Join the celebration! Ok, there’s no real celebrating going on this year, but there should be! Because on July 30, 2016, Medicare turns 51 and she’s still going strong!
Here’s some background. Medicare is a national public insurance program administered by the federal government. It provides health insurance to Americans aged 65 or older. It also covers younger Americans who have disabilities, end stage renal disease or ALS.
Today, over 54 million seniors receive guaranteed health benefits from Medicare, regardless of their income or medical condition. No matter your health or wealth, Medicare is there for you. And we really should be very grateful for it.
Because before Medicare was established in 1965, 35% of the elderly lived in poverty, 50% of seniors did not have health insurance and more than 25% went without care because they could not afford it. (Medicare: 35 Years of Service) Back in those days, way before the Affordable Care Act, health insurance companies would only insure healthy people. Since most people start having health problems as they age, health insurer discrimination against sick people disproportionately impacted seniors. Getting health care 
was especially difficult for the elderly in communities of color. Check out this link for more on racism and health care.
Since 1965, Medicare has dramatically increased equal access to care by providing insurance to all persons aged 65 or older and by requiring that our hospitals desegregate. As a result, Medicare has had a transformational impact on healthcare equity among seniors, reducing disparities in access, cost and outcomes. Today, thanks to Medicare, only about 10% of seniors live in poverty. (See: Poverty Among Seniors, KFF 2015)
Moreover, Medicare has been pivotal in holding the line on inflation overall, as well as on medical inflation. As reported in the May 2016 Economic Letter published by the Federal Reserve Bank of San Francisco, much of the downward trend in healthcare services price inflation “reflects lower payments from public insurance programs.” Thank you, Medicare!
Most importantly, Medicare is helping us live longer, better lives. According to a 2015 article America’s Health Care Elixir by Kimberly Leonard (US News & World Report):
By ensuring access to care, Medicare has contributed to a life expectancy that is five years higher than it was when the law went into effect.
Of course, traditional Medicare can and should be improved. Check out 50 Wishes to Improve Medicare for more details. For example, Medicare only covers about 80% of hospitalization costs. It doesn’t cover prescription drug costs. And it doesn’t cover dental, or long-term care. Most people buy separate policies to cover those costs.
But increasingly, people are turning to private insurer-managed Medicare plans (called Medicare Advantage plans) that offer limited additional benefits, though at the cost of limited provider networks, and increased costs to Medicare. Is this really good? Maybe in some cases, but looking at the big picture, it’s not good at all.
In his blog Does the Private Health Care Marketplace Provide Efficiency and Value?, John Geyman, MD points out:
The private sector is much less efficient than public programs. Compared to traditional Medicare, privatized Medicare is more expensive, less efficient, less reliable, more restrictive in choice of physician and hospital, and has much higher administrative costs (e.g. 15 percent overhead compared to about 2 percent for Medicare).
So why even allow private insurer-managed Medicare plans? Dr. Scott Gottlieb, MD, in his article The Politics of Why Medicare Advantage is Capturing Seniors, suggests that politics contributes to Medicare’s deficiencies:
Washington’s benign neglect of Medicare’s traditional fee for service program is perhaps the best sales tool for Medicare Advantage plans.
This is related to a well-known conservative strategy called Starve the Beast: Underfund public programs like the Post Office or Medicare, reduce their ability to function efficiently, and the public begins to think that privatization would be a good idea.
In spite of all this, Medicare has improved the lives of our seniors and we wholeheartedly support fully funding and improving it so that it can better meet all our needs. Even more, we support expanding Medicare to everyone. Expanding Medicare to us all would advance equality in healthcare. High quality, affordable coverage and free choice of doctors, hospitals and other providers would be universal.
Remember, Obamacare hasn’t solved all our problems – not by a long shot! Over 30 million Americans still do not have health insurance, even now. And insured people at every income level are still struggling to afford their health insurance premiums and out of pocket costs.
We can do better. If you want a system that covers everybody for everything, join HEAL California! Let’s guarantee everyone access to better quality healthcare, with more choice, at less cost. A better healthcare future awaits!
Learn more about Medicare here: Medicare Facts & Fiction, Center for Medicare Advocacy