The modern-day health miracle known as Medicare

By Mary L. Ford
Daily Hampshire Gazette (Northampton, Mass.), Letters, July 24, 2015

I’m fed up with citizens complaining that government is a problem, not a solution. I want my children and nieces and nephews to know that because of Medicare, my generation as we grow old does not have to turn to them to cover hospital bills and doctors’ costs.

Only 2 percent of Americans over 65 lack coverage today. That’s public sector success. Fifty years ago President Johnson signed Medicare into law. It was a scaled-back first step toward universal health coverage in the U.S. which had failed to get enough support under Harry Truman, like FDR before him.

Since elders often needed the most care, lived on reduced incomes and had earned the right to be free from worry about affording medical attention, elected officials decided to start by covering them.

By lessening financial stress for retirees and their children, this 1965 program helped millions of families increase their standards of living over the next quarter century.

Of course, Medicare’s inherent aim was to improve the health of seniors by enabling them to afford needed services. And it worked. For just one example, cataract surgery in those over 65 doubled between 1965 and 1975, using modern technology to maintain vision and independence.

Fast forward to 2013 when a study showed federally insured seniors accessing services and avoiding medical debt at a rate much better than any other group. Medicare beneficiaries even fared twice as well as those insured through workplaces.

With a small Medicare payroll tax, a monthly premium after age 65 and minimal paperwork, the basic guarantee of covering most of seniors’ doctor and hospital bills has been both effective and efficient (only 1.6 percent of the dollars go to administration and overhead, according to the 2013 trustees’ report).

Medicare was expanded first to include another category of people with high health expenses and lower incomes – those unable to work for two years due to disability. Over time it has added more preventive services as well as a prescription option. Medicare’s straightforward administration has enabled it to add benefits smoothly and include new categories of beneficiaries, like those on kidney dialysis.

Today, Medicare is the largest insurance program in the U.S., public or private, serving more than 52 million people. It needs tweaks to be sure, but is deemed highly successful by health economists and beneficiaries. This month’s Medicare Trustees’ report shows full funding through 2030, beating projections.

Still, harkening back to earlier political struggles, the most “moderate” Republican front-runner said this past Wednesday in New Hampshire that we need to “phase out” the program in the future.

Wrong! We should expand this program, making improvements where necessary, eventually covering all Americans and releasing employers from having to run what is actually a societal benefit.

Most Americans now rely on Medicare as part of their family security. We expect it to provide adequate health coverage in later life and earlier in case of significant disability.

It enrolls and treats the healthy 65-year-old the same as the person with multiple chronic illnesses. Unlike private insurers, this taxpayer plan has little need for sales reps, expensive advertising and hordes of claims denial clerks. Doctors and their staff waste less time determining eligibility. This is a case of a public program functioning better than companies competing in a market.

President Obama’s Affordable Care Act spurred years of outrage about “government taking over health care” although, ironically, it mostly applied patches to private insurance systems.

The true national health insurance plan is Medicare, which has already been serving us for 50 years.

We take it for granted. Isn’t that a case of government fulfilling a real need of citizens, and getting it pretty much right?

In fact, isn’t this an example of what a practical, comprehensive, fair, cost-effective, no-drama program to provide health care at all stages of life ought to look like?

Let’s fight against any attempts to cut one of this country’s best programs.

Let’s work to get it improved and expanded to serve all of us.

I hope to see you at the celebration in front of City Hall at 1:30 p.m. Thursday.

We’ll be wishing Medicare at 50 a hearty Happy Birthday … and hoping for many, many more years of its coverage ahead.

Mary L. Ford served as mayor of Northampton from 1992 to 1999. She has worked for Kaiser Permanente and for federally qualified community health centers.