Monday, July 30th, marked the 47th anniversary of Medicare. This indispensible program has allowed for medical care for seniors and currently serves 48 million Americans (3.4 Million in Florida alone).
In its 47 year history, Medicare has undergone many changes. These changes vary in their size and scope – the addition of benefits for dialysis in 1972, the Emergency Medical Treatment and Labor Act (EMTALA) in 1985, expanding coverage to include mammograms in 1988 and the establishment of Medicare Advantage Plans in 1997. None were larger than the Medicare Modernization Act of 2003 – which extended coverage of prescription drugs to seniors for the first time.
In 2010, thanks to the Patient Protection and Affordable Care Act, a series of important updates have been made. New preventive physicals are available to seniors. Out-of-pocket costs are eliminated for preventive screenings. Value based purchasing requirements are in place for hospitals, so that some of their Medicare reimbursement is tied to quality outcomes. Medicare’s solvency is improved by preventing wasteful overpayments to private health insurers administering Medicare Advantage Plans. Increasing funding is provided to crack down on fraud and abuse in the Medicare system, saving the taxpayers already $4.1 Billion dollars in 2011 alone. And seniors in the Medicare Prescription Drug Plan (Part D) have saved an average of $600 per Medicare Beneficiary with almost 2 million Americans saving an aggregate of $660 million.
Most promising is the newly created Centers for Medicare and Medicaid Innovation (CMMI). To date, CMMI has awarded grants that are projected to improve the quality of care for Medicare beneficiaries while saving the tax payers over $2 billion in reduced medical costs. The Accountable Care Organizations funded by CMMI will allow for changes in our healthcare delivery system that improves the care of individual patients, help our communities be healthier as a whole, all the while reducing our healthcare costs.
Since its creation in 1965, the Medicare program has been an immense success. In fact, only 8 percent of seniors rated their coverage through Medicare as “fair” or “poor” – which is in stark contrast to the 20% with employer based private health insurance plans who rate their insurance as “fair” or “poor.” An often unspoken reality is that 35% of seniors lived in poverty prior to the passage of Medicare, while the number of elderly poor now stands at 8.9%.
Medicare was a groundbreaking legislative achievement in 1965, despite a great deal of lobbying raising objections that Medicare would lead to “socialized medicine.” Despite vehement opposition in the 1960s, and constitutional challenges similar to ones seen leveled against the Affordable Care Act, 47 years of experience and improvements has led to the indispensible benefit of 48 million Americans today.
Happy Birthday Medicare!