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Speaker 1: We've heard for years now how the aging population is

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Speaker 1: increasingly straining public programs for seniors like social Security and

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Speaker 1: medicare here in the US. Around the world, political fights

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Speaker 1: and protests have broken out in response to this urgent question,

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Speaker 1: how do you pay to care for so many retired people?

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Speaker 1: At the same time, the US Census Bureau tells us

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Speaker 1: that just seven years from now, people over sixty five

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Speaker 1: will outnumber those under eighteen. It's even got a name

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Speaker 1: in the public policy world. They call it the twenty

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Speaker 1: thirty problem. And while Washington drags its feed over what

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Speaker 1: to do, some companies are seeing opportunity. Bloomberg reporter Priya

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Speaker 1: onon rights in BusinessWeek about a tech startup called Papa

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Speaker 1: that's looking to fill some of the void. It provides

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Speaker 1: household services to seniors so they can stay independent.

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Speaker 2: Loneliness is a huge issue in this country, especially among

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Speaker 2: the elderly, and the company he has said that this

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Speaker 2: is also a companionship option.

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Speaker 3: Someone can request to.

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Speaker 2: Have a pal come to their house just to chat

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Speaker 2: even but.

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Speaker 1: The company is learning just how difficult that can be,

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Speaker 1: and later in the show, health economist Jonathan Skinner he'll

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Speaker 1: tell us what it will take to meet the needs

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Speaker 1: of all those retiring baby boomers.

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Speaker 4: A society can only hope to have this many people

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Speaker 4: surviving to be eighty five or ninety and ninety five

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Speaker 4: and living rewarding lives as retirees. The problem comes when

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Speaker 4: they require assistance, and for many people who are older,

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Speaker 4: their needs aren't being met by the current insurance programs.

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Speaker 1: I'm Wescasova today on the Big Take the hard realities

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Speaker 1: of the aging economy. You've written a story about this

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Speaker 1: company called Papa Ink, which you describe as a family

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Speaker 1: on demand task rabbit for seniors. Can you tell us

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Speaker 1: more about this company what they do.

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Speaker 2: Papa is a startup that is essentially a gig economy

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Speaker 2: version of home assistance. They sometimes describe themselves as family

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Speaker 2: on demand, so customers, seniors or family members of them

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Speaker 2: can hire contractors from Papa's network to come to their home,

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Speaker 2: hang out and chat, do household chores, take them to

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Speaker 2: doctor's appointments, essentially anything that doesn't involve some of the

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Speaker 2: more traditional and intimate work done by nurses, such as

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Speaker 2: bathing people helping them use the bathroom, and they call

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Speaker 2: the customers in this case Papa's and the contractors are

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Speaker 2: called pals, hence the name the company PAPA.

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Speaker 1: Part of the idea here is to enable older people

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Speaker 1: to stay more independents stay in their homes for longer, since,

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Speaker 1: as we know, eldercare in America is a pretty complicated thing.

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Speaker 2: That's right, and loneliness is a huge issue in this country,

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Speaker 2: especially among the elderly. The Surgeon General has talked about

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Speaker 2: this before, and the company has said that this is

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Speaker 2: also a companionship option. Someone can request to have a

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Speaker 2: pal come to their house just to chat. Even Andrew Parker,

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Speaker 2: the CEO of PAPA, who declined to sit for an

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Speaker 2: interview for our story, often says that he started the

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Speaker 2: company after hiring a college student to help entertain his

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Speaker 2: grandfather and that it was an AHA kind of moment

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Speaker 2: for him.

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Speaker 1: And so how is this paid for?

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Speaker 2: PAPA contracts with Medicare Advantage and Medicaid health plans as

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Speaker 2: well as a number of large employer based health plans.

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Speaker 2: The papas who actually using the surface often don't have

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Speaker 2: to pay anything and they can use it for a

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Speaker 2: certain number of hours per year through their health insurance plan.

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Speaker 2: So the business model is a little bit different from

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Speaker 2: Uber and lyft in that case where you're not necessarily

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Speaker 2: as a user paying per ride per food delivery, you

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Speaker 2: instead have a certain number of hours per year through

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Speaker 2: your health insurance plan.

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Speaker 1: And how does PAPA make money.

