Happy Birthday Medicare - It Still Works After All These Years
Medicare turned 59 on July 30th. That’s a long time, especially for a government program that now serves a quarter of our population. I’ll reveal my age in telling you that I was 17 when Medicare was signed into law by President Johnson. At 17 I didn’t even realize that it had been signed into law and that it would immediately impact my grandparents lives and eventually play a big part in the lives of me and my parents. I never took the time or even thought about asking my parents how it changed their lives. I know that my mother and her siblings took turns at taking their parents into their house and caring for them as their parents grew frail. Before Medicare I guess their safety net was family, church, or welfare. What a relief it must have been for people back then to realize that they could now count on Medicare for their medical care.
I think there is another thing that Medicare gives us . . . the feeling of self-reliance. You hear all the time of older people saying they don’t want to be a burden to their kids. That attitude may be stronger for some than. For me and most people I know, paying my own way is important to me. A significant percentage of each paycheck throughout my career was taken out to pay for Medicare. But I didn’t complain too much because it gave me satisfaction knowing that I had this safety net that would take care of me when I got old. While there are always ways to improve, Medicare has been a success.
There are not very many government programs that have lasted 59 years and have continued to be well liked by those who have benefited from its services. According to a survey done by the KFF, an independent source of health policy research, polling, and journalism –
Most Medicare beneficiaries ages 65 and older report being satisfied with their care. The vast majority of Medicare beneficiaries ages 65 and older (94%) report being very satisfied or satisfied with the quality of their medical care, with no significant differences by race and ethnicity, gender, and metropolitan status, according to data from the 2018 Medicare Current Beneficiary Survey (MCBS).
That is a huge vote of approval and, in these days of the recognition of the importance of diversity, was the same across a diverse population.
So, have our lawmakers made changes to Medicare over the years? Yes, some were good, but some have not helped with access and innovation. President Reagan championed a change that added a cap to Part A and B, but it was repealed the next year due to the increase in premiums. Later, coverage for people under 65 with qualifying disabilities was added. Then, an option for Part C, now called Medicare Advantage, was included which gave beneficiaries another choice in their Medicare Coverage. George W. Bush signed into law the Part D prescription drug coverage which was a boon to the health of seniors. Just recently, numerous changes were made to Medicare with the enactment of the Inflation Reduction Act, including a yearly cap on seniors’ out-of-pocket expenses for prescription drugs and price-setting provisions for prescription drugs. All these changes had to be balanced against the overall cost of benefits and in the premiums for part B and part D. It also had to be determined how much government control was going to be levied over our choices and access to our medical care.
I’ve written extensively about the limits to access and innovation that price fixing will put on our prescription drug program. The dictated prices for the first 10 drugs selected under the Inflation Reduction Act will be released in a few weeks. I will write more about the final dictated prices toward the end of the month, but this is a prime example of using the wrong tool to control prices. Competition has always been the most efficient and long-lasting solution to ensure access while maintaining a balance between innovation and the price of medicines.
Another area where the government is inserting itself to the determent of choice and benefits is the threat to lower payments for Medicare Advantage plans. There are always going to be bad players in government regulated healthcare, the approach is to weed out the bad players, not apply cuts that threaten the stability of Medicare Advantage plans that are serving over half of seniors on Medicare.
As the candidates for President finally seem to have come into focus, it is evident that both candidates are leaning toward more government control of our healthcare. Later this month I will also talk a little more about where the candidates stand on our healthcare. It is evident that there will be battles to be fought to keep our government from coming between you and your doctor. I’m hearing more and more talk about politicians who are pushing for the government to become the single payer for healthcare, an approach that has shown to ration care, control prices and limit innovation in those countries that have government-controlled healthcare.
It seems that everything in our lives costs more, and for people on fixed incomes, that’s not good. If we really want to save money, we should encourage competition, reward preventive care, encourage innovation, and expand telehealth and home services so older Americans can age in place. This is what I want to hear from those candidates that are hoping to get my vote this November.
Best, Thair