To celebrate Medicare’s 48th birthday, support Medicare for All

By Pat Berger, M.D.
Wicked Local News (Brookline, Mass.), Aug. 1, 2013

July 30, 2013, was the 48th anniversary of the signing of the Medicare act of 1965 into law. This very special birthday calls for acknowledging the vital role Medicare has played in the lives of our seniors over the last 48 years.

Before Medicare was enacted, the elderly faced poverty, the fear of being stricken by costly illness, and dependency on family or charity despite holding jobs for many years. We all know from our own families that Medicare coverage is a resource we count on for our grandparents, parents, and ourselves as we near the magic age of 65. What a lifesaver Medicare has been!

But why can’t we have a system that provides everyone with guaranteed medical care from birth to death?  All the other developed countries cover everybody, pay half as much for their health care as we do, and provide better outcomes. America is the only developed country allowing the health care system to be run by private corporations that have transformed medical care into a commodity to be bought and sold.

We are faced with premiums, co-pays, deductibles, co-insurance, means testing, and insurance caps that make health insurance unaffordable for almost 50 million Americans. It is shocking that in America, loss of a job because of illness can lead to loss of medical coverage, bankruptcy and even homelessness.

We are now beginning the implementation of the federal Affordable Care Act (ACA, or Obamacare). There are provisions in the law that will give patients some important protections, and will cover about 20 million more people. But Obamacare does not address the problem of the power of corporate interests and their focus on making money from health care. The ACA actually promotes business for the health insurance industry by mandating that everyone buy insurance or pay a stiff fine. Obamacare does not cover everyone, and most importantly, it does not have the ability to control the soaring cost of health care.

Efforts to slow the cost curve may be mildly successful in the short term using expensive and untried system tweaks, such as accountable care organizations, electronic medical records, and pay-for-performance. But these experiments create more bureaucratic and administrative regulations. The best part of the ACA is that it allows the states to set up their own health care systems in 2017, as long as they cover more people more effectively. Plans are being made now to establish a single-payer system for Massachusetts in 2017.

By achieving a true Medicare for All, or single-payer system in 2017, it would put patients first, cover everyone, be affordable and sustainable, be simple to understand, and allow choice of doctor with no insurance middleman interfering in the decisions between doctors and patients.  Medicare for All would have a single governmental agency that pays all the medical bills and is publicly funded through an equitable tax system. It would save money by eliminating the enormous administrative bureaucracy generated by the multiple health insurance companies. It would control costs by consulting with patient advocates, doctors’ groups, hospitals and public health programs in order to provide the best patient care in the most cost effective manner.

America now spends trillions on health care each year, and wastes at least a third of it on administration, profits from corporate entities, a fragmented system, and ineffective or unnecessary clinical care. Having one system that is accountable to the people, that is focused on quality patient care, and is based on medical need and not ability to pay, changes the whole vision of health care.

Our health is not a commodity, it is a human right. Let’s remember Medicare’s birthday by working for Medicare for All in 2017!

Dr. Pat Berger is a retired primary care physician and co-chair of Mass-Care, the organization leading the campaign for single payer health care reform in Massachusetts. She lives on Heath Street.