Medicare at 50: Successful, Popular, and Threatened By Conservatives

Thursday marked Medicare's 50th birthday. It's improved the lives of millions of Americans, and it can as much for even more people. That's why Republicans have never stopped trying to end it.

Fifty years ago, Lyndon B. Johnson signed the Medicare amendment under Title XVIII of the Social Security Act, guaranteeing health insurance to Americans 65 and older, regardless of income or medical history. Republicans like former senator Tom Coburn believe America was better off before Medicare. In 2011, then Sen. Coburn (R-Okla.) said:

"You can't tell me the system is better now than it was before Medicare," he said.

Coburn agreed that some people received poor care -- or no care -- before Medicare was enacted in the 1960s, but said communities worked together to make sure most people received needed medical attention.

He also conceded that doctors and hospitals often went unpaid for their efforts, or accepted baked goods or chickens in partial payment.

Here's a snapshot of life before Medicare:

• Only about half of Americans over 65 had health insurance.
• Nearly half Americans over 65 were uninsured. Coverage for them was unaffordable. Older people were charged more than three times as much for insurance as younger people, because insurers considered them "bad risks."
• Nine out of ten married seniors, and eight out of ten individual seniors were responsible for their own health care costs, and received no help from government or private agencies. Most paid with health insurance or dug into their own savings, when they could pay at all.
• More than one in four seniors went without medical care due to cost issues.
• More than one in three seniors lived in poverty.

Fifty years later, Medicare has changed health care for the better.

• Medicare covers 49 million Americans over 65, and 65 million younger disabled Americans, who would otherwise be uninsured.
• Just 2 percent of Americans over 65 are uninsured.
• According to analysts, Medicare has increased life expectancy for Americans over 65 by five years.
• Those on Medicare are less likely to go without care or have unmanageable medical bills than people under 65 who have health insurance.

No wonder Medicare is such a popular program. The Kaiser Family Foundation's most recent survey of American attitudes towards Medicare found that the program is as popular with, and important to, Americans as ever.

• 77 percent view Medicare as a "very important" program, including majorities of Democrats (89 percent) and Republicans (69 percent)
• 75 percent of those covered by it say Medicare is working well
• 70 percent think Medicare should continue to as it is today, including majorities of Democrats (78 percent) and Republicans (64 percent)

Despite all of the above, Medicare has been under attack from Republicans since its birth. Ronald Reagan himself warned against "socialized medicine."

Republican rhetoric against Medicare has soften slightly in 50 years, but they've never stopped trying to do away with the program. Today, destroying Medicare (and Medicaid, and Social Security) is a big part of the GOP's war against the poor, the elderly, the disabled, and economically disadvantaged.

• Today, Republican presidential candidate and former Florida governor Jeb Bush says he wants to "phase out" Medicare, and replace it with a system from which people get government funds to help them purchase private health insurance.
• In 2012, Republican presidential nominee Mitt Romney adopted running mate Rep. Paul Ryan's (R-Wis.) plan to privatize Medicare by converting it to a "premium support" program. In other words, vouchers.
• House Republicans have repeatedly approved budgets that would end Medicare as we know it, by slashing its funding, and replacing it with a voucher system for purchasing private insurance, while passing the costs on to seniors.
• Since they haven't been able to kill the program outright, Republicans have tried to starve Medicare of funds.

It's precisely because Medicare is both successful and popular that Republicans want nothing more than to "drown it in the bathtub" for its 50th birthday. Conservatives feared the passage of programs like Social Security and Medicare for the same reasons they feared the passage of health care reform. They knew that if these programs were successful, they'd become so popular that Americans would never voluntarily give them up.

Not only did conservatives worst fears regarding Medicare and other programs come true, but Medicare's success may yet serve as a model for further health care reform. A December 2014 New York Times/CBS survey showed that 59 percent of Americans support the government offering a healthcare plan similar to Medicare to compete with the private market. Calls for "Medicare for all!" may resound as loudly as they did during the the health care reform debate.