Improve Medicare and Expand It to All

From Common Dreams: http://www.commondreams.org/view/2011/07/06-12

by Jim Recht

Published on Wednesday, July 6, 2011 by CommonDreams.org

In honor of its 46th birthday this month, here is a brief history of Medicare: of the bitter controversy surrounding its creation, its subsequent achievements, and its current position at the center of congressional budget debates. I believe that once they understand the deep differences between this institution and our country’s more recent attempts at healthcare reform, most reasonable individuals will conclude that a national insurance system like Medicare offers a solution to the healthcare crisis, and that it should be fully funded and extended to cover all Americans from birth.

During the contentious debate that preceded its adoption in 1965, Medicare was attacked by powerful special interests -- among them, the insurance industry and the American Medical Association -- who decried it as "socialized medicine" and warned that it would destroy our healthcare system and even threaten our basic freedoms. It seems difficult today to imagine how such fear-mongering could have been taken seriously. Over the past half-century, by affording hundreds of millions of Americans access to high-quality health care, Medicare has played a major role in increasing life expectancy and overall quality of life in this country. Funded via a progressive tax mechanism that asks incrementally more of our wealthiest neighbors, and boasting better service and far lower administrative costs than the "leanest" private insurance, Medicare has become along with Social Security one of the most popular government programs in history.

In his speech announcing the new plan, then-President Johnson reminded the country that "there is a tradition we share today. It calls upon us never to be indifferent toward despair. It directs us never to ignore or to spurn those who suffer untended...[it] is as old as the day it was first commanded: 'Thou shalt open thine hand wide unto thy brother, to thy poor, to thy needy, in thy land.'"

The current administration's health reform legislation, and our own Massachusetts Health Reform that preceded and inspired it, are part of a very different story. That one begins in 2006 when, largely in response to Bush Administration pressure, then-Governor Mitt Romney signed into law legislation that dismantled our extensive healthcare safety net, partially replacing it with an “ownership culture" that has required hundreds of thousands of low- and middle-income residents to purchase insurance policies sold by private corporations through a state-run exchange.

5 years on now, despite our mainstream media's oddly strained attempts to suggest otherwise, we face overwhelming evidence that the Massachusetts Reform has failed. According to the comprehensive report released this month by Mass Care (masscare.org), Massachusetts reform has certainly forced many more Massachusetts residents to purchase health insurance policies – a boon to insurance companies, whose revenues have increased dramatically. But the difference between having insurance and having adequate access to quality healthcare has grown more oppressive than ever. For most individuals and families except for the very poorest and the wealthiest, out-of-pocket payments and insurance premiums have continued to skyrocket. Wait times for primary care appointments have increased, while ever fewer primary care doctors accept new patients -- they simply cannot cope with the administrative costs and frustrations of a system dominated by private insurance companies, each with its own system of authorizations, denials and appeals. Finally, with state spending continuing to increase at alarming rates, it is now beyond question that the reform is financially unsustainable.

Continue reading at: http://www.commondreams.org/view/2011/07/06-12