(Host) Medicare was initially proposed as a national health insurance
plan that would cover all Americans, not just seniors. Novelist,
essayist and educator Deborah Lee Luskin thinks now’s the time to bring
the original plan for universal coverage back.
(Luskin) When my
grandmother was born in Eastern Europe in 1900, her life expectancy was
48 years. Unlike her twin brother, she survived childhood, and
immigrated to the United States at age nine. At 14, she left school and
worked as a milliner. After she married, she helped my grandfather run a
delicatessen. When that enterprise failed, my grandmother kept house in
a five hundred square-foot apartment, raised two children, and sewed
piecework for extra cash.
The first Medicare bill was signed
into law the year my grandmother turned 65. Twenty years earlier, in
1945, Harry Truman had sought to establish a national health insurance
plan.
The idea of universal health coverage was met with an
outcry against socialized medicine, so the plan was modified to offer
health benefits only to recipients of Social Security.
My
grandmother was in the first cohort to receive Medicare benefits,
beginning in 1966. By then, her life expectancy had increased to 73.8
years. She was seventy-three and a half when she died. As it was
designed to do, Medicare paid my grandmother’s late-in-life
hospitalizations, which she would otherwise not have been able to
afford.
According the National Academy of Social Science, "the
Medicare program was modeled on the private insurance system in place in
the 1960s," insurance that was aimed at covering only hospitalization
for catastrophic illness. But in 1965, no insurance company would sell a
policy to anyone over 65, thus the need for Medicare.
My mother
received Medicare benefits until her recent death at age 87. According
to the Life Expectancy Calculator at the Social Security website, I can
expect to live another 28 years, twenty of them covered by Medicare – if
it still exists.
Over the years, Medicare has slowly expanded
coverage for medical office visits and for prescription drugs, but not
adequately, especially considering the changes in medical practice and
longer life expectancy.
Additionally, Medicare routinely
underpays for services as part of the great cost shifting that’s become
routine in the financing of American healthcare.
Now, there are some who propose to privatize Medicare completely, shifting the entire burden of finding coverage to seniors.
It’s
a highly complex issue, but one that those of us who vote must
understand as the political discourse heats up. Taxes support many
things, from moon shots to cancer research, but not everyone goes into
space or gets cancer – every one uses health care. Currently, only
Americans over 65, the disabled, and the impoverished have national
health insurance; those of us who work and pay for it don’t.
So
Medicare isn’t perfect, but it’s a good start. With expanded coverage
and greater emphasis on health maintenance, Medicare could serve as the
basis for the kind of universal health care that Harry Truman envisioned
when he initially proposed National Health Insurance for all.