Happy Birthday, Medicare
On Medicare’s 44th birthday, we should be learning from its example. Instead, we’re trapped in the same cycle that almost destroyed it.
It’s been a bad week for health care reform. The August recess deadline is out the window, the Energy and Commerce Committee watered down the House bill (weakening the “public option,” a plan to compete with for-profit insurance companies, and upping the premiums low-income people would pay), and the Senate Finance Committee’s proposal offers no public option at all, only funding for weaker health care co-ops.
In the midst of it all, Medicare turned 44. On this day in 1965, it emerged from a long and divisive legislative battle not very different from today’s. Opponents then as now warned that the plan would undermine personal freedoms and keep Americans from their doctors. Actor Ronald Reagan, in a speech recorded and distributed by the American Medical Association in 1961, speculated that its passage would mean that “one day, you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”
Things didn’t quite turn out that way. Americans in their sunset years—the 43 million Medicare beneficiaries 65 and older—are actually much happier with their health care payments, coverage, and access to care than 19- to 64-year-olds who get coverage through our employers. Seniors on Medicare consistently report better reliability and quality of coverage.
In fact, many younger Americans would like to be part of a system like Medicare: an April poll from the Kaiser Family Foundation found that 67 percent of Americans support the creation of a public insurance option modeled on Medicare, and 79 percent would like to see Medicare extended to cover those 55 and older. Even after being taken off the table in Washington, the grassroots movement for single-payer health care, sometimes called Medicare for All, has grown larger, more active, and more diverse.
Vilifying all public—and even partially public—plans as “socialized medicine” seems a poor birthday gift for such a program. So others are giving Medicare the birthday party it deserves.
Single-payer supporters from across the country are descending on Washington today to celebrate Medicare with cupcakes, rallies, and appeals to their congressional representatives—asking them to co-sponsor the single-payer bills and amendments in Congress, to demand that the Congressional Budget Office compare the cost of single-payer legislation to other health care plans (past cost-benefit analyses have found single-payer to be a great deal), and to reject campaign contributions from the healthcare industry.
“Medicare on its 44th birthday is remarkably successful," says Dr. John Geyman, past president of Physicians for a National Health Program. “It's the one solid rock we have in our disjointed healthcare system…It provides a comprehensive set of benefits, free choice of providers and hospitals anywhere in the country, and simplified administration with an overhead of only 3 percent—versus administrative overhead and profit-taking five to nine times larger for private insurers.”
Still, Geyman says, Medicare could have been better “were it not for political compromises along the way allowing it to be privatized”—such as 2003 legislation that gave the private sector control over prescription drug benefits, resulting in “a bonanza the drug and insurance industries” but restricting government from negotiating lower prices.
In other words, this week we’re on the road to repeating Medicare’s mistakes instead of its successes.
Happy birthday anyway, Medicare.