Dear Medicare: Happy birthday!

Since I first met you on July 31, 1965, I have been smitten with your looks, your fairness, your support of the elderly without regard to social or economic status, skin color, ethnicity, intellectual IQ, emotional IQ, address, clubs, choice of transportation, hobbies, reading list, or favorite restaurant. You took care of our grandparents, our parents, and now you are taking care of us!

Your birth was not without pain. Some of the Southern congressmen could not stand the idea of people with differing skin colors being in the same hospital room. Eventually President Lyndon Johnson, his staff, and senior citizen groups, wore down Congress, the insurance industry, the unions, and the American Medical Association, and Medicare, health care for all Americans aged 65 and over, became law. It was implemented in July of 1966. Health care was not just a necessity, it was now a right for these folks.

In July of 1965, I was moonlighting as a substitute physician in Ravena in southern Albany County, New York with Dr. John Mosher and Dr. Ira
Lefevre while I was chief resident at Albany Hospital, now known, of
course, as Albany Medical Center Hospital. (Dr. Richard T. Beebe was
chief of medicine at Albany Hospital and allowed us to make ends meet
in this way.) More than half of our patients in Ravena who were over
65 couldn’t pay for their needed medical care and instead left
vegetables and chickens at Mrs. Mosher’s back door. When Medicare came
in, it allowed older folks to be treated as paying patients, restoring
their dignity and their ability to be diagnosed and treated at an
early stage of their illness. Countless lives were saved and diseases
prevented. Practitioners and hospitals flourished.

Through the years, dear Medicare, you have been declared broke and
broken, and somehow in response to pressure by physicians and
patients, wise and compassionate politicians have patched you up and
you carry on.

In 2003 you were "modernized" by radical conservatives and the drug
and insurance companies, and, frankly, you were exploited. We are just
now waking up to the fact that the real goal of this "modernization"
was privatization. We are now paying private insurance companies 13
percent more to deliver benefits to those 65 and older through these
private Medicare Advantage plans than through traditional Medicare.
This wasteful and unnecessary payment scheme was highlighted in the
recent struggle over Medicare physician reimbursement rates and
hopefully will be addressed through the political process over the
next year.

Those of us who believe health care is not just a necessity, but
should become a right for all, hope that sometime soon you will have a
baby and expand your family!

That baby is already in gestation stage as HR676, Expanded and
Improved Medicare for All.

More than 90 members of Congress have signed on in support of this
legislation, and there is a strong and growing wave of grass-roots
support, as well as in the medical community, local governmental
entities, and the labor movement. Your overhead of 4 percent, dear
Medicare, is one-sixth that of private insurance plans, and one third
that of not-for-profit plans. Among its many benefits, socially and
economically, single payer improved and expanded Medicare for all
would eliminate the huge administrative expense in time and staff to
deal with myriad insurance company plan requirements and reduce
overhead. Hospitals would have a guaranteed budget, and rural and
urban physicians and other practitioners will have patients for whom
they will get full reimbursement. At least 22,000 lives will be saved
and over 500,000 medical bankruptcies will be avoided each year. Job
mobility and the economy will improve as health insurance becomes
separated from employment.

New opposition groups are arising, however, who are very clever about
espousing "universal health care", but, upon scrutiny, what they are
really supporting are private insurance-based plans and the status quo.

This is really like putting lipstick on a pig. Even with lipstick,
pigs are still pigs.

Forcing everyone into private insurance plans is not the solution to
our health care crisis for anyone except the insurance industry. We,
your family, dear Medicare, seek to expose these efforts as the
cynical delay and denial tactics they represent. We will not let your
estimable reputation and outstanding 43 years of success be
besmirched, or curtailed by your undermining and privatizing

Medicare, we still love you.

Happy birthday, and many more!

Dr. Richard Propp is chair of the Capital District Alliance for  Universal Healthcare, Inc.

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