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President Obama's March 5th Health Care Summit was a welcome step
towards enacting health care reform. Hopefully, this kind of
inclusive engagement will allow different interests to coalesce and
commit to ensuring that all Americans have health care coverage.
As
the discussions regarding health care reform continue, and decisions
are made, the Center for Medicare Advocacy reminds policy-makers
that Medicare, the country's only experiment with national health
insurance, has a lot to teach about how best to provide health care
coverage for all.
For
over 40 years, until it was morphed into a system of expensive
private plans in 2003, Medicare was a resoundingly successful
public/private partnership. Before Medicare began in 1965, half of
all older people had no health insurance and nearly 35% lived in
poverty. Today, poverty among older people has dropped by two-thirds
and the vast majority of Americans over 65 and people with
significant disabilities have Medicare health insurance.
The Center for Medicare
Advocacy urges reformers to develop a public option in any final
health care legislation. With some updating and adjustments, the
public/private partnership of the traditional Medicare program could
serve as that option. President Obama, Congress, and those who are
able to participate in serious efforts to reform health care
coverage should look to the lessons from Medicare Parts C and D.
Let’s not repeat the mistakes made in those programs – specifically,
the enormous complexity and excessive costs resulting from multiple
private plans. People want choices of health care providers, not
health insurance plans.
Reformers should learn
from Medicare's past and present. Medicare Parts C and D moved
Medicare much too aggressively toward private plans, alienating and
confusing many beneficiaries, costing taxpayers billions of
unnecessary dollars, and threatening Medicare's viability. Rather
than repeating those errors on a grand scale, we should look instead
to traditional Medicare which balances a public program with a
private claims processing infrastructure. That is a reasonable model
for a national health plan. The traditional Medicare program – with
the addition of a cap on out-of pocket spending and phased in
coverage for coordinated care, dental, vision, hearing services and
long-term care – could serve as the basis for a national health
plan.
The standard for any
health care program should be what's best for its beneficiaries and
what's most cost-effective for taxpayers. Until it was privatized,
Medicare met that standard; it worked well for older people and
people with disabilities, and it was cost effective for taxpayers. A
Medicare model with appropriate fine-tuning could also work to
provide health care for all Americans. |