Two Visions for Medicare’s Future: Destroy It, Or Expand It To Cover Everyone
On July 30th, 1965, Medicare became the law of the land. For over a half century, it has stood as a shining example of government at its best. Today, it efficiently provides high quality health care to nearly 50 million seniors and nearly 9 million Americans with disabilities.
After decades of success, Medicare is under attack. The Republican Party wants to destroy Medicare by turning it from a guaranteed benefit into a privatized voucher program where beneficiaries receive inadequate coupons to purchase insurance on the private market.
But Democrats are fighting back in the best possible way: Offering a far superior competing vision. The Democratic Party is increasingly unified around improving Medicare’s benefits and expanding it to cover all of us.
It was a Democratic President and a Democratic Congress that created Medicare for seniors. They did so as a first step to Medicare for All. A second important step was taken in 1972, when Medicare was expanded to cover people with disabilities. Now Democratic candidates and incumbents alike are ready to finish the job and extend an improved Medicare to cover everyone else.
This past September, Senator Bernie Sanders (I-VT) introduced the Medicare for All Act of 2017 along with 16 Democratic Senators, many of whom are likely to run for President in 2020. In the House, the Expanded and Improved Medicare for All Act has 123 co-sponsors, nearly two-thirds of all House Democrats. The recently launched Medicare for All Caucus in the House had over 70 founding members.
The growing momentum behind Medicare for All terrifies Republicans, as it should. It puts the lie to the Republican claim that government is the problem, not the solution. Medicare is more universal, efficient, fair, and secure than private sector health insurance. Expanding it will make it stronger and better.
Moreover, Medicare for All represents the will of the people. The American people are divided on many issues, but this is not one of them. Sixty-four percent of voters are more likely to back candidates who support expanding Medicare, versus only twenty-two percent who are less likely.
In classic Trumpian fashion, Republicans are resorting to blatant lies to attack Medicare for All. Seema Verma, the woman Trump put in charge of Medicare, recently made the outrageous claim that expanding Medicare to cover everyone would hurt seniors.
The truth is exactly the opposite. Medicare currently covers the most expensive part of the population, seniors and Americans with disabilities. Adding younger people to Medicare would strengthen the system by creating a larger and healthier insurance pool. Furthermore, all major Medicare for All plans would significantly improve the program for current beneficiaries. The plans add dental, vision, and hearing coverage, as well as other important benefit improvements. And current beneficiaries would pay less for that improved coverage. No co-pays when you go to the doctor. No deductibles to satisfy.
Tellingly, Verma also attacked Medicare for All by claiming that it would be a “socialized system” that would give “the government complete control over decisions pertaining to your care.” That is fearmongering at its worst. In fact, it is our current system that gives private health insurance the power to decide whether to approve a necessary procedure. It is our current system that gives unaccountable CEOs the power of life and death. Medicare for All would bring more accountability and more transparency.
Fortunately, fearmongering about expanding Medicare is hard. The program is well known to all of us. It has stood the test of time.
Most of us know someone on Medicare, even if we are not yet on it ourselves. We know that Medicare respects the doctor-patient relationship, but relieves its beneficiaries of the financial worry of whether a procedure is affordable. It’s no surprise that beneficiaries of the “socialized system” of Medicare are considerably happier with their coverage than those who have private health insurance.
The only entities who benefit from continuing to have a private system are the for-profit insurance corporations. There’s a reason that Americans currently pay the highest prices in the world. In contrast to Medicare’s administrative costs of just 1.4 percent, the administrative costs of private health insurance average around 11 to 17 percent. If we simply eliminated that waste and bloat, Americans could receive better care at a lower cost.
Medicare for All is not only much more efficient, it will cover everyone and give each of us much more choice. Currently, for-profit private health insurance limits our access to particular doctors who happen to be “in network.” We are charged exorbitant fees if we go to doctors “out of network” even if we have no choice, because we are treated by out-of-network doctors in an in-network hospital. In contrast, Medicare for All would have one single network. All doctors would be available and our out-of-pocket costs would be zero when we saw them.
In the midterm elections this November, voters won’t just be picking candidates. They will also be determining Medicare’s immediate future.
If Republicans retain control of both houses of Congress, they are certain to intensify their attacks on Medicare (as well as Medicaid and the Affordable Care Act). They will know that they dodged a bullet.
They will recognize that their control of both Congress and the White House might end in 2020. There will undoubtedly be a forceful attack on Medicare in the name of reducing the deficit that their tax giveaway to the wealthy created. Shockingly, they have already hinted that this is their game plan!
But if Democrats take control, they will have the opportunity to hold hearings on Medicare for All and pass it out of the House and Senate. Then, they can dare Donald Trump to veto a policy supported by an overwhelming majority of the American people. If he does so, it will very likely contribute to Democratic victory in 2020.
Medicare for All is coming. It is coming because it is profoundly wise policy and profoundly winning politics. When we are able to celebrate Medicare’s birthday by rejoicing in the creation of Medicare for All, we will have given the program the gift of protection. And the program will give us the right to guaranteed, high quality health care from the cradle to the grave.