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Speaker 2: Papa makes money by contracting with these health insurance plans,

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Speaker 2: some of which receive government subsidy because they're Medicare advantage

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Speaker 2: in Medicaid.

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Speaker 1: So you mentioned at the beginning that this is a startup,

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Speaker 1: and they have gotten some pretty big investment in the company.

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Speaker 3: That's right.

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Speaker 2: Papa has raised hundreds of millions from large investors, including

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Speaker 2: soft Bank and Tiger Global, Alexis o'hannian, who is the

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Speaker 2: co founder of Reddit but better known as the husband

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Speaker 2: of Serena Williams. And the company was last valued by

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Speaker 2: investors at one point four billion in twenty and twenty one.

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Speaker 2: During the pandemic, when I think a lot of people

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Speaker 2: in this country, the idea of helping people be less

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Speaker 2: lonely became prominent in everyone's mind.

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Speaker 1: Who are the people who are providing the service, the

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Speaker 1: ones that they call the pals who go to older

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Speaker 1: people's homes and help them out.

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Speaker 3: They're independent contractors.

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Speaker 2: And Papa actually has a couple of bullet points on

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Speaker 2: their website that they list for who is eligible to

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Speaker 2: sign up to become a PAL if you're twenty one

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Speaker 2: or older, have US work authorization, can communicate in English,

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Speaker 2: and can pass a background check. But it's gigwork, so

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Speaker 2: the training is not very extensive, though the company says

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Speaker 2: it does offer an array of optional training options that

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Speaker 2: it sends to pals over email and other methods, and

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Speaker 2: makes available in the app if someone wishes to go

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Speaker 2: through and learn more about how to be a better

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Speaker 2: pal to the person they're visiting at home.

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Speaker 1: So there's no special training required to become a PAL.

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Speaker 1: It's sort of like being an instantcart delivery person in

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Speaker 1: the sense that almost anyone can sign up.

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Speaker 2: Federal requirements stipulate that if you're a Medicare eligible home

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Speaker 2: health aid, you need to complete at least seventy five

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Speaker 2: hours of classroom supervision and practical training. But popas service

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Speaker 2: is stripped down. It doesn't offer the clinical elements of homecare,

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Speaker 2: so it's not subject to that seventy five hour rule.

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Speaker 2: It's required training for pals is a short video that

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Speaker 2: stresses the importance of avoiding physical contact with clients. The

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Speaker 2: company told us that they've added more voluntary training over

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Speaker 2: the past year, and that they send pals emails containing

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Speaker 2: an average of six links with additional optional training content,

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Speaker 2: along with a quarterly newsletter that includes a link to

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Speaker 2: safety related materials.

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Speaker 3: These are supplementary and.

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Speaker 1: So beyond that, is there any sort of vetting process

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Speaker 1: of people who sign up to go to people's homes.

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Speaker 2: The company says it performs background checks and that it

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Speaker 2: also requires pals to acknowledge patient privacy rules, But they

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Speaker 2: also say that the average person does not require training

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Speaker 2: to support their grandparents, parents, or elderly neighbors.

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Speaker 1: How's it working out? You talked to quite a few

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Speaker 1: people who use the service. What do they say about it?

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Speaker 2: America has a huge shortage of healthcare workers and caregivers,

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Speaker 2: so for many people, Papa is a lifesaver. Manuela Lopez

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Speaker 2: is a seventy two year old retiree in Grand Rapids, Michigan,

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Speaker 2: who I spoke with, and she also called Papa a

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Speaker 2: life saver. She's a diabetic and amputee and she uses

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Speaker 2: PAPA for help getting to the supermarket and to doctor's appointments.

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Speaker 2: And she said she can't just walk out the door

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Speaker 2: by herself, and papa's service has been a game changer,

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Speaker 2: and so for many people looking for help. You know,

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Speaker 2: they might need some help around the house, they might

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Speaker 2: need support to be able to get to the doctor,

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Speaker 2: but they don't necessarily need help going to the bathroom

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Speaker 2: or taking a shower. PAPA is there to support this

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Speaker 2: huge shortage of healthcare workers and caregivers in America.

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Speaker 3: I spoke with a number of folks who.

