Medicare’s Legacy

Now that the partisan effort to repeal the partisan Affordable Care Act (ACA) has stalled, an opportunity has opened for a meaningful debate on a bi-partisan solution to the healthcare crisis.

There is a healthcare system in the United States that was initially intended as a base from which to build a universal healthcare system. It is Medicare and Sunday, July 30, 2017, is its 52nd anniversary.

Medicare was prevented from being expanded into a universal system by a “poison pill” inserted by Rep. Wilbur Mills, chair of Ways and Means at the time. Instead of one system for those on low incomes and the elderly that could easily be expanded, Mills created a “three layer cake” of Medicare Parts A and B and Medicaid.

Though many were unsure if it would work, Medicare did succeed in enrolling 19 million seniors in its first year, without computers. Prior to Medicare, more than 50% of seniors were without health insurance. Medicare also lowered poverty rates in the elderly by 75%.

In the decades since Medicare was created, certain populations have been added to it, such as people with end-stage kidney disease and amyotrophic lateral sclerosis (AML). In the ACA, Sen. Max Baucus added the entire town of Libby, MT and the surrounding Lincoln County into Medicare because of a health crisis brought about by exposure to asbestos.

This history is important to understand as we move forward. Medicare is an American legacy that has been adopted by countries such as Canada and Taiwan as a basis for their universal systems. The Taiwanese system was developed with input from American health experts.

Let’s celebrate our American legacy of Medicare. It is a bi-partisan solution that is fiscally conservative and provides a social safety net. As we debate next steps to address the healthcare crisis, let’s consider that one solution is already here and include National Improved Medicare for All.