A Prescription for ALL Americans – Expand and Improve Medicare
Maine AllCare board member Suzanne Roberts, MD, MDiv spoke at the Portland celebration of Medicare's 50th birthday on July 30, 2015
Hello Everyone! My name is Suzanne Roberts and I am a doctor. I practice Primary Care Internal Medicine in Old Orchard Beach Maine. I am the Vice President of MaineAllCare, which is the Maine chapter of a national organization called Physicians for a National Health Program. We are a group of over 19,000 physicians, medical students, and health care professionals who support a national single payer health plan, and we strongly support expanding Medicare to cover everyone.
I graduated from medical school 26 years ago; I have never practiced medicine without Medicare, and I cannot begin to imagine what my practice would look like today without the red, white and blue Medicare card that is so important to all of my patients over the age of 65. But another scene that I cannot imagine is what my practice would look like if everyone HAD Medicare; if all of my patients, from their first breath until their last, had health insurance that was not dependent upon their employment status and not dependent upon the size of their bank account, but health insurance that was theirs: permanent and portable, period. We can all understand that a basic kindergarten through 12th grade education, funded by our taxes, is a good investment in our communities; why can’t we understand that a universal health insurance funded by our taxes, like Medicare, will also make our communities stronger?
Doctors KNOW that our healthcare delivery system is broken, every day we go to work and try to help our patients survive within it. We would love to see ALL of our patients have equal access to quality health care. Just last year a Maine Medical Association poll of doctors found that 66% of us supported universal health care. But we need your help because we cannot successfully advocate for change alone.
Maine AllCare members celebrate Medicare's 50th birthday at Monument Square in Portland with art exhibits, music and speeches. (Click to see more)
So I have a prescription for you, because you didn’t think I was going to let you get away from a visit with the doctor without a prescription, did you? Your prescription is this: TALK ABOUT MEDICARE EXPANSION. Talk about expanding Medicare to EVERYONE in the country. Talk to your doctor about it. Help you doctor to imagine a country where everyone has Medicare from birth to death, where insurance coverage is never an issue, and where your doctor can get back to taking care of patients, not paperwork. Talk to your family and help them to imagine what life would be like if every one of us, kids, grandkids, nieces, nephews--- every one of us had Medicare too. What would it be like if your loved ones never needed to worry about losing health insurance if they lost their job; or if they never had to worry about going bankrupt due to medical bills? Talk to your neighbors, your friends at church or at work, at the gym or on the beach; TALK about our vision of Medicare for all.
Fifty years ago the American Medical Association opposed the creation of Medicare, calling it “socialized medicine”. I am standing here today saying “Thank God!” their fear mongering was ignored and Medicare was born. Now is the time for us to join together in expanding what was started 50 years ago; let’s put a red, white and blue Medicare card in everyone’s wallet! Happy Birthday Medicare!
America needs cost-effective universal health care
By Julie Pease, M.D.
August 4, 2013
In recent months, the people of Maine have witnessed activity by many different players in the health care system as Maine moves to implement the Affordable Care Act.
We’ve seen Gov. Paul LePage veto the expansion of MaineCare, which will leave 70,000 Mainers without access to health care. We’re watching MaineHealth and Anthem try to exclude local hospitals and providers in order to gain “market share” in the upcoming insurance exchange.
We’ve seen highly paid hospital lobbyists and executives successfully persuade Gov. LePage and the Legislature to repay the state’s hospital debt. We’ve learned that businesses are being granted a reprieve from the mandate to offer health insurance to their employees, although individuals remain subject to the mandate beginning in January 2014. Even with ACA subsidies, many of the individual insurance options in the marketplace will be either inadequate or unaffordable for many Mainers.
In the meantime, the problems in the health care system continue to grow. Patients are struggling. The costs of health care consume more than 20 percent of our state’s GDP.
In Maine, an estimated 1,800 individuals and families declared bankruptcy in 2012 due to medical costs. Although some of these people were insured, the majority had health insurance that was inadequate to cover the high costs of medical care. There are 130,000 Mainers who continue to have no health insurance at all; thousands more are under-insured.
When people are under-insured or have no insurance, they delay getting necessary health care and they don’t fill life-saving prescriptions due to cost. That leads to poor health outcomes. When people delay too long, the outcomes are catastrophic. In Maine, someone dies every three days because of lack of health insurance (over 130 deaths per year).
Despite these overwhelming problems in the health care system, there are some bright spots. Our own publicly-funded health care systems (Medicare and the Veterans Administration) remain highly popular and provide better care at lower cost to the most vulnerable patients.
