She begins with a startling fact from the 20th century: between 1930-1960, while the life expectancy of rich men increased by eight years, the life expectancy of poor men was unchanged. Though Social Security and Medicare have improved the end-of-life experiences of poor and middle-class Americans, a chasm remains between the golden year experiences of the rich and poor.
One difference is how the children of wealthier Americans are more prepared to guide their parents through later-life. She tells of a friend of hers who recently wrote her about the difficulties of navigating the medical, financial, and legal challenges arising from her father's end-of-life care. She says they have taken her "nearly to the limits of my intellectual capacity" - and she is a health-care policy expert with a PhD!
Her friend's point summarizes decades of research. Gaps in class, education, and income translate into gaps in end-of-life care. Wealthy, educated Americans tend to have educated children who can help them make the best end-of-life decisions and are likely to be with them at the end of their lives. This has important implications for retirement policy. Cutting benefits by raising the retirement age will force lower-income Americans, who haven't experienced a large increase in longevity, to work longer and miss out on their golden years.