American Forum Op-Ed

In 1935 President Franklin D. Roosevelt signed into law the bill establishing the Social Security Administration. It was bitterly opposed by many as an intrusion of government into the lives of private citizens. As originally envisioned it was a very imperfect and incomplete plan, with many defects. Many millions of needy citizens were not included.

There have been many changes in Social Security since 1935. For the most part, these have been positive changes such as adjusting costs and benefits and including more people. This has been an ongoing evolution. Still today there are imperfections and inequalities, such as the lower contribution rates for the wealthy.

There are still some people who oppose Social Security and say: “I don’t need it and I don’t want it.” But the vast majority of senior Americans are dependent on it. It has made life easier for our entire society. Very few people today would agree to its abolition.

In 1965, President Lyndon Johnson signed into law the establishment of Medicare, to provide access to affordable health care for seniors and persons with disabilities. Again it was opposed by many, and there were attempts to repeal it. This program also has gone through many changes since 1965, some to make it more efficient, or to add benefits, some to lower costs. And there have been recognized abuses and wastes.

Nevertheless, Medicare has been remarkably effective in bringing access to health care to millions of persons who otherwise would have had to do without care. The increasing life expectancy of Americans is the lasting legacy of Medicare.

However there are still many who grumble about Medicare. Even persons who use and benefit from Medicare complain: “Get the government out of our lives!” However today it would be hard to imagine what life would be like for many persons without Medicare.

Is history repeating?

On March 23, 2010 President Barak Obama signed health care reform into law -- the Patient Protection and Affordable Care Act. Again, this was a very controversial act, fraught with omissions, ambiguities, inconsistencies, and concessions to special interests. Again there has been talk of repeal, or of opting out of its provisions.

But passage of this bill came after many years of almost universal recognition of the serious inadequacies and injustices of our health care system, and after a number of failed efforts at reform by Congress. There has been great pressure on Congress to simply JUST DO SOMETHING!

The major opposition to this bill has been spearheaded by businesses in the health care field which anticipate losing some of their enormous profits, especially the drug and health insurance industries. Major concessions have been made in an attempt to keep them “on board,” but the handwriting is on the wall. They recognize that their dominant role in controlling health care in this country will necessarily and inevitably diminish.

As with Social Security and Medicare, we can anticipate many changes in the present health reform legislation, changes which will modify, clarify, and improve its provisions for the betterment of our health and our country.

Access to health care for all seniors is important. Having a Medicare system that works? Crucial.

As we age, visits to doctors’ offices increase. Before President Johnson signed Medicare into law 44 years ago, many seniors lacked health care because of the cost. Imagine! But now, through Medicare, our federal government provides a valuable program for seniors and people with disabilities to improve their medical well-being. Coverage has helped reduce senior poverty by two-thirds.

Since 2003 and the implementation of the Medicare Modernization Act, Medicare Advantage plans (code for private insurance companies) have taken a toll on traditional Medicare. These Medicare Advantage plans are reimbursed at a higher rate than traditional Medicare, sometimes as much as 17 percent higher. This cost is being paid out of the traditional Medicare fund and is a strain on the Medicare budget. Passage of health-care reform will reduce this overpayment to private insurance companies, thereby easing any burden on working families' tax dollars.

In addition to cost savings in overpayments, meaningful reform will prohibit private-insurer discrimination against seniors with pre-existing conditions. Also, seniors will have more control when choosing providers.

The cost of prescription drugs, too, will go down. As things stand now, seniors on fixed or limited incomes often face agonizing either/or choices between high-priced medications and ever-increasing living expenses. True reform will provide more help for low-income seniors, more flexibility in changing drug plans and a closing of the dreaded donut hole – a gap in coverage that costs the average Medicare recipient thousands of dollars. All of these factors -- and the promise of no co-payments for Medicare preventive services such as check-ups and cancer screenings -- add up savings for all seniors and taxpayers.

There's more.

Meaningful reform should also bring savings to Medicare in the form of early Medicare enrollees. Persons age 55-64 (the pre-Medicare age group) should be allowed to buy-in to Medicare. More than 5 million Americans age 55-64 do not have health insurance. People in this age group should be able to see a doctor more often, especially for preventive care as this is the wrong time in your life to have to cut corners with your health. Through meaningful reform we can create an affordable way for them to buy in to Medicare coverage.

This early enrollment would allow people to seek medical care for their ailments. As of right now, these pre-Medicare people wait until they turn 65 and enter the Medicare system already ill. Sometimes, they have waited so long that their once easily treatable condition is now an expensive and life-threatening illness. An opportunity to buy-in at a younger age reduces the possibility of long term health care issues.

In fact, why not extend Medicare to everyone?

Medicare is a great American success story. Medicare for all would be a great American legacy.
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Fransetta is president of Florida Alliance for Retired Americans.
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Copyright (C) 2009 by the Florida Forum