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Speaker 2: Said that PAPA was a solution they relied upon for

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Speaker 2: their family members when they didn't know where else to

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Speaker 2: go for support and being a caregiver, you know, if

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Speaker 2: you're supporting a parent yourself, having another caregiver available is

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Speaker 2: tremendously helpful to many people.

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Speaker 1: And yet Pria you also found that the company is

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Speaker 1: facing some pretty big challenges in matching up people with

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Speaker 1: the customers.

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Speaker 3: That's right.

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Speaker 2: We reviewed more than one thousand confidential complaints logged by

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Speaker 2: PAPA over the last four years and found dozens of

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Speaker 2: allegations of sexual harassment and assault, as well as an

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Speaker 2: allegation of unlawful imprisonment. These were complaints filed by both

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Speaker 2: the company's workers and members with the company.

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Speaker 5: Now.

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Speaker 2: The company says that less than one percent of its

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Speaker 2: complaints are safety related, and they also added that they,

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Speaker 2: and I'm going to quote directly, we know any failure

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Speaker 2: in protecting the safety of our members and pals is unacceptable.

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Speaker 2: And they said that whenever you're connecting people, there's a

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Speaker 2: chance something can go wrong, and they're committed to doing

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Speaker 2: everything they can to try to ensure that never happens again.

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Speaker 1: And peer, what are some examples of some of the

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Speaker 1: things that both the customers and the service providers encounter.

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Speaker 2: Pals of filed complaints alleging that clients have tried to

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Speaker 2: kiss or fondle them, or that their residences were covered

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Speaker 2: in feces or infested with cockroaches, are in one case,

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Speaker 2: home to an alligator. Other times it's the pals who

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Speaker 2: have been accused of stealing or harassing their clients or

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Speaker 2: getting naked in their home. The more than thousand complaints

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Speaker 2: we reviewed were from records that we obtained, but there's

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Speaker 2: also a court case going on In Minnesota. Middle aged

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Speaker 2: man was sent to a seventy year old woman's house

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Speaker 2: earlier this year. He arrived the woman gets around using

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Speaker 2: a walker or power chair. He helped her get to

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Speaker 2: a couple of stores, and then when they returned to

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Speaker 2: her home, he allegedly raped her and there's a criminal

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Speaker 2: complaint against him. PAPA is featured throughout the criminal complaint,

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Speaker 2: though it's not named in the case as a defendant.

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Speaker 2: The company said in a statement that it's CEO, Andrew Parker,

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Speaker 2: has had several conversations with a member and offered her

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Speaker 2: all the help and support they can, and that the

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Speaker 2: CEO and the woman who is a victim in this

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Speaker 2: case have become, they said, quite important in each other's lives.

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Speaker 2: Papa also said it removed the contractor from its platform

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Speaker 2: and that's conducting an internal review of its trust and

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Speaker 2: safety practices after this devastating incident, and it also said

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Speaker 2: that it has added a two person manual review of

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Speaker 2: his background check data to its screening process because its

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Speaker 2: system did not flag a prior conviction that this man

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Speaker 2: had for domestic assault before being sent to this woman's home.

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Speaker 1: And the person accused in the case, Martin Jermaine Blue Senior,

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Speaker 1: has said the encounter was consensual and denied the state's

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Speaker 1: charges of criminal sexual conduct, kidnapping, and assault with a

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Speaker 1: dangerous weapon. He's being held on a two hundred thousand

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Speaker 1: dollars bound pending trial. A lawyer for Blue didn't respond

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Speaker 1: to requests for comment for The BusinessWeek's story.

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Speaker 5: Prea.

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Speaker 1: Since PAPA is covered by insurance companies and covered by Medicare,

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Speaker 1: what do they have to say about the things you're reporting?

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Speaker 2: The Centers for Medicare and Medicaid Services said the agency

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Speaker 2: has been reviewing complaints and grievances that allegedly involve Papa's service,

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Speaker 2: and they said that most complaints revolve around customer service,

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Speaker 2: but they're also aware of the allegations we described in

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Speaker 2: our story and serious concerns, and that they continue to

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Speaker 2: monitor complaints against PAPA. And they also added that if

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Speaker 2: a Medicare advantage plan were contracted with a partner that

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Speaker 2: they think isn't up to par with CMS standards, they

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Speaker 2: have meaningful ways to discourage a plan from using a service.

