Forty-eight years ago this summer, President Lyndon B. Johnson signed Medicare into law, providing health care for millions of older Americans. As our state begins full implementation of the Affordable Care Act, it is appropriate to reflect on the progress we have made on giving health care access to Americans, and commit to delivering Medicare for All.
At the signing of the Medicare law, Johnson said, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years.”
The Medicare program has largely succeeded in fulfilling that promise. Seniors get the health care they need, when they need it. It still doesn’t cover all medical needs, but over the years, it has been expanded several times to increase the number of people covered, and the number of services provided. In 1972, people under age 65 who had long-term disabilities were included in Medicare. In 2003, prescription drug coverage was added.
Preventive services added
More recently, the Affordable Care Act (often called Obamacare) added preventive-care services to Medicare, as well as mammograms and other health screenings, and it reduced the co-payments seniors pay for prescription drugs.
For older Minnesotans, Medicare has been a lifesaver.
Minnesotans under 65, however, have been covered — or not covered — under a fragmented and broken system of employer-based health insurance, private plans, public programs, or no insurance at all.
Fortunately, during the next five months, many previously uninsured Minnesotans will receive health care coverage through the MNSure insurance exchange of the Affordable Care Act (ACA). Those who were denied coverage because of preexisting conditions should no longer face that problem. Young adults whose parents have good coverage are now eligible for coverage through them.
Minnesota leads nation in implementation
Minnesota, under Gov. Mark Dayton and the DFL Legislature this year, is leading the nation in its thoughtful and comprehensive implementation of the ACA. By upgrading MinnesotaCare and expanding Medicaid, Minnesota will make health care accessible to hundreds of thousands of additional people.
However, the ACA is not Medicare. It does little to eliminate the bureaucratic waste in our current system or reduce the overall costs of our health care system – and it will not cover everyone.
Nationally, about two-thirds of the low-income people eligible for coverage under the ACA will not be covered because their states have chosen not to expand Medicaid. Minnesota is doing much better than those states, but there will still be a couple hundred thousand Minnesotans without coverage, and many more who have coverage will not have affordable access to some needed services. Although the ACA will close some gaps in our dysfunctional health care system, gaps will remain, and many people needing care will fall into those cracks.
As soon as the ACA is fully implemented, it is time to turn our attention to completing the promise of Medicare for all. Legislation to enact a proposed Minnesota Health Plan (MHP), a Medicare-style plan for everyone is the only solution to rapidly rising medical costs.
Beefing up coverage, saving money
The MHP would beef up the coverage that Medicare recipients get — including nursing home care and many other needed services — and extend those same benefits to everyone, regardless of age. The Minnesota Health Plan would cover all Minnesotans for all of their medical needs.
Yet the MHP would save money, eliminating the costly bureaucratic insurance system and delivering health care directly. And, in providing health care to all instead of health insurance for some, we would leave medical decision-making with patients and their doctors, not subject to government or insurance company interference. A growing number of Minnesota physicians and nurses are supporting the MHP, because they are tired of patients who get inferior treatment based on insurance company restrictions.
Two years from now, when the nation celebrates the 50th anniversary of Medicare, we want to be on the verge of passing the Minnesota Health Plan. Five decades after Medicare covered people over 65, it is time for Minnesota to cover people under age 65 as well, finally delivering Medicare for All.
John Marty, DFL-Roseville, is a state senator. He first published this article in his newsletter, “To the Point!” which is published by the Apple Pie Alliance.
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But here’s the lesson
we should take from this experience:
I watched Hubert Humphrey on the floor of the U.S. senate arguing for the passage of the $63 million Medicare bill. He said “If this program ever costs more than $100 million I’ll eat the paper it’s written on!”
Last year’s Medicare budget was $804.2 billion. That’s almost 10 thousand times the original cost.
Jus sayin.
Wrong lesson!! Your quoted fact is in error
Medicare does not cost $804 billion. It’s big alright, but this exaggerates Medicare’s costs by conflating its costs with other programs’ costs..
According to CMS, its FY 2012 budget for Medicare is $476 billion. Medicaid ? $255 billion.
(http://www.hhs.gov/budget/budget-brief-fy2013.pdf) According to the CBO, Medicare was subject to $565 billion in total outlays for 2012 (http://www.cbo.gov/sites/default/files/cbofiles/attachments/43060_Medicare.pdf). So there is a discrepancy between these 2 sources, I’m pretty sure both involving estimation. But both are a far sight from your number.
So I did a search using your quoted $804.2 billion number and how it was presented in your source: I found it in a Wikipedia entry (at http://en.wikipedia.org/wiki/2012_United_States_federal_budget), and its table CLEARLY describes that figure as “Department of Health and Human Services including Medicare and Medicaid”. Quote your sources !
