By Jessica Schorr Saxe, M.D.
The Charlotte (N.C.) Observer, July 27, 2015
What do these recent news stories in the Observer have in common?
An insurance agent connives to sell Affordable Care Act policies to homeless people by encouraging them to report inflated incomes. His clients/victims discover they can’t afford their deductibles nor can they any longer receive medications or other services earmarked for the uninsured.
Health care advocates across the state call on Governor McCrory to develop a plan for Medicaid expansion, noting that hundreds of thousands of North Carolinians would benefit significantly, at little cost to the state.
A benefit concert is held to pay mounting medical bills for an artist severely injured when struck by a car.
The answer: None of these stories would exist if the United States provided health care to all – as every other developed nation does.
July 30, 2015, is the 50th anniversary of the day President Lyndon Johnson signed the Medicare bill and handed former President Harry Truman, a longtime advocate of a national health care program, the first Medicare card. It marks a good time to reflect on the progress made and possibilities remaining, as the original Medicare proponents envisioned that the program would, in time, expand to cover everyone.
Many of us have become so accustomed to Medicare that we forget what a success it is. As the Commonwealth Fund notes, it has accomplished its two basic goals: improving access to care for the elderly and protecting them from financial hardship.
Before its implementation, 48 percent of seniors lacked health insurance; today the figure is 2 percent.
Medicare recipients are less likely to miss needed care, are less plagued by medical bills, have fewer negative insurance experiences, and are more satisfied with care than private insurance customers. Its administrative costs of about 2 percent are considerably less than those of private insurance, which average 12-14 percent.
By ensuring access to care, Medicare has contributed to a five-year increase in life expectancy at age 65. Another benefit of the program has been integration, as hospitals rapidly desegregated in order to participate and receive federal funding.
And Medicare is popular, with 77 percent of Americans supporting it, including majorities of Republicans, Democrats, and Independents.
Its shortcomings include a lack of comprehensiveness and seamless integration. At present, it is a mix of different programs – Medicare A, B, C, and D – each of which is administered and funded differently. Uniting the different parts and expanding it to cover all U.S. residents would actually simplify the program.
If we expanded Medicare to include everyone, we would all benefit from improved health care, relief from anxiety about medical bills, greater choice of providers and hospitals, and freedom from the oppressive bureaucracy that plagues both patients and providers.
As a physician, I would love to see us return to the primary mission that has inspired our profession for millennia – caring for patients, listening to their stories, concentrating on their well-being – instead of filling out forms and dancing to the beat of insurance companies.
Happy Anniversary, Medicare! Let’s celebrate its success by improving it and expanding it to all.
Dr. Jessica Schorr Saxe is chair of Health Care Justice – NC, a chapter of Physicians for a National Health Program. Reach her at HCJusticeNC@gmail.com.