On July 30, 1965 — 50 years ago — President Lyndon B. Johnson signed the law creating Medicare, the huge government social program that successfully insures Americans over the age of 65.
Ronald Reagan, an aging actor who found employment as a General Electric huckster, warned in 1961 that passage of a Medicare-like measure was “one of the traditional methods of imposing statism or socialism on a people.” Reagan raised fears of “big gubament” — a pronunciation that became a trademark of his — and then concluded, “You and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”
He was wrong; Medicare did not rob his children and the children of those of his generation of their freedom; instead, it freed them from the financial danger and possible ruin of having to care for sick and dying parents. All the evidence proves that Medicare provides financial security for seniors and their families. The medical insurance program also has significantly reduced the mortality rate among Americans aged 65 and older.
The program’s success has not deterred Reagan’s heirs, who continually agitate to end it. The latest entrant in the “let’s-kill-Medicare” sweepstakes is Jeb Bush, supposedly one of the moderates in the crowded GOP presidential field. At a New Hampshire town-hall meeting earlier in July, the former Florida governor called Medicare “an actuarially unsound healthcare system.” While promising not to “touch” the insurance program for people currently receiving benefits, Bush claimed that for younger Americans, “We need to figure out a way to phase out this program… and move to a new system.”
A spokesman said the third member of the syntactically challenged Bush family to run for president did not mean to say what he apparently said. “Phase out this program” suggests ending Medicare and replacing it with something like Representative Paul Ryan’s proposed voucher system. But no, the spokesman claims, what Bush really meant was modifying the system by perhaps raising the eligibility age. The problem with the spokesman’s contention is that Bush never mentioned changing the age requirement.
Besides, that favorite Republican idea was shot down in 2013 when the Congressional Budget Office issued a study showing that raising the eligibility age to 67 would save little or no money. Moving 65- and 66-year-olds off Medicare takes the healthiest beneficiaries out of the system, leaving behind the oldest and sickest. The result: Premiums would go up. The unintended consequences do not stop there: Those same 65- and 66-year-olds may be young and healthy by Medicare standards, but they are old and sick compared to the broader population. Denied Medicare, they would enter the insurance exchanges under Obamacare, forcing those premiums to rise.
Bush is not the only Republican contender to threaten Medicare. New Jersey Governor Chris Christie has advocated raising the age of eligibility to 67, as has Florida Senator Marco Rubio. Kentucky Senator Rand Paul has suggested, in the past, privatizing Medicare. And Rick Perry, the former governor of Texas, argued in 2011, when he first ran for president, that Medicare is unconstitutional.
All of the Republican candidates insist Medicare is on the brink of bankruptcy (it is not) and that the insurance program cannot control costs. It is, of course, true that Medicare’s spending has grown faster than the economy as a whole, but that is true of health spending across the board. But there is another truth on spending: Medicare’s spending per beneficiary and premiums are lower than that of private health insurance. Also, with the exception of a brief period in the 1990s, the cost growth for Medicare has been slower than for private insurance companies. The news for conservatives gets even worse, since the evidence so far suggests that the Affordable Care Act has led to a slowing in cost growth for all health insurance programs, including Medicare.
So, Medicare relieves seniors and their families of the fear of financial ruin, extends life expectancy, and is cheaper than private insurance. Why, then, do Republican candidates threaten to kill the program? The answer is political: Medicare is the kind of government-run program that conservatives insist cannot work. Their ideological conviction overrides experiential investigation. Since the ideology says Medicare has to fail, the facts do not matter. Ideology trumps reality.
Conservatives hate programs like Medicare, and they hate them even more when they work. It is too bad that their ideological blinders prevent them from realizing what other Americans know too well: Medicare is a success.
So, happy 50th to the healthcare insurance program for seniors! May you have many more!