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Speaker 1: And what about the investors who have put a lot

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Speaker 1: of money behind this company.

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Speaker 2: We reached out to a number of investors for this story,

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Speaker 2: including SoftBank, Tiger Global, Lexis Ohanian, and they all declined

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Speaker 2: to comment.

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Speaker 1: So where do you think it goes from here? What

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Speaker 1: happens to Papa?

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Speaker 2: I'm interested in seeing whether health Plans re up contracts

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Speaker 2: with PAPA for next year. It'll also be interesting to

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Speaker 2: see what families think about this, I think, I mean,

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Speaker 2: I would like to hear from families that have hired

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Speaker 2: PAPA for their relatives. I spoke with a number of

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Speaker 2: families for the story, but I'm interested in hearing from

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Speaker 2: more about what they make of the precautions that the

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Speaker 2: company takes and whether they feel those are sufficient.

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Speaker 1: Priya, thanks for coming on the show.

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Speaker 3: Thanks for having me.

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Speaker 1: After the break. What the economics of aging tells us

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Speaker 1: about how to care for seniors. So now we've heard

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Speaker 1: about some of the challenges of helping seniors age gracefully,

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Speaker 1: and you can be sure many other companies will be

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Speaker 1: stepping up to figure out how to provide services to

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Speaker 1: older people. But that still leaves the big question, what

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Speaker 1: about the social programs intended to care for older Americans?

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Speaker 1: As we know, there is not a lot of political

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Speaker 1: appetite in Washington to tell the truth about the coming

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Speaker 1: costs of senior care. So will people ultimately have to

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Speaker 1: pay more or will they receive less? I put that

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Speaker 1: question to Jonathan Skinner. He's a research professor in economics

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Speaker 1: at Dartmouth, and he leads several projects funded by the

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Speaker 1: National Institute on Aging.

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Speaker 4: I don't think we're ready, and I think that the

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Speaker 4: impact of baby boomers is going to become strongest in

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Speaker 4: the next ten or fifteen years. The good thing is

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Speaker 4: that as people age currently that they're often in better health.

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Speaker 4: That is, people who are sixty five or seventy are

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Speaker 4: typically more active. Some of them are even working, they

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Speaker 4: are traveling. Whereas the problem comes when people turn eighty

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Speaker 4: five or ninety and they really do require a lot

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Speaker 4: of help.

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Speaker 1: And this question of people living longer. A couple generations ago,

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Speaker 1: we wouldn't be talking about so many people living to

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Speaker 1: be eighty five, let alone ninety five. What's involved in that,

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Speaker 1: in trying to take care of that many people.

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Speaker 5: Well, I view this as great news.

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Speaker 4: A society can only hope to have this many people

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Speaker 4: surviving to be eighty five or ninety and ninety five

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Speaker 4: and living rewarding lives as retirees. The problem comes when

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Speaker 4: they require assistance, and for many people who are older,

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Speaker 4: their needs aren't being met by the current insurance programs. Medicare,

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Speaker 4: for example, does not cover many things that older people

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Speaker 4: will need to require.

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Speaker 1: So Ashley, let's talk about the details of that. Because

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Speaker 1: medicare social Security, these programs that are specifically in place

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Speaker 1: for retired people, for older people, they were made for

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Speaker 1: another time. Can you talk about what the assumptions were

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Speaker 1: when these programs were put in place versus what the

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Speaker 1: needs are today.

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Speaker 4: That's a great question and it requires I could spend

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Speaker 4: a few hours talking about that, but let me start

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Speaker 4: with each one.

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Speaker 5: In turn.

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Speaker 4: Social Security certainly is flexible. It's a wonderful annuity, meaning

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Speaker 4: that it pays an amount until you die, so you

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Speaker 4: don't have to worry about running out of Social Security

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Speaker 4: for an individual. It also has a unique characteristic in

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Speaker 4: that it adjusts for inflation, so as inflation goes up,

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Speaker 4: you get more.

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Speaker 5: So it's a great system.

