The History Of Medicare, US Healthcare Funding, From Hope To Financial Crisis
September 24th, 2010Insurance No CommentsUS Medicare is a social insurance program which provides health insurance coverage for people aged 65 and over, and for those who meet certain other special criteria. Medicare (US) is a single-payer health care system, similar to systems in other countries, such as Canada, Australia and the UK, except that US Medicare only covers a part of the total population. This short article reviews the history of Medicare in the United States, and examines the challenges which the program faces due to demographic changes and spiraling costs of medical treatment.
In a single-payer health care system there is one large insurance fund which pays the health costs of the entire population, or a large group of the population, such as people over 65 years of age. In these systems, an organization, the Federal government in the case of US Medicare, collects the insurance payments through taxes, and uses the fund to provide a universal health care service.
In 1961, in the US, Robert M. Ball (former commissioner of Social Security) recognized the obstacles to financing health insurance for older people. In simple terms, the old require more regular, and more costly medical treatment, on account of their age, while they have less disposable income to buy private health insurance because they are retired.
Ball therefore concluded that the only way to finance elderly health care was the same mechanism used to finance old age pensions: collect the payments from those in work, and provide the health insurance protection to those who have retired without requiring any further payments.
Medicare supporters then can argue that Medicare is not like an unearned entitlement, but rather a form of social insurance. The people who are benefiting from the scheme today, are those who paid into the scheme when they were working. It is true that some people end up paying more in than they get out, but that is also true of any other insurance scheme.
However many conservative politicians, including Barry Goldwater, Ronald Reagan and George Bush Senior, opposed Medicare. They argued that such a scheme would lead to the end of individual responsibility, and perhaps even to the advent of socialism in the US.
Nonetheless Medicare passed into law in 1965. At the ceremony President Lyndon B Johnson enrolled the first two Medicare beneficiaries. They were former President Harry Truman and Mrs. Truman.
In the present day Medicare is facing a severe financial crisis, which arises from two fundamental causes. Firstly there is a demographic shift towards an older population. Ironically this has been caused by medical advances which mean that people now live much longer. Those who are under 65, in work, and paying taxes, now find that they have to support an increasing number of over 65s benefiting from the Medicare scheme.
Secondly the costs of medical treatment have increased very rapidly, particularly for many new treatments which were not available when the scheme was set up in the 1960s.
It has been predicted that the scheme will run out of money in 2019 unless something is done. Fixing this crisis must therefore be a major domestic policy priority for US governments over the next decade.
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