The true numbers, for Medicare, Medicaid and all these other health care programs, are a very big problem, and I take your point that we often end up way past where we intended to go with big programs. But your argument is not advanced by exaggeration.
Source?
I’m not finding any evidence on the Internet that Hubert Humphrey ever said what is put in quotes in that assertion. A search for the “quote” in its entirety yields zero results. Five of the only six results searching for the two phrases “hubert humphrey” + “I’ll eat the paper” are your comments on Star Tribune and Minnpost, and from “Bob the Bilderberg” of Minneapolis on Topix.
The only other result is a quote from the text of a speech about the 1964 Voting Rights Act: “If the Senator can find in Title VII … any language which provides that an employer will have to hire on the basis of percentage or quota related to color, race, religion, or national origin, I will start eating the pages one after another, because it is not in there.”
http://www.amnation.com/vfr/archives/002600.html
Reason dictates that it’s unlikely that Vice President Humphrey would have publicly made such a substantial error in forecasting the costs of Medicare, but I’m open to seeing the evidence.
I guess you had to be there
People my age don’t have to rely on the internet to recall history. I’m sorry the historians didn’t see fit to record that moment so you could read about it 48 years later.
Don’t need to be there
The moment has been recorded if it happened.
“Published under this title since 1873–and before that in three forms and under three titles (Annals of Congress, Register of Debates, and the Congressional Globe)–the Record records the daily floor proceedings of the House and Senate, substantially verbatim….
The Congressional Record, which currently averages about 272 pages a day, is a substantially verbatim account of the proceedings of Congress. It is published daily when either or both Houses of Congress are in session. The Record can be thought of as the world’s largest daily newspaper as it contains an account of everything that is said and done on the floors of the House and Senate.”
http://thomas.loc.gov/home/abt.cong.rec.html
Prior to the Internet, there were still rules of attribution. Otherwise, people could just make up whatever they wanted and say someone said it.
“[I]n our reasonings concerning matter of fact, there are all imaginable degrees of assurance, from the highest certainty to the lowest species of moral evidence. A wise man, therefore, proportions his belief to the evidence.” – David Hume
http://www.bartleby.com/37/3/14.html
I look forward to the evidence, in full context.
I’m sure you were
Hubert Humphrey was Vice President when the Medicare bill was introduced (January 27, 1965). If you’ve ever read the Constitution, you might know that the Vice President’s role in the Senate is limited to voting in the case of a tie. He does not speak in favor or in opposition to legislation.
Meanwhile. . .
The Defense Department just announced a few weeks ago a deal to purchase 71 F-35 fighter jets for $7 billion. Plus, the Navy is planning on buying 12 SSBN[X] nuclear submarines at $6 billion EACH. Altogether, that’s over 50 years of Medicare budgets. Perhaps we should buy 35 jets and 6 subs and extend Medicare to everyone. Just sayin’.
What Senator Marty did not say is how Congress wants to raise the minimum age for Medicare and impose other “cost saving” measures. The same Congress has no problem appropriating obscene amounts of money for ridiculous new generations of fighter planes, tanks and subs. I suppose more drones too. If Congress has to spend so much for this Defense establishment, it can’t afford to spare any expense to create new enemies to justify “defending” the country against them.
Isn’t that the Trumans in the picture alongside LBJ ?
Harry Truman attempted to advocate universal health care access and insurance years before Medicare and Medicaid became law. Of course, he found very powerful opposition from the same interests who would like to dismantle what we’ve got today. He howled in the wilderness anyway.
Universal Health Care
I, for one, can’t wait for universal health care. Most industrialized countries implemented it after the war and have far lower health care costs and for better coverage because of it. But for some reason the United States has been resisting it all along, even though it’s the only thing that makes logical sense. Create a pool that covers everyone so premiums for all are as low as humanly possible. Everyone shares, everyone benefits, and no one is left out in the street to die or has a medical bill so crushing that they have to declare bankruptcy after losing all their assets.
Paying for it is ridiculously easy. As Jon pointed out, we spend a huge amount of money on “defense.” Our budget is $1,753 billion compared to the next runner up, China, at $166 billion.
http://en.wikipedia.org/wiki/List_of_countries_by_military_expenditures
We spend more money on the military than the next dozen countries combined. We have more aircraft carriers in our inventory than the entire rest of the world.
I’m generally a big proponent of our military–we have to give them the right tools to do their job. Currently though, that does not mean more big weapons platforms. Instead we need hard hitting infantry that can go into places and take out small pockets of insurgents. How about we scrap a few expensive weapons programs, mothball some carriers, and use those savings to heal people instead of killing them?
Any politician who can get universal health care in place has got my vote no matter what their party affiliation.