Surprisingly, Medicare isn’t even 50 years old yet. It came into being as part of the Social Security Act of 1965, 20 years after Harry Truman first proposed a universal national health insurance program. Truman was unable to get that off the ground, but legislators seemed inclined to favor a scaled-back version covering only citizens over 65, who found it difficult or impossible to get insurance from private providers. A GOP win in 1952 precluded the program's consideration for eight years, but even JFK's moxie was insufficient to get the bill, now known as Medical Care for the Aged, passed in the early 1960s.
It took the old New Dealer, Lyndon Johnson, using the momentum of a landslide 1964 Presidential victory, to bend Congress to his will. LBJ was a consummate dealmaker, but also a populist at heart, and his support for Medicare was rooted in his Texas upbringing. As he told his press secretary, Bill Moyers, at the time, “It’s just like your mother writing you and saying she wants $20, and I’d always sent mine a $100 when she did. I never did it because I thought it was going to be good for the economy of Austin. I always did it because I thought she was entitled to it. And I think that’s a much better reason and a much better cause and I think it can be defended on a hell of a better basis.”
Another disclosure, to his Vice-President, Hubert Humphrey, is even more illuminating: “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.”
Medicare initially covered 17 million Americans, and it covers 40 million today. As the cost of services rises and the ratio of workers paying taxes slides compared to the number of retirees eligible for coverage, the system should be evaluated carefully for future adjustments.
The Republicans in Congress think a better way to deal with it is to blow it up.
In a 10 budget plan presented this week by Representative Paul Ryan, the GOP proposes to abolish Medicare and replace it with Obama-care-for-Elders; a plan that would give vouchers to the aged infirm to buy their own insurance from private vendors. (How this will save money when Medicare is already cheaper than private health care insurance should make for interesting fine print in the proposal.)
Ryan would also get rid of Medicaid, the health plan for low-income Americans, changing it from a joint federal-state project to a block grant program that would put the burden of caring for the indigent squarely on cash-strapped states. In that scenario, can you imagine Alabama, for example, sustaining coverage for the 20 percent of the population, mostly elderly and children, currently covered by Medicaid? Me neither, and we’re one of the few states with a doctor for a governor.
Here’s why this matters to you, my young friend. Anybody over 55 escapes the wrecking ball; they’ve paid into the system and would be allowed to get their mandated Medicare benefits. You, on the other hand, will no longer be eligible for the single-payer coverage Medicare presently represents. You will be given a menu of private providers and a government subsidy with which hopefully you will find a health insurance plan you can afford. Guaranteed benefits will become a thing of the past for you. If the private providers raise their premiums, you’ll have to cover that.
Oh, yeah, and Ryan would raise the age at which you’d qualify from 65 to 67. But you’ll probably still be working at the coffee shop then, so not to worry.
All, right, I kid. But trust me, those years are going to fly by faster than you comprehend, and if you don’t ensure your insurability in 2011 and 2012, you’re going to be in no position to argue four decades from now. Yes, insurance is the dullest, least relevant issue in your life today. What Paul Ryan and the Publicans are about is screwing up your tomorrow.
Politics is a game, innocuous as fantasy football, until it’s not, and then when you realize it’s changed your world, it’s too late to do anything about it. The coming battle over Medicare isn’t sexy, it isn’t glamorous and it certainly isn’t about winning the future. It’s about saving it.
Medicare worked for Harry Truman—his was the first Medicare card—and it will work for you, if the Republicans who hate promoting the general welfare of the republic can be stopped from destroying it. It’s your fight, though. It will require mettle and savvy and soul, and an understanding of what Lyndon Johnson was talking about when he signed the original Medicare legislation 46 summers ago: “Many men can make proposals. Many men can draft laws. But few have the piercing and humane eye which can see beyond the words to the people that they touch. . . and fewer still have the courage to stake reputation, and position and the effort of a lifetime upon such cause when there are so few that share it. There just can be no satisfaction, nor any act of leadership, that gives greater satisfaction than this.”
Courtney Haden is a Birmingham Weekly columnist. Write to firstname.lastname@example.org.