This is part one of a three-part series that takes a dive into the history of Medicare, Direct Contracting Entities, and how citizens can make their voices heard to make change for Medicare.
By Wally Pearce
Special to the Express
To tell the story of how this plateau was attained, it’s important to step back from a brief look at healthcare before and after Medicare. Keep in mind, what you learn here is sanctioned by the Congress. Since 1965, Medicare is efficient and permits enrollees the ability to manage their own healthcare plan.
Healthcare insurance began with the Great Depression in the 1930’s and grew rapidly during the 1940s and 1950s. The reason for the rapid growth was the treatment of health insurance in the federal tax code. When Social Security was enacted in 1935, the program didn’t include any health insurance provisions because of strong physician opposition to government-sponsored health insurance.
In 1945, the Truman administration began working on a national health insurance plan to provide insurance coverage to all Americans as advocates for a national insurance plan continued their efforts, with much of their attention being directed to obtaining healthcare for the elderly. However, during the 1950s, proposals advanced for hospital and nursing home insurance coverage for the elderly. However, because of strong political opposition these bills went nowhere because of concern that rapidly rising medical costs, if tied to Social Security, would undermine the Social Security program.
In the 1950’s, approximately one-half of all Americans were covered by health insurance; this percentage rose to 71 percent by the end of the decade. The remaining 29percent translated into 50 million uninsured Americans. Meanwhile, physicians began to resist the mounting paperwork involved in filing out insurance claims.
During the 1950’s, the price of hospital care doubled, and medical breakthroughs were coming at a fast pace. Medications became available to treat infections and conditions like glaucoma and arthritis, and new vaccines were developed to prevent childhood diseases like polio. Although people had access to healthcare, many were unable to afford it.
Prior to Medicare, only a little over one-half of those aged 65 years old and older had some type of hospital insurance; few among the insured group had insurance covering any part of their surgical and out-of-hospital physicians’ costs.
Most hospitals were small, locally oriented institutions in the early 1960s; and three out of five general hospitals had fewer than 100 beds. The traditional American “voluntary” or community hospital was a not-for-profit organization. In the first half on the 1960’s, the average life expectancy was 69.8 years.
By 2010, that number had increased by almost a decade to 78.2 years. Forty-five years post Medicare, people are living longer thanks to the advances medicine and science made in treating serious illnesses such as heart disease, cancer, stroke, even certain disease’.
Medicare’s succinct chronical
Medicare was signed into law in 1965 and that led to Medicare and Medicaid. The main purpose of Medicare was to assist the nation’s elderly 65 years of age and older, so they would be able to meet their hospital, medical, and other healthcare needs. Many of its architects thought Medicare for the elderly was the first step toward eventually achieving health care coverage for all. It’s important to mention here that today, Medicaid provides health care coverage for 74-million people, including nearly 8 million senior citizens and people with disabilities.
However, that was stopped by the politics of 1965. Although it wasn’t, the program has remained quite stable over time, with modest expansions in coverage and eligibility. Medicare for all wouldn’t be consider until 65 years later during the 2020 Presidential campaign. The original Medicare (known today as Traditional Medicare) program included Part A (Hospital Insurance) and Part B (Medical Insurance).
Today these two parts are called Traditional Medicare and over the years, Congress has made changes to Medicare. For example, in 1972, Medicare was expanded to cover the disabled, and people with end-stage renal disease requiring dialysis or kidney transplant. At first, Medicaid gave medical healthcare insurance to people getting Social Security.
Today, a much larger group is covered:
- Low-income families
- Pregnant women
- People of all ages with disabilities
- People who need long-term care
Medicare Prescription Drug plan Part D, started in 2003 and was the biggest change to Medicare’s 38 year history.
Traditional Medicare provides Part A and Part B coverage has no out-of-pocket maximum or cap on what a beneficiary may spend on their healthcare. With Traditional Medicare, enrollees must also purchase Part D drug coverage separately and may be subject to co-pays for prescriptions. The combination of Medicare Part A and Medicare Part B coverage helps pay for the complex, expensive healthcare and the associated hospital, rehab, skilled nursing stays, etc.
Medicare medication coverage (Medicare Part D) helps pay for brand-name and generic prescriptions.