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Speaker 4: The problem is that it is very sensitive to baby

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Speaker 4: booms and baby busts, and so it's scheduled to start

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Speaker 4: running out of money in a decade or so. The

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Speaker 4: good news there is that I think that's fixable in

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Speaker 4: the sense that what we'll see is maybe a reduced

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Speaker 4: cost of living adjustments for people with higher incomes, maybe

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Speaker 4: slightly higher taxes. So I think that there are a

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Speaker 4: variety of ways that it could be fixed, assuming that

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Speaker 4: Congress bites the bullet and goes and does it.

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Speaker 5: Medicare is more difficult.

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Speaker 4: It was designed in nineteen sixty six to basically take

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Speaker 4: care of people who need hospital care and need to

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Speaker 4: see a doctor. It at the time didn't take into

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Speaker 4: account drugs, which it does now, which is great with

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Speaker 4: the prescription drug party, but it still is very limited

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Speaker 4: in the sense that it'll only cover a nursing home

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Speaker 4: if it's for rehabilitation purposes. It'll only cover home healthcare

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Speaker 4: if it's rehabilitation. That is, it has sort of a

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Speaker 4: natural ending. The alternative is Medicaid.

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Speaker 5: Which is for people who are either very sick or.

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Speaker 4: Are poor, and that generally doesn't pay as well, so

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Speaker 4: you can't always get into as nice a nursing home.

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Speaker 4: The problem are the people who are in between. You know,

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Speaker 4: they're taking care of their spouse. They realize that they

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Speaker 4: they're getting older too. They can't really take care of

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Speaker 4: the spouse the way they'd liked. They go to their

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Speaker 4: doctor to ask for help, and there's really nothing to

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Speaker 4: cover except for out of pocket payments for a private nurse.

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Speaker 4: And for many many Americans, that's just not feasible, and

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Speaker 4: so that's what I worry about, is that people are

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Speaker 4: trying to age in place. They don't want to go

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Speaker 4: to a nursing home, they don't want to give up

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Speaker 4: their independence, but they need help and it's not there.

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Speaker 1: And I guess another big challenge facing Medicaid in particular

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Speaker 1: is that at the time it was started, the assumptions

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Speaker 1: of how long people were going to live were much shorter,

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Speaker 1: and so when they did the calculations of what the

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Speaker 1: program were going to cost, they weren't taking into account

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Speaker 1: lots and lots of people living into their nineties.

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Speaker 4: That's exactly right, I think again, it's good news that

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Speaker 4: lots of people are living into their nineties, but both

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Speaker 4: higher health care costs and more people being covered it

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Speaker 4: means that, you know, in some way cases, people can

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Speaker 4: be receiving Medicare for as long as they paid in.

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Speaker 5: If they live to a ripe old age.

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Speaker 4: So that's definitely a problem, a more intractable problem than

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Speaker 4: Social Security for the federal government because there's no sort

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Speaker 4: of simple fix for Medicare, and that's.

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Speaker 1: Something that we talked about quite a lot. You know,

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Speaker 1: you can make those adjustments as you describe them to

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Speaker 1: social Security. Maybe some people who have more will get

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Speaker 1: a little bit less. You can eke out some more

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Speaker 1: years out of the system. But where does the money

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Speaker 1: come for expanding medicare as It will absolutely certainly have

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Speaker 1: to happen.

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Speaker 5: That is a really tough question.

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Speaker 4: Where will more money come from Medicare? I mean, they

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Speaker 4: are trying to increase the Part B premiums that's what

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Speaker 4: you pay when you retire, and they're trying to increase those,

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Speaker 4: but there's limits on how much they can spend.

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Speaker 5: I personally think.

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Speaker 4: That there are a lot of ways to save and expenditures.

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Speaker 4: I think there's a fair amount of waste in the

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Speaker 4: Medicare program, but I don't see it being politically popular.

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Speaker 4: In order to really change the system, you're going to

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Speaker 4: have to make a lot of people unhappy. There's an

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Speaker 4: old sort of saying that we try to remind ourselves

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Speaker 4: of when whatever we get involved with policy, is that

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Speaker 4: when we talk about cutting Medicare costs, each dollar of

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Speaker 4: cost is somebody else's revenue, and they don't like having

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Speaker 4: their revenue cut because it's their livelihood. And so it

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Speaker 4: becomes very difficult to make changes in the policy world.

