Medicare, We Hardly Know Ya
July 31, 2009 at 6:38 pm Judith Stein 4 comments
44 years ago Medicare was enacted into law. All of today’s dire warnings about a public health option – socialism and government barring the doctor’s door – were made in opposition to Medicare. Despite such opposition from “conservative,” leaders, including Senator Bob Dole, Medicare passed.
Before Medicare, 50% of everyone 65 or older had NO health insurance. Now, as a result of Medicare, almost all older people are insured. Medicare, which is national, government-run health insurance, succeeded in insuring older people where private insurance failed. And, until the Bush Administration privatized Medicare with the extraordinarily subsidized private “Medicare Advantage” and Part D plans, Medicare was remarkably cost-effective too. It’s private Medicare, not the traditional, public program, that’s bleeding taxpayers of billions of dollars.
Medicare has been a success, fiscally and morally. It took on the job of insuring health coverage and care to people that private insurance had abandoned. Since 2003, on the other hand, private Medicare plans have cost us all tens of billions of dollars that went to support the private insurance industry, not to providing health care. In addition, private Medicare plans have too often engaged in marketing abuses and restrictive coverage practices.
As Paul Krugman recognizes in today’s New York Times, people with Medicare love it. They do not want government to fool around with the traditional program. Ironically, these are sometimes the same people who worry that a public health care option will cause long waits for health care and government invasions into their private medical decisions. They, and their family members, (which accounts for pretty much all of us), forget that the traditional Medicare program is a public health insurance option.
Hello, America, meet Medicare: Our 44 year-old public health insurance option that provides care to all its enrollees, anywhere in the country, and that has provided health and economic security for millions of older people, people with disabilities, and their families.
Happy anniversary, Medicare. Thank you for showing us what a true public insurance program can offer.
Entry filed under: Health Care Reform, Medicare, Public vs. Private Health Coverage, Single Payer. Tags: Health Care Reform, Medicare, Public plan.
CMA Health Policy Blog 
1.
Kenneth Dardick MD | August 3, 2009 at 5:12 pm
As a physician who treats many patients under the Medicare program I can attest to the overall simplicity and transparency in dealing with the program. Medicare coverage has limits, but they are well-known and understood. The benefits are considerable. Let’s not fall prey to the fear-mongering and red flags being waved about the horrors of a “public plan”.
Medicare is a remarkably efficient public plan -let’s learn from its successes.
2.
Tom Gibson | August 4, 2009 at 9:13 pm
A study by the Robert Woods Johnson Foundation last year showed that people on Medicare only got the care that science says they should 55% of the time. Why would anyone want a public plan that didn’t work half of the time? What business would still be around if they only performed at that level. Would it be acceptable if the US Postal Service only delivered 55% of the mail?
Tom Gibson
3.
Anonymous | August 4, 2009 at 9:47 pm
I do not believe this is true of the services that the traditional Medicare program is authorized to cover. I have been representing beneficiaries, NOT provider for over 30 years.
Further, just last week my oncologist told me she was not going to order a necessary test beause my PRIVATE employer group health insurance plan “has not been covering it lately”. I have cancer – I needed that MRI.
4.
Tom Gibson | August 4, 2009 at 10:10 pm
According to Medicare they paid out $25 Billion in “unnecessary” radiology diagnostics in 2007 because they were duplicative, would not change the diagnosis/treatment/outcome, or they were simply not needed for any medical reason. Medicare routinely denies coverage for care and is far less predictable in some cases than private insurance.
Medicare is currently considering ways to cut back on radiology because it is one of the biggest waste areas in the program. They also have been denying all claims for people that were put into the hospital by their doctor for “observation” (you go to the emergency room and they can’t figure out why you are having chest pains so they keep you) and with increasing frequency for testing that it doesn’t consider “medically necessary”.
The biggest difference between claims procedures in Medicare is that they have no mechanism to get pre-approval for procedures like private insurance. You get the care your doctor ordered and then you find out whether your claim will be paid or not.
I deal with beneficiaries every day. Medicare is far worse to deal with since it is almost impossible to appeal a decision.
Tom Gibson