Medicare Anniversary

Thursday is the anniversary of Medicare's enactment.

JOHN GEYMAN
Geyman is professor emeritus of family medicine at the University of Washington. He is past president of Physicians for a National Health Program and author of the book "Shredding the Social Contract: The Privatization of Medicare.

He said today: "Medicare on its 44th birthday is remarkably successful. It's the one solid rock we have in our disjointed healthcare system. It covers 43 million Americans age 65 and older as well as some 2 million disabled people. It is consistently rated more highly than private insurance in terms of reliability and quality of coverage. It provides a comprehensive set of benefits, free choice of providers and hospitals anywhere in the country, and simplified administration with an overhead of only 3 percent -- versus administrative overhead and profit-taking five to nine times larger for private insurers.

"Medicare was passed in 1965 after a fierce political debate even more divisive than the one we're having now. Those opposed to reform today are saying that a government program will get between you and your doctor. But traditional unprivatized Medicare shows that to be untrue -- less bureaucracy than that of the private insurance industry, with its more than 1,300 insurers working hard to cherry pick the market for their maximal revenue by denying claims or even canceling coverage.

"Despite its successes, Medicare is not a perfect program. It would be even more successful were it not for political compromises along the way allowing it to be privatized. A good example is the Medicare legislation of 2003. The problem was soaring prices of prescription drugs. The result has been a bonanza for the drug and insurance industries. The new drug benefit was handed over to the private sector to manage, prices have continued up unabated, the government was prohibited from negotiating lower prices as the Veterans Administration does, and new subsidies were offered to private insurers for Medicare Advantage, private Medicare plans that seek out healthier Medicare beneficiaries.

"The same forces are at work today as healthcare reform proposals make their way through Congress. Under pressure from industry and their lobbyists, the public plan has been watered down to a small and ineffectual option at best, if it ever survives to being enacted. But the strengths of traditional Medicare as a system of social insurance, coupled with a private delivery system, remains a solid foundation upon which to build a better system in this country in terms of access, affordability, quality, efficiency and reliability."