title: The aging enterprise: in whose interests?
abstract: This paper revisits the aging enterprise in the context of the new competitive business ideology. Public policy has created an aging enterprise that assures that the needs of the aged will be processed and treated as a commodity. The medical-industrial complex, which comprises the most significant part of the aging enterprise, is a primary beneficiary of the recent reformulation of values and expectations vis-a-vis the state and the private sector. The new business ideology in health is aimed not only at controlling costs but, more importantly, at establishing health care as a market good like any other. Issues of access to needed services are raised for Medicare and Medicaid beneficiaries and for the uninsured. Budget cuts, medical cost control, and the market ideology are resulting in greater fragmentation, privatization, and corporatization of services, as indicated by the author's research on the private nonprofit health and social services sector in a sample of 8 states and 32 communities. In this paper, age-segregated politics and policies in the United States are challenged to utilize grass-roots political efforts that cross age and class barriers. Single-interest aging-based policies are criticized as a form of selfish separatism that could supplant an important and vitally needed intergenerational and coalition strategy.
mesh_terms: D000368:Aged; D003363:Cost Control; D003953:Diagnosis-Related Groups / Q000191:economics; D006291:Health Policy; D006297:Health Services Accessibility / Q000639:trends; D006299:Health Services for the Aged / Q000191:economics*; D006801:Humans; D008389:Marketing of Health Services; D006278:Medicare; D011203:Poverty; D012935:Social Justice; D014481:United States