50th Anniversary of Medicare, Medicaid Marks Half a Century of Kept Promises

Tuesday, July 28, 2015

Statement attributable to:
Robert Wergin, MD
American Academy of Family Physicians

“It has been said you can judge a society by how that society treats their elderly. Fifty years ago, a bipartisan Congress developed Medicare and Medicaid. Since then, these programs have been the bedrock of health care for elderly and disabled Americans, low-income families, and children.

“Before the launch of Medicare, half of elderly Americans had no health insurance. Reliance on employer-based coverage failed to protect retirees, and many insurance companies refused to cover older, higher-risk patients. Those who did have insurance generally owned plans that eliminated coverage for pre-existing conditions, imposed caps on coverage or limited coverage to specific services.

“Even then the cost of medical care was skyrocketing and the bill for a single hospitalization devastated elderly patients with or without insurance. As the 1963 Survey of the Aged noted, ‘Many aged persons never recover from the economic effects of a single hospital episode. Unfortunately, the heaviest burden is likely to fall on those with the least resources.’

“Medicare turned that around. In the five decades since Medicare’s launch, the percentage of uninsured older Americans has plunged to 3 percent. Their out-of-pocket expenses for medical care plummeted from as much as 56 percent of their income to 13 percent.

“Likewise, Medicaid has saved the lives of millions. Not only has it provided health insurance coverage for millions of low-income families, but it also has supported long-term care services for elderly and disabled Americans.

“Today, Medicaid provides coverage for nearly six in 10 elderly nursing home residents and nearly four in 10 childbirths. The percent of uninsured children has declined 40 percent since the 1997 passage of Medicaid’s Children’s Health Insurance Program, falling from 15.4 percent of the children in the nation in 1998 to 8.9 percent in 2012. Likewise, infant mortality dropped 75 percent between 1964 and 2011. Today, Medicaid covers 67.9 million Americans.

“As President Johnson said in his Jan. 7, 1965, special message to Congress, “Whatever we aspire to do together, our success in those enterprises--and our enjoyment of the fruits that result--will rest finally upon the health of our people.”

Editor's Note: To arrange an interview with Dr. Wergin, contact Megan Moriarty, (800) 274-2237, Ext. 5223, or mmoriarty@aafp.org.

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