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Happy Birthday to Medicare!

CTS friends surprised me recently with a birthday party. The cake was decorated with the words, “Welcome to Medicare!” Very touching. Actually, this chronological milestone doesn’t particularly bother me so I was able to enjoy the humor. And since I’ll not be retiring right now, I won’t be using Medicare right away.   But I’m signed up and the card is in my wallet, ready when I need it.

My welcome to Medicare, and Medicare’s fiftieth anniversary came within days of each other. For most of us the expectation of Medicare coverage has always been a part of our adult lives. Vietnam, the assassinations and racial and political turmoil of the 1960s, oil crises in the 1970s, the Gulf War, 9/11 and its aftermath, and various recessions have come and gone evoking their own anxieties and perils. But Medicare has endured. Doctors and hospitals no longer attack it as socialized medicine; they simply accept payment. Aging brings on lots of things to worry about, including many rooted in tough economic realities. But basic health care coverage is not one of them. And for that we should be very grateful.

Prior to Medicare it is estimated that about one half of all seniors were uninsured. Now virtually all seniors are covered. Prior to Medicare about one third of all elderly persons lived in poverty. That number is now closer to eight percent. Most of the improvement is due to Social Security as more and more Americans have entered retirement having made payroll contributions over a full career. But absent Medicare today, and in the face of rising health care costs, many seniors would still not be able to afford health care.

Meanwhile, studies have shown that people who have health care coverage access medical care more frequently. This is no guarantee of a higher quality of life for all seniors, but certainly many elderly persons are living happier and healthier lives, and for far longer, than their counterparts half a century ago.

Of course, the fans of privatizing almost every government program continue their perennial “the sky is falling” warnings about the affordability of Medicare. We’re already into another round of that with the launch of the presidential primary season. Solutions range from raising the age of eligibility to shifting everything to a voucher system which would allow – or force – seniors to purchase private insurance in a competitive market. Unfortunately, these arguments don’t really hold up under economic scrutiny.

Studies have shown that raising the age of eligibility will save very little money. And, according to Princeton economist Paul Krugman, Medicare costs per beneficiary have consistently grown more slowly than private health insurance premiums. Furthermore, according to Krugman, the passage of the Affordable Care Act was followed by an unprecedented pause in Medicare cost growth, suggesting that the program is far more sustainable than critics warn. Krugman concludes, “Medicare at 50 still looks very good. It needs to keep working on costs, it will need some additional resources, but it looks eminently sustainable.”

Carrying around a Medicare Card is, to be sure, a sobering reminder of the passage of time. But I’m also reminded that it’s a comforting reassurance that generations of American elderly in years past never had. Today such assurance is more important than ever as middle class wages remain stagnant, as fewer and fewer companies offer private health insurance coverage to their employees, and as unions – public and private – are relentlessly stripped of their ability to negotiate benefits for their members. In today’s political climate fashioning any kind of alternative to Medicare that would significantly improve rather than diminish the support and comfort it gives to seniors seems highly unlikely.

So I enjoyed my “welcome to Medicare” cake and am pleased to have shared a significant, albeit somewhat older in my case, birthday milestone with the program. It’s hard to imagine a more significant gift that has transformed more lives over the decades. I’m not really eager to use it! But when it’s easy to take so much for granted, it’s good to consider what growing old was like without it. Happy birthday indeed.

John H. Thomas
August 13, 2015

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