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Speaker 1: And just recently, we all saw this drama in Washington

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Speaker 1: over whether to raise the debt ceiling narrowly escaped a

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Speaker 1: disaster yet again. But these sorts of programs what to

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Speaker 1: spend government money on, we're front end center. What does

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Speaker 1: that sort of political argument over who gets what mean

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Speaker 1: for this aging population and all the money that it's

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Speaker 1: going to need to support it.

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Speaker 4: It makes me worried not so much about the current generation,

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Speaker 4: but about the people who expect to get medicare fifteen

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Speaker 4: years from now, because what's going on now is that

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Speaker 4: everybody's made a promise we're not going to touch Medicare,

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Speaker 4: we're not going to touch Social Security, but instead we'll

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Speaker 4: just keep expanding the debt and we'll basically fund this

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Speaker 4: stuff using deficit spending implicitly, and at some point that's

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Speaker 4: not going to work so well, and at that point

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Speaker 4: there will be or there could be, some serious cutbacks

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Speaker 4: in terms of what's offered to different people. What worries

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Speaker 4: me is that politicians will come up with the idea

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Speaker 4: of just cutting reimbursement rates as a way to shave

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Speaker 4: the amount that Medicare spends. And that's a pretty inefficient

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Speaker 4: way to cut back on spending because you end up

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Speaker 4: basically with care where the doctors just can't really afford

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Speaker 4: to provide that kind of care.

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Speaker 1: Well, another statistic that speaks directly to what you're saying

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Speaker 1: is that millennials now have surpassed baby boomers as the

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Speaker 1: largest living adult population. So this problem is only going

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Speaker 1: to get worse. As you say down the line, like

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Speaker 1: the thing we're looking at with the baby boomers is

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Speaker 1: just kind of a preview of what's to come.

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Speaker 5: I think that's right.

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Speaker 4: I think we have a stocked refrigerator and we've got

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Speaker 4: a bunch of people pulling stuff out of the refrigerator.

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Speaker 5: But when the next.

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Speaker 4: Group comes along, it's going to be like, huh, wait

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Speaker 4: a minute, they borrowed all this money. Now what are

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Speaker 4: we going to do? And that's what I worry about.

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Speaker 1: Just to throw another wrinkle into this, how did the

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Speaker 1: pandemic shape the landscape for care for seniors?

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Speaker 4: First of all, it was a disaster for people who

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Speaker 4: are in nursing homes. Some research we did suggest that

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Speaker 4: it wasn't simple COVID nineteen that caused excess mortality among say,

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Speaker 4: for example, people with dementia, but it was being shut up,

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Speaker 4: closed off being stuck in your room. That is, we

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Speaker 4: found even places there were very few COVID cases that

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Speaker 4: mortality was higher, particularly among people in nursing homes.

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Speaker 5: Sort of.

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Speaker 4: The sad thing is that now projections for Social Security

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Speaker 4: and Medicare have improved somewhat because so many people died

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Speaker 4: who were elderly. That is unfortunate, But I think that

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Speaker 4: the pandemic has also changed a lot of patterns in

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Speaker 4: how care is provided. It's increasingly expensive to hire a

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Speaker 4: competent person to work in a nursing home.

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Speaker 5: It's hard work in.

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Speaker 4: The longer term as there are more and more older

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Speaker 4: people that need to be taken care of. I think

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Speaker 4: that the cost structure of caregiving is going to go

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Speaker 4: up in ways that will surprise people. And I think

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Speaker 4: it may also change people's views about going into nursing homes.

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Speaker 4: That may cause some people to think twice given what

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Speaker 4: they observed, and perhaps cause them to remain in their

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Speaker 4: own home and try to have more independent living because

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Speaker 4: they saw what happened to their friends who were locked

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Speaker 4: down in a nursing home for like nine months.

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Speaker 1: When we come back, some possible solutions before the US

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Speaker 1: hits a senior care crisis. You know, we're talking about

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Speaker 1: the various government policy fixes institutions like nursing homes, but

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Speaker 1: is part of the problem just the way people live now.

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Speaker 1: It used to be that your parents would move in

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Speaker 1: with you, your grandparents would move in with you, and

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Speaker 1: you would care for them when they're aging. And now,

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Speaker 1: with our much more mobile population and families often living

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Speaker 1: far apart, has that changed the way older people are

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Speaker 1: just cared for.

