CMA Health Policy Blog

Health Care Reformers Should Learn from Medicare

April 22, 2009 at 8:20 pm Judith Stein 2 comments

President Obama’s March 5th Health Care Summit was a welcome step towards enacting health care reform. Hopefully, this kind of inclusive engagement will allow different interests to coalesce and commit to ensuring that all Americans have health care coverage. Unfortunately, recent reports about plans for healthcare reform indicate that we may be about to repeat past mistakes – to the detriment of people needing care and of taxpayers.

As the discussions regarding health care reform continue, and decisions are made, the Center for Medicare Advocacy reminds policy-makers that Medicare, the country’s only experiment with national health insurance, has a lot to teach about how best to provide health care coverage for all.

For over 40 years, until it was morphed into a system of expensive private plans in 2003, Medicare was a resoundingly successful public/private partnership. Before Medicare began in 1965, half of all older people had no health insurance and nearly 35% lived in poverty. Today, poverty among older people has dropped by two-thirds and the vast majority of Americans over 65 and people with significant disabilities have Medicare health insurance.

The Center for Medicare Advocacy urges reformers to develop a public option in any final health care legislation. With some updating and adjustments, the public/private partnership of the traditional Medicare program could serve as that option. President Obama, Congress, and those who are able to participate in serious efforts to reform health care coverage should look to the lessons from Medicare Parts C and D. Let’s not repeat the mistakes made in those programs – specifically, the enormous complexity and excessive costs resulting from multiple private plans. People want choices of health care providers, not health insurance plans.

Reformers should learn from Medicare’s past and present. Medicare Parts C and D moved Medicare much too aggressively toward private plans, alienating and confusing many beneficiaries, costing taxpayers billions of unnecessary dollars, and threatening Medicare’s viability.

Rather than repeating those errors on a grand scale, we should look instead to traditional Medicare which balances a public program with a private claims processing infrastructure. That is a reasonable model for a national health plan. The traditional Medicare program – with the addition of a cap on out-of pocket spending and phased in coverage for coordinated care, dental, vision, hearing services and long-term care – could serve as the basis for a national health plan.

The standard for any health care program should be what’s best for its beneficiaries and what’s most cost-effective for taxpayers. Until it was privatized, Medicare met that standard; it worked well for older people and people with disabilities, and it was cost effective for taxpayers. A Medicare model with appropriate fine-tuning could also work to provide health care for all Americans.

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