Medicare’s 45th

Today is Medicare’s 45th birthday. Despite its faults and limitations, without Medicare coverage, much of what we do in the GeriPal world would not be possible. I think it’s worth reflecting on what Lyndon Johnson had to say about Medicare during the struggle to pass the legislation:

“I’ll go a hundred million or a billion on health or education. I don’t argue about that any more than I argue about Lady Bird [Mrs. Johnson] buying flour. You got to have flour and coffee in your house and education and health. I’ll spend the goddamn money. I may cut back some tanks. But not on health” (from NEJM 11/27/2008)

…and what he said on July 30, 1965 during the signing ceremony:

“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. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts.” (from SSA.gov)

In 1959, 35% of seniors lived in poverty, twice the rate of adults under 65. Today, the rate of poverty among seniors is comparable to the general adult population. Some economists argue that Medicare had little to do with this, but given what we know about how medical costs can decimate a family’s economy, I have to disagree. There was once the political will to do the hard work of meaningful health care reform—let’s hope we continue to have the will moving forward.

Happy 45th, Medicare!

Helen Chen, MD