The Pardu

The Pardu
Watchful eyes and ears feed the brain, thus nourishing the brain cells.

Thursday, July 30, 2015

Medicare's 50 Years

Medicare is 50 years of age today.

In Independence Missouri, these two famous Democrats signed Medicare into law. 

Images via Twitter Michael Beschloss ‏@BeschlossDC

Johnson arriving at airport to meet with Truman.

American Freedom by Barbara (Conservative webpage with honest reporting)

Johnson signed the bill, he did so alongside an elder Harry Truman -- who, two decades before that, had become the first sitting president to pursue universal health care seriously. On November 19, 1945, only 7 months into his presidency, Harry S. Truman sent a Presidential message to the United States Congress proposing a new national health care program. 
Medicare, Johnson promised, would help realize Truman’s dream for the nation’s elderly: 
“No longer will older Americans be denied the healing miracle of modern medicine,” Johnson said. “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.”
Medicare was born 50 years ago today and its stillunder-attack_55b93d85e4b095423d0db7f9? 

The 1965 Medicare vote looks like this:

Summary of Party Affiliation on Medicare Vote

In 2009 or early 2010,  MedPage published a piece regarding healthcare as integral to life prior to Medicare.  Let's consider a few excerpts.
"The program — which provides insurance for some 43 million elderly and disabled people — is considered both a huge success that has markedly improved the health of the nation’s elderly and an unbelievably complex, unsustainable program that accounts for an ever-increasing portion of the federal budget."
 Most patients who are enrolled in Medicare like the program. “It’s been very successful in getting seniors access to care that they hadn’t had before the program,” explained Gail Wilensky, an economist at the Galen Institute and administrator of the Health Care Financing Administration in the early ’90s. 
Before Medicare was created in 1965, only about 55% of seniors had health insurance, said Stuart Guterman, an economist at the Commonwealth Fund.
The piece also includes detailed comment about how Medicare has developed to an expensive social program. I also found arguments against Medicare in the piece. 

AS the GOP goes about it mission to kill Medicare in its current form and as the Koch brothers salivate about the prospect of millions at the mercy of greedy insurance companies, The Heritage Foundation offers graphics that illustrate their arguments. 

Longer Life Expectancy Means Longer Enrollment in Medicare

Created on July 30, 2015
The average life expectancy in the United States has increased since Medicare was created, but the program’s eligibility age has remained constant at age 65. As a result, seniors collect benefits for almost three times as long compared to when the program started.

Despite my non-economist and non-actuarial background I question the reasons for the increase in life expectancy since 1965. We can assume that life expectancy has increased since the early 1900s; the increase post Medicare could be attributed to the life sustaining program. If we simply settle for the chart above, the increase seems virtually exponential.

The answer for many conservative politicians: raise the eligibility age from 66 to 70 with an incremental stop at age 67. 

US News Dot Com

A chart showing the life expectancy for Americans, by race.

Health is also far from post-racial. While America has made progress on this front, including through the Affordable Care Act, many gaps persist between blacks and whites.
Issues in health and health care that lead to a shorter life span for black Americans start before birth. The average black baby enters the world under different circumstances than the average white baby, and the gap only grows between birth and death.
In 2012, about 13 percent of babies born to black mothers had low birth weights (less than 2,500 grams), compared with 7 percent of babies born to white mothers, according to the Centers for Disease Control and Prevention.
While the infant mortality rate for white America is 5.2 infants out of 1,000 births dying before age 1, the infant mortality rate for black America is much higher – 11.5 per 1,000 – putting the population subsection nearly on par with Mexico. 

A graphics showing Leading Causes of Death and Life Expectancy

Cancer-related deaths also account for part of the life-expectancy gap between blacks and whites – accounting for 0.634 years' worth of lost life expectancy for blacks. In terms of years lost before age 75, black Americans lose nearly 1,796.7 years per 100,000 members of the population due to cancer deaths, while white Americans lose 1,420 years. Although genetics may be somewhat responsible for such differences, socio-economic factors such as diet, lifestyle and a lack of preventive care are far greater contributors. Of the U.S.’ racial and ethnic groups, black Americans have the highest cancer-related death rates and the shortest survival for most cancers, according to the American Cancer Society.
A graphic showing five year cancer survival rates by race.

Let's consider the GOP wins the Oval Office and retains the current congressional census; younger Americans could suffer the ravages of the insurance and healthcare providers. Let's extrapolate the consideration a bit more. If you are African American or Hispanic you may very well see Medicare eligibility established well beyond your potential (actuarial) life.  

Why the charts and graphs related to mortality regarding specific illness and mortality from birth? While, many white American cannot care less about mortality in minority communities, Medicare shouldn't exist with even remote prospect of unintentional discrimination regarding eligibility and benefit cycle. If mortality rates are accurate ad the GOP has its way with Medicare, should we assume the reality of aging would come with a pre-established abandonment of minorities. Would the GOP set eligibility with adverse impact on African-Americans and Hispanics.  

Well, something tells me the GOP would not hesitate.

Happy half century Medicare!

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