its own rules.

Of course, this response may not help Nancy or her client. So, I will send this item to the Social Security Administration, along with Nancy’s email address, with a request to please expedite this matter. Nancy, if you hear back from these folks, please let me know how things went for your client.

AND YET ANOTHER REQUEST FOR INFORMED GOVERNANCE

The aforementioned SHIP program appears to have once again dodged a wrongheaded effort to kill its $52 million in annual federal spending support. Perhaps SHIP was inadvertently caught in the fiscal crosshairs of conservative lawmakers after bigger game. Whatever its real or perceived sins, however, the program’s retention and even expansion is needed by those older and disabled Americans who must navigate Medicare and its endless gauntlet of complex if not unfathomable rules. SHIP’s funding supports a largely volunteer counseling program that millions of Medicare beneficiaries turn to, often as a last resort, for problems they cannot solve on their own. For now, the program’s annual appropriation appears secure.

I urge and implore congressional leaders to give serious thought to this question: How much healthier and financially better off would the nation be if consumers were more informed about Medicare and equipped with the tools to make better decisions about how to purchase and use it?

The post Is there any relief for astronomical drug costs? appeared first on PBS NewsHour.

Photo by Shannon Stapleton/Reuters

Editor’s Note: Journalist Philip Moeller, who writes widely on aging and retirement, is here to provide the answers you need in “Ask Phil.” Send your questions to Phil.

Lauren – Mass.: For the past three years my income has been $30,000. We have a small cottage that we want to sell. We bought it for $135,000, and we’re selling for $230,000 with a capital gain of $20,000. My husband is not on the deed. I will be 64 in October. What happens to my Medicare benefit?

Phil Moeller: Regardless of changes in your future taxable income, nothing would happen to your Medicare benefit. However, it could be another matter when it comes to how much you pay for that benefit. People who must pay Medicare’s premiums for Part B and Part D — and nearly everyone on Medicare does — face high-income surcharges under what’s called the program’s income-related monthly adjustment amount, also known as IRMAA. The surcharges begin kicking in when a couple’s modified adjusted gross income, or MAGI, exceeds $170,000 a year ($85,000 for a single person). There’s a two-year lag between when you earn the money and when it will affect IRMAA charges. Premiums in 2016, for example, are based on 2014 tax returns. If you file for Medicare when you turn 65 in late 2017, for example, your premiums would be based on your 2015 tax return. Now, it doesn’t appear that your home sale would boost your MAGI enough to trigger these surcharges. But if it did, it would not show up until your 2016 tax return, meaning it would not affect your Medicare premiums until 2018. But as I said, it doesn’t look like your taxable income would jump enough to trigger the surcharges for even a single year.

Jackie – S.C.: I have power of attorney for a person whose nursing home bill is $1,350 per month, with medicine costs of another $175. He only draws $1,338 per month in retirement income. He had additional savings that helped cover costs, but those funds are gone and now he faces eviction. Is there anything we can do to help cover his medicine costs?

Phil Moeller: Yes. I am assuming he is dually eligible for Medicaid and Medicare, because your note did not mention anything about Medicare premiums. Medicaid should help with these drug expenses. However, the income figure you provided may be net of his Medicare premiums. If so, Medicare’s Extra Help program might defray some or even all of the costs of his medications. Call a Medicare counselor with the State Health Insurance Assistance Program in South Carolina, and see what can be done.

Wayne – Wash.: I am age 69 and have Medicare Part A coverage. I thought I could cancel Medicare Part A and legally enroll in my employer’s health savings account program, but I found out I could not unenroll in Part A. The HSA started in 2016. My last contribution was in Apr 2016:

Year to date contribution is $6,696.09.

Year to date distribution is $5,294.33.

Current fair market value of the account is $1,402.29.

My question is how do I “zero” out the account? The HSA has suggested the following: I send them $5,294.33 to cover the distributions and do a withdrawal of $6,696.62 ($5,294.33 + $1,402.29). This will in effect set the account to $0.00 and “close” the account.