Recently, Medicare passed its 48th birthday. Forty-eight years of experience demonstrates that Medicare, our cherished national public insurance system, could become the solution to the health care crisis in America.
On the occasion of the 48th anniversary of Medicare, I urge Congress to implement real health care reform by improving and extending Medicare to every person in the United States.
A single universal system would give everyone the same access to quality health care regardless of health, wealth, age or employment. It would allow patients to choose their physicians, rather than having insurance companies choose for them. It would spare people the specter of bankruptcy if any family member should have a serious accident or illness. It would help struggling families and small businesses by funding health care with progressive taxes rather than unaffordable insurance premiums. It would eliminate labor-management disputes over health care benefits.
An improved Medicare system would also allow the government to negotiate fair prices for pharmaceuticals, medical devices and health services, and would make it easier to identify and eliminate fraud. It would reduce costs of health care by eliminating the extraordinary and unnecessary administrative waste generated by the private health insurance industry and by the bureaucratic complexities of the Affordable Care Act.
America needs cost-effective universal health care as exists in every other industrialized country. No other nation uses our unique private insurance system which penalizes the sick by charging them more, by reducing their benefits, or by denying care altogether. None allow private insurance companies to place profit over coverage. All of them encourage health care by reducing or eliminating deductibles and co-pays. And all of them provide better care to more people for less money than we do.
Replacing the current health care system with an improved system of Medicare for all would improve this nation’s health. It would save lives and save money.
We must move beyond the bureaucratic, complex, expensive and limited reforms offered by the Affordable Care Act. Instead, let’s improve the popular Medicare program and expand it to cover everyone.
Dr. Julie Pease of Brunswick is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all.
Expand Medicare on its 48th birthday
To the Editor:
This week marks the 48th anniversary of Medicare.
Passage of this law did not happen overnight. Notable among many early supporters were Theodore Roosevelt as part of the Progressive Party platform (1912), Senator Cappar who introduced a health insurance bill (1935), President Franklin Roosevelt in his state union speech (1944), President Truman in a health message to Congress (1945), a Social Security Administration report (1951), the Annual Conference of Governors (1960) and President Kennedy in his address on Medicare from Madison Square Garden (1962).
Medicare, a giant step forward, was signed into law by President Johnson on July 30, 1965. After Medicare became law, President Nixon sought to go further by proposing health care for all Americans.
Where are we now, 48 years later, in the pursuit of universal health care in this country?
The Affordable Care Act, still leaving millions uninsured, would potentially expand coverage to many. The law is, however, facing passive aggressive and outright resistance. States are choosing not to expand Medicaid, 19 states are not setting up their own exchanges, companies are cutting workers’ hours and limiting the number of workers to avoid providing coverage; dissenting voices are everywhere.
In addition to this, unemployment and underemployment remain high; towns and cities are fiscally challenged and, in Detroit’s case, being forced into bankruptcy; medical costs keep rising; and some voices even seek to undermine Medicare.
One can only conclude that we have lost our way. The approval rate of Congress is abysmal; the voice of the people is not the voice of many of our politicians. Small steps have not worked. In a democratic country that prides itself on being of, by and for the people, health care must be seen as a human right of the people. We need visionary leadership to embrace this principle and act on it.
It would be truly unifying and uplifting to this nation, if on the 50th anniversary of Medicare, we could celebrate landmark legislation expanding it to the point where all people are included.
Jean C. Sawyer
Published in The Brunswick Times Record, July 31, 2013
Letters to the editor: Medicare should be cheered, expanded
On July 30, 1965, Lyndon Johnson signed Medicare into law. As we note that anniversary, it is interesting to compare the health care news of our own day.
For instance, an article in the July 25 Portland Press Herald ("Briefcase: Wellpoint stock sets record ahead of health care reform") reports: "Shares of Wellpoint Inc. hit an all-time high Wednesday, after the nation's second-largest health insurer trounced second-quarter earnings expectations and detailed how it expects to benefit from the health care overhaul and other growth opportunities over the next few years."
I'm no economist, but it seems to me that if the payer of medical bills is trouncing earnings expectations, then the payer of premiums must be paying for more than health care.
This is of particular note when we read the same day that Anthem, a subsidiary of Wellpoint, is entering an exclusive partnership with the nonprofit MaineHealth ("Anthem-MaineHealth network approved -- with conditions"). Is that a strategy to improve health, or to "benefit from growth opportunities"?
There's other news, too: about whether to expand Medicaid coverage to the thousands of Mainers who have no insurance; about postponing the Affordable Care Act's mandate; about the move by some employers to reduce workers' hours so they can avoid providing health insurance.
