When was Medicare established?

Medicare provides health insurance to sixty-three million seniors in the United States. Each year the program costs the federal government around $836 billion.

Both the program's budget and the number of people enrolled has increased steadily in recent years as the Baby Boomers, America's largest generation, reach the program's eligibility age of sixty-five. 

The program as we know it today began in 1965 when the Congress passed a law which amended the Social Security Act to establish a program to provide those sixty-five and older access to healthcare regardless of their medical history or income.

When President Lyndon B. Johnson signed the bill into law, only around sixty percent of seniors had access to healthcare.

Who is eligible to receive Medicare?

Medicare Parts A and B are what are known as original Medicare.

Part A covers inpatient hospital services, post-hospital skilled nursing facility (SNF) services, hospice care, and some home health services. Around ninety-nine percent of seniors in the US are enrolled in Medicare Part A because "because they or their spouse paid Medicare payroll taxes for at least 40 quarters (about 10 years) on earnings covered by either the Social Security or the Railroad Retirement systems." Those who do not meet the eligibility requirements are able to pay a "premium of either $274 or $499 each month in 2022 depending on how long they or their spouse worked and paid Medicare taxes."

Part B of the program covers costs related to physicians’ services, outpatient hospital services, durable medical equipment, and other medical services. Unlike Part A, the program requires members to pay a monthly premium for Part B coverage. In 2022, the premium increased by fifteen percent to $170,10. For those who receive Social Security benefits, the premium is deducted from their monthly payment.

Part C, or Medicare Advantage Plans, and Part D which helps seniors keep down the cost of prescription drugs are fully optional plans. Medicare members can purchase these plans which vary depending on where the individual lives.

What is Medicare for All?

Medicare for All, popularized by presidential candidate Bernie Sanders would expand the current program to cover all age groups.

There are more than 28 million people, or around eight percent of the population that do not have insurance in the US. This number balloons to over fifty percent when looking at the number of people who are under-insured meaning that their health care costs are overly burdensome; for example if "their out-of-pocket costs, excluding premiums, over the prior 12 months are equal to 10 percent or more of household income" or if "their deductible constitutes 5 percent or more of household income."

Costs can vary widely because of the plans available in one's area and by what they are offered by their employer. The patchwork system in the United States leaves Americans paying the highest prices for healthcare in the world.

Proponents of Medicare for All have often made ethical arguments in its support arguing that the currency system and "our failure to guarantee healthcare to all exacerbates economic inequality through high out-of-pocket costs for care, medical debt, and bankruptcy."

With a centralized insurance system, a government can take advantage of economies of scale by pooling patients together to bring down costs. Another way is through limiting the number of medical suppliers to help bring down costs. So, for example, rather than buying the prosthetic hips needed for a replacement for several companies, the government can create contract with one or a select few. This encourages competition, as those companies who are interested in the bid must show that they have a cost-effective and high quality product.

Does the public support Medicare for All?

Various polls conducted over the years have found widespread public support for Medicare for All, a fact often ignored by mainstream politicians. A 2021 poll conducted by Reuters and Ipsos found that around seventy percent of all respondents (and fifty-one percent of those who identified as Republicans) supported Medicare for All.

Response from Washington

Those who oppose Medicare for All tend to argue that people like their doctor and want more choice when it comes to healthcare. While, this may be true in cases of those with excellent insurance, the millions who lack coverage or have adequate coverage have very little choice when it comes to their healthcare and are left in an extreamly vulnerable position.

Some also argue that it would increase costs and taxes on the middle class, but this claims have been disputed. Regardless of if a single-payer system is implemented, it is clear that the American health care system needs reform to ensure that all those who live in the country have access to high quality care.