By RICHARD PROPP
Albany Times Union
First published: Sunday, August 3, 2008
Dear Medicare:
Happy birthday!
Since I first met you on July 31, 1965, I have been smitten with your looks, your fairness, your support of the elderly without regard to social or economic status, skin color, ethnicity, intellectual IQ, emotional IQ, address, clubs, choice of transportation, hobbies, reading list, or favorite restaurant. You took care of our grandparents, our parents, and now you are taking care of us!
Your birth was not without pain. Some of the Southern congressmen could not stand the idea of people with differing skin colors being in the same hospital room. Eventually President Lyndon Johnson, his staff, and senior citizen groups, wore down Congress, the insurance industry, the unions, and the American Medical Association, and Medicare, health care for all Americans aged 65 and over, became law. It was implemented in July of 1966. Health care was not just a necessity, it was now a right for these folks.
In July of 1965, I was moonlighting as a substitute physician in Ravena in southern Albany County with Dr. John Mosher and Dr. Ira Lefevre while I was chief resident at Albany Hospital, now known, of course, as Albany Medical Center Hospital. (Dr. Richard T. Beebe was chief of medicine at Albany Hospital and allowed us to make ends meet in this way.) More than half of our patients in Ravena who were over 65 couldn’t pay for their needed medical care and instead left vegetables and chickens at Mrs. Mosher’s back door. When Medicare came in, it allowed older folks to be treated as paying patients, restoring their dignity and their ability to be diagnosed and treated at an early stage of their illness. Countless lives were saved and diseases prevented. Practitioners and hospitals flourished.
Through the years, dear Medicare, you have been declared broke and broken, and somehow in response to pressure by physicians and patients, wise and compassionate politicians have patched you up and you carry on.
In 2003 you were “modernized” by radical conservatives and the drug and insurance companies, and, frankly, you were exploited. We are just now waking up to the fact that the real goal of this “modernization” was privatization. We are now paying private insurance companies 13 percent more to deliver benefits to those 65 and older through these private Medicare Advantage plans than through traditional Medicare. This wasteful and unnecessary payment scheme was highlighted in the recent struggle over Medicare physician reimbursement rates and hopefully will be addressed through the political process over the next year.
Those of us who believe health care is not just a necessity, but should become a right for all, hope that sometime soon you will have a baby and expand your family!
That baby is already in gestation stage as HR676, Expanded and Improved Medicare for All.
More than 90 members of Congress have signed on in support of this legislation, and there is a strong and growing wave of grass-roots support, as well as in the medical community, local governmental entities, and the labor movement. Your overhead of 4 percent, dear Medicare, is one-sixth that of private insurance plans, and one third that of not-for-profit plans. Among its many benefits, socially and economically, single payer improved and expanded Medicare for all would eliminate the huge administrative expense in time and staff to deal with myriad insurance company plan requirements and reduce overhead. Hospitals would have a guaranteed budget, and rural and urban physicians and other practitioners will have patients for whom they will get full reimbursement. At least 22,000 lives will be saved and over 500,000 medical bankruptcies will be avoided each year. Job mobility and the economy will improve as health insurance becomes separated from employment.
New opposition groups are arising, however, who are very clever about espousing “universal health care”, but, upon scrutiny, what they are really supporting are private insurance-based plans and the status quo.
This is really like putting lipstick on a pig. Even with lipstick, pigs are still pigs.
Forcing everyone into private insurance plans is not the solution to our health care crisis for anyone except the insurance industry. We, your family, dear Medicare, seek to expose these efforts as the cynical delay and denial tactics they represent. We will not let your estimable reputation and outstanding 43 years of success be besmirched, or curtailed by your undermining and privatizing adversaries.
Medicare, we still love you.
Happy birthday, and many more!
Dr. Richard Propp is chair of the Capital District Alliance for Universal Healthcare, Inc.