The other option I can envision is to withdraw the unspent amount of $1,402.29 (which will close the account) and then just pay the taxes and penalties on the contribution of $6,696.09.

Phil Moeller: I don’t know why you can’t unenroll from Part A. Unless you are already receiving Social Security payments, you can unenroll. However, I’ll assume your reasons are valid.

As for the HSA itself, I see no reason why you should repay all the money that’s been distributed from the plan. Most of these dollars came from you, didn’t they? In my view — and I am not claiming to be an expert here — the only dollars you would need to repay would be the ones the company contributed on your behalf. You would also need to pay back the amount of the tax benefits you claimed on the account. Your HSA should have this information.

While you could face an IRS penalty for improperly claiming the tax benefits in the first place, my experience is that if you take care of this within a tax year and have no improper tax deductions on your 2016 tax return, you will escape a penalty.

The unspent funds are supposed to be used for qualifying medical expenses. So simply withdrawing them yourself may be unwise. Odds are that repaying any company contributions and tax benefits would represent an amount close to or even greater than the balance of unspent funds. So, I’d ask the company if it would back out these amounts from your account balance. If there is a remaining balance of your own, post-tax funds, can the company switch these into whatever health plan you’re now using? Also, would it move some if not all of its HSA contributions into your new insurance plan?

Best of luck, and please let me know how all this turns out. If there are other readers who have faced similar problems, please chime in as well. These HSA “gotchas” have been a major problem for lots of folks.

Ellen – Kan.: I will turn 65 soon, but am still working full time, and because of my husband’s sudden death two years ago, I will still need to work for several years. I have good health insurance with my small consulting company employer. Do I have to file for Medicare?

Peter – Va.: I turned 65 in April, but I am still employed full time and have health coverage through my employer. Should I sign up now for Medicare Part A, or should I wait until I retire and/or I lose health converge?

Betty: I am turning 65 in August. I plan to continue working and keep my high-deductible insurance plan through my employer. I contacted my state’s Office on Aging, and the woman I spoke with (perhaps a volunteer) said that I don’t need to do anything until I retire and switch to Medicare. But I read elsewhere that it is necessary to fill out an application indicating “on the back” that I am declining Medicare at this time. I’ve only seen an online application option, so I don’t know whether or how I need to indicate that I don’t want Medicare this year. My concern is that I don’t want to be hit with a penalty later because of a requirement I wasn’t aware of.

Phil Moeller: So long as you have a valid group employer health plan, you do not have to file for Medicare when you turn 65.

However, if you do not have a high-deductible health plan, you might want to enroll in Part A of Medicare, which covers hospital care. Part A charges no premiums to people who have worked enough to qualify for Social Security benefits. It can come in handy to cover some hospital expenses that are not fully paid by your employer health plan. However, Part A invalidates the use of an HSA health plan.

Also, to Ellen, you are eligible for Social Security survivor benefits. I don’t know if you’ve claimed them, but if not, you might want to do so. If they are less than your own retirement benefits would be at age 70, you should file for them right away. If your husband made a lot of money and your survivor benefit will be larger than your own retirement benefit, I would advise you to wait to file for it until it reaches its maximum value when you turn 66.

Ellen’s follow-up: God bless you for getting back to me so quickly and putting my mind at ease. My husband made less than I do, and I was advised not to claim them when he died two years ago. So if I understand you correctly, I can file for them now and not jeopardize the benefits I get from my wages when I retire? Will the IRS take part of his Social Security benefits if I do opt to get them?

Phil’s follow-up: Yes. You can file for them without jeopardizing your own retirement benefits later. Make sure that the person at Social Security you deal with understands that you are electing to claim only your survivor benefit. Depending on your total income, a portion of your Social Security benefits may be taxed.

The post How selling a home may affect what you pay for Medicare appeared first on PBS NewsHour.

Tessa Hadley reads her story “Dido's Lament,” from the August 8 & 15, 2016, issue of the magazine. Hadley has published six novels and four story collections, including “Sunstroke and Other Stories” and “Married Love.” She won this year’s Windham Campbell Prize for Fiction. She has been publishing fiction in The New Yorker since 2002.