By CHRISTINE ADAMS
Houston Chronicle, July 29, 2010
Today marks the 45th birthday of Medicare, the public insurance program that guarantees basic medical coverage to all seniors and people with severe disabilities regardless of their income, health status or where they live.
In Texas, Medicare covers just under 3 million Americans. The breakdown by race is 60.7 percent white, 24.9 percent Hispanic, 11.7 percent black and 2.6 percent “other.” Of those Texans covered, 84.2 percent are seniors and 15.3 percent are disabled.
Medicare enjoys popular support despite the initial bitter resistance to passing it. Before its enactment, the elderly were at high risk for falling into poverty because most people had health insurance through their employer. Upon retirement, many had difficulties paying for medical care.
Over the years, the program has expanded. You are probably unaware that the Medicare program also pays for much of the durable equipment for many hospitals. It also funds the vast majority of residency training in the United States, including resident physician salaries and benefits, and gives subsidies to teaching hospitals in exchange for training resident physicians.
The president’s National Commission on Fiscal Responsibility and Reform is considering cuts to the Medicare program. We are told that the purpose of the cuts in Medicare (and to Social Security as well) would be to reduce the national deficit and protect the nation’s financial health. One has to ask: Are health care and insurance against poverty for seniors and the disabled no longer priorities for our society? And if Medicare is cut, where would the money come from to educate our future physicians and other health professionals?
Rather than cut Medicare, if we want to dramatically reduce health care costs and thus lower our national debt, we need to build on what works and expand to a “Medicare for All” national health insurance program. Every other industrialized nation has some form of national health insurance. They pay half as much per person, cover everyone and have as good or better overall medical outcomes than we do. According to both the World Health Organization and the Commonwealth Fund, our overall rankings are still at the bottom or near bottom when compared to other industrialized nations despite that fact that we spend twice as much.
How can these democratic nations spend so much less yet have such high-quality care? It’s because none have for-profit private health plans that play central roles in financing health care. They are able to put a higher percentage of their health care dollars to actual health care because they are not paying for the waste and profiteering associated with the “middleman” private health insurance industry.
Medicare operates as a single-payer health care system with administrative costs of just 4 percent to 6 percent compared with for-profit health insurance administrative costs of between 16 percent and 26.5 percent. In a “Medicare for All” program, administrative savings would amount to about $400 billion each year by eliminating unnecessary paperwork and bureaucracy. That’s enough to provide high-quality health care for every American and end co-pays and deductibles. Americans could go to any provider they wished to see. And, as with Medicare, the majority of health providers and hospitals would remain private and could receive fair reimbursements for their services.
So celebrate the birthday of Medicare (and Social Security on Aug. 14) and reflect on their lessons for today: that we have a social contract to care for our fellow citizens and we can save money if we fulfill it with a national health program. Tell the debt commission, “No cuts to Medicare. Expand it to all of us.”
Adams is a licensed psychologist and statewide secretary for Health Care for All Texas.