All very complicated, not to mention distracting from the basic mission of health insurance -- making medical care affordable by spreading its cost.
What a contrast is the Medicare story. Despite the program's problems and the chronic, yet surely resolvable, issue of its funding, it has proved to be far more cost-effective than private health insurance (1 to 5 percent overhead cost versus 12 to 30 percent for private insurers, according to www.politifact.com), far more inclusive and certainly more efficient than the stopgap ACA.
Indeed, we should celebrate Medicare's 48th anniversary by resolving to take it to the next level -- Medicare for all.
Daniel C. Bryant, M.D.
Published in the Portland Press Herald, August 8, 2013
Medicare at Age 50: Building on Its Success
By Nancy Altman
Medicare -- signed into law fifty years ago, on July 30, 1965 -- was supposed to be just the first step.
For the fifty years before Medicare's enactment, progressives had fought unsuccessfully for universal, government-provided health insurance. In 1912, President Theodore Roosevelt's Progressive Party platform advocated universal, government-sponsored, health insurance, but he was defeated in his quest for another term as president. In 1917, the California legislature approved universal health insurance, and the governor supported it, but a 1918 ballot resolution defeated the measure after a massive, well-financed business and physician-fueled campaign against it. President Franklin Roosevelt seriously considered including national health insurance in his 1935 Social Security legislation, but decided against it out of fear that it would bring down the entire legislative package. President Harry Truman made universal health insurance a top priority, but got nowhere.
The five-decade long history of defeat convinced activists to shift to an incremental approach. They decided to start with a sympathetic group and debated which one that should be. The top candidates were seniors and children. On the one hand, covering children was relatively inexpensive and could lead to a lifetime of better health. On the other hand, seniors were most in need of health insurance and were already used to and supportive of Social Security's government-sponsored wage insurance. And they voted.
So the decision was made to start with them. The expectation was that, after Medicare was enacted, children and others would be quickly added. And, indeed, just seven years later, in 1972, President Richard Nixon signed into law legislation which extended Medicare to people with serious and permanent disabilities.
But then came Watergate, distrust of government, and President Ronald Reagan's famous declaration, "Government is not the solution to our problem; government is the problem." Expansion of Medicare to children or other demographic groups disappeared from the public agenda. But the need for universal high-quality health care, efficiently provided, did not.
Conservatives and centrist Democrats, increasingly in control, looked for alternative approaches. Inclined toward private sector solutions but recognizing that some limited government role was essential, they favored private sector health insurance and savings supported by favorable tax treatment. For those who fell through the cracks and who were deemed worthy, they favored means-tested health insurance provided at the state level, with federal support.
Those are the solutions that have dominated since 1972, despite the obvious advantages of simply expanding Medicare. Means-tested Medicaid, included in the same 1965 legislation that enacted Medicare, was expanded every few years, most recently as part of the Affordable Care Act in 2010. The means-tested State Children's Health Insurance Program (CHIP) was enacted in 1997. And, the Affordable Care Act authorized state exchanges offering private health insurance subsidized with income-tested, government subsidies. During these decades, the tax expenditure on health care insurance grew from the fourth largest tax expenditure in 1986 to the largest today -- at a loss of revenue of over $200 billion a year. And during this same period, conservatives amended Medicare to include private health insurance and means-tested elements.
But these methods of providing health insurance are vastly inferior to universal, government-sponsored health insurance -- essentially, Medicare for All. Universal, government-sponsored insurance is the most effective and efficient way to cover everyone. Insurance is least expensive when it covers the most people; the large size of government-sponsored health insurance provides economies of scale and the greatest ability to negotiate over prices and control costs. Moreover, unlike private health insurance, a government plan has no marketing costs and no high CEO salaries. It can provide health care less expensively and more efficiently for everyone. For these reasons, every other industrialized country provides universal coverage, spends less as a percentage of GDP, and produces better health outcomes.
But we don't have to look to other countries to see the advantages. Medicare covers seniors and people with disabilities, people who, on average, have the worst health and the most expensive medical conditions, requiring the largest numbers of doctor and hospital visits with the concomitant largest number of health care claims. Yet, Medicare's administrative costs are the lowest around. Medicaid, whose administrative costs vary from state to state, is less efficient than Medicare, because its coverage is statewide, not national, and it must impose complicated and expensive means testing, Even with that, both Medicare and Medicaid are significantly more efficient than private health insurance. Compared to Medicare's administrative costs of just 1.4 percent, the administrative costs of private health insurance sponsored by very small firms or purchased by individuals can run as high as 30 percent. Even the administrative costs of health insurance sponsored by large companies typically run around 7 percent. Read More of this story.