On July 30 1965, under the leadership of President Lyndon B. Johnson, Congress created Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history. Before Medicare’s creation, approximately two-thirds of those over 65 had health insurance, with coverage often unavailable or unaffordable to the rest, because older adults paid more than three times as much for health insurance as younger people, and millions were excluded as “rick factors.”
Before Medicare it was far from uncommon to see a family swept into destitution almost overnight owing to a serious illness or accident and the attendant high medical bills.
Because of Medicare, as well as the Voting Rights Act, Civil Rights Act, Head Start and his vision of the “Great Society,” Johnson is regarded today by most historians as one of our great presidents, at least domestically, despite the disastrous Vietnam War which he pursued maniacally.
Medicare was signed into law in Independence, Mo. Former President Harry Truman was the first person to be issued a Medicare card, in symbolic recognition of his attempt to introduce a national health care program following World War II.
Medicare spurred the racial integration of thousands of waiting rooms, hospital floors, and physician practices by making payments to health care providers conditional on desegregation.
Medicare provides health insurance for almost 50 million Americans, about four-fifths age 65 and up, and one-fifth younger people with disabilities and catastrophic illnesses.
On average, Medicare covers about half (48 percent) of the health care charges for its enrollees, who must then cover the remaining approved charges either with supplemental insurance or with another form of out-of-pocket coverage.
Critics of Medicare often point out that the system is deficient in some important ways: It does not cover many issues associated with vision, nor dental work, nor extended mental care. These can also be debilitating and expensive problems with significant health ramifications.
Over the past half century, however, Medicare has expanded to include benefits for speech, physical, and chiropractic therapy, and hospice care. It also now permits the option of payments to health maintenance organizations. In 2003, under President George W. Bush, a Medicare program for covering almost all drugs was passed, and went into effect in 2006, although many analysts saw it as a giveaway to Big Pharma.
Who doesn‘t like Medicare?
Because Medicare is “social” insurance funded by wage deductions, like Social Security, it incurred the opposition of conservative Republicans in thrall to private enterprise. Most Republican voters on Medicare wouldn’t dream of abandoning it for the kind of unregulated private medical insurance the Right promotes, but GOP legislators answerable to their biggest corporate funders do not have such voters in mind.
Republicans still won’t give up their attempts to dismantle the program that brings quality health care and economic security to tens of millions of seniors. Presidential candidate Jeb Bush talks about wanting to “phase out” Medicare – and he’s the “moderate!”
The right wing has a different plan for Medicare – basically to give seniors a voucher for health insurance, say good luck and wave goodbye! The GOP has also been relentless in trying to dismantle the Affordable Care Act (Obamcare), which has extended health care benefits to millions more Americans, although still under the aegis of private insurance.
Because of cost controls and the large number of people it serves, Medicare is cheaper to run than private medicine based solely on the profit motive. If politicians and voters are concerned about controlling the budget, as Robert Reich has pointed out, “Medicare isn’t the problem. In fact, it’s the solution.”
The American health care scorecard is very clear: We have the most expensive health care system in the world, and show poorer results. By almost every measure of a nation’s health – longevity, birth weight, infant mortality, incidence of disease, teenage pregnancy, etc. – the U.S. rates overall 37th among nations. Profit, corruption and “administrative costs” are shortening our lives. We are on a par with developing countries such as Cuba, which actually beats American numbers in infant mortality and other health criteria.
As America looks forward, the answer is not to “phase out” Medicare, but to expand it to all, in a system such as every other advanced industrial nation already enjoys. Medicare for All is needed to slow health care costs, reduce the federal budget, democratize access to the necessities of life, and improve American productivity.
Happy birthday, Medicare! Celebrations are occurring all over the country. See here.
Photo: Lyndon Johnson signing Medicare bill, with Harry Truman, July 30, 1965 | Wikipedia (CC)