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Speaker 4: Yes, But I think that change has started quite a

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Speaker 4: bit earlier. I think that the greater degree of migration

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Speaker 4: started really with baby boomers as children, so they were

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Speaker 4: moving around all over the country. They weren't exactly shall

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Speaker 4: we say, inviting their parents to come and live with them.

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Speaker 4: So I think some of that transition has occurred, and

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Speaker 4: there is much more emphasis on extended care facilities, on

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Speaker 4: places where there are a lot of older people living

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Speaker 4: but still doing kind of active things.

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Speaker 1: Like adult communities and places where you have independent living

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Speaker 1: but then can transition to greater levels of care as

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Speaker 1: you needed.

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Speaker 4: Exactly, you started at one place and then you kind

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Speaker 4: of moved to the next place, and then you moved

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Speaker 4: to the nursing home. So it's much more integrated and

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Speaker 4: your friends can come and visit you. There is people

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Speaker 4: who can't afford to buy in. If you happen to

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Speaker 4: have bought a house, you're in pretty good shape because

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Speaker 4: you can probably sell your house for a profit And

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Speaker 4: baby boomers made a lot of money on their houses

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Speaker 4: and they could afford the don payment to move into

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Speaker 4: these facilities. But for people who rented all their life

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Speaker 4: or never you know, maybe they lost their house in

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Speaker 4: a divorce or something, they're stuck. And so I definitely

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Speaker 4: worry about inequality for people who are aging, because once

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Speaker 4: you've reached a certain age, you can't do much to.

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Speaker 5: Undo any past financial mistakes.

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Speaker 1: What are your thoughts about non medical companion services that

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Speaker 1: have grown up in the last decade that helps seniors

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Speaker 1: with household tasks and groceries. Is this is service that

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Speaker 1: is really important? Do you think that we're going to

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Speaker 1: start to see more and more of this.

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Speaker 5: I think yes.

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Speaker 4: I think there's an increasing recognition that people and remained

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Speaker 4: independent if they get a little bit of help, if

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Speaker 4: they get help with laundry or shopping or things like that.

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Speaker 4: I certainly think if they ever come up with autonomous

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Speaker 4: cars driving cars, that would be a huge boon to

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Speaker 4: the elderly population, just because driving is a huge problem

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Speaker 4: for people who are seeking to remain independent. But the

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Speaker 4: downside for millennials is that the longer people stay in

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Speaker 4: their house, the more difficult it is going to be

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Speaker 4: for the next generation to buy their own house.

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Speaker 1: So what is the solution here. We have an enormous

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Speaker 1: number of people, we have a certain lack of will

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Speaker 1: in Washington to address it. Something's going to give eventually.

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Speaker 1: As someone who's studied this for a long time, where

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Speaker 1: do you see it heading?

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Speaker 4: I think nothing will happen until there's a crisis. And

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Speaker 4: my concern is that the crisis will occur when there's

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Speaker 4: an economic downturn and interest rates are up and the

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00:27:05,359 --> 00:27:11,760
Speaker 4: debt burden becomes nearly intolerable. Everything's fine now because basically

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Speaker 4: the government's credit cards don't have a limit, and you

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Speaker 4: can keep going and keep going and keep going. But

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Speaker 4: at some point things don't work out well.

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Speaker 1: Jonathan Skinner, thanks so much for talking with me today.

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Speaker 1: Thank you thanks for listening to us here at the

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Speaker 1: Big Take. It's a daily podcast from Bloomberg and iHeartRadio.

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Speaker 1: For more shows from iHeartRadio, visit the iHeartRadio, app, Apple podcasts,

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Speaker 1: or wherever you listen, and we'd love to hear from you.

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Speaker 1: Email us with questions or comments to Big Take at

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Speaker 1: Bloomberg dot net. The supervising producer of The Big Take

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Speaker 1: is Vicky Bergolina. Our senior producer and the producer of

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Speaker 1: this episode is Catherine Fink. Phil de Garcia is our engineer.

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Speaker 1: Original music by Leo Sidrin. I'm wes Kasova. We'll be

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Speaker 1: back tomorrow with another Big Take.

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Speaker 3: Pang Dam Pan Pan Panda Bombar