The History Of Medicare, United States Healthcare Funding, From Hope To Financial Crisis
Friday, September 24th, 2010In the United States the Medicare system provides health insurance coverage for those who are above 65 years of age. Medicare is a social insurance program, a single-payer health care system, and it operates in a similar way to the Medicare systems in Canada and Australia, except that in the US it is restricted to those above 65, plus some other groups of people such as the disabled. This article reviews the history of Medicare in the US, from its founding in the Sixties, to the funding crisis faced today due to demographic changes, and to spiraling health care costs.
In a single-payer health care system there is one large insurance fund which covers the health care costs of the entire population, or a large group of the population. The single payer, which is usually the national government, collects the insurance premiums, usually in the form of a health tax. This money is then paid into the insurance fund, where it covers the health costs of the nation’s population.
In 1961, in the US, Robert M. Ball (former commissioner of Social Security) recognized the obstacles to financing health insurance for older people. In simple terms, the old require more regular, and more costly medical treatment, on account of their age, while they have less disposable income to buy private health insurance because they are retired.
Ball therefore concluded that the only way to finance elderly health care was the same mechanism used to finance old age pensions: collect the payments from those in work, and provide the health insurance protection to those who have retired without requiring any further payments.
Those who support Medicare would say that it is not an unearned entitlement. They would say it is social insurance, where people pay into the scheme when they are young, healthy, and in work, and they receive the benefits when they are old and sick.
However many conservative politicians, including Barry Goldwater, Ronald Reagan and George Bush Senior, opposed Medicare. They argued that such a scheme would lead to the end of individual responsibility, and perhaps even to the advent of socialism in the US.
Despite conservative opposition Medicare became US law in 1965. Lyndon B. Johnson was president at the time, and he enrolled as the first scheme member former president Truman, with Mrs. Truman as the second member.
Now in the 21st century Medicare is facing a severe funding crisis. There are two reasons for this. Firstly people nowadays tend to live much longer: an increasing proportion of the population are over 65, and receiving benefits from the scheme; a reducing proportion of the population are under 65, and paying taxes into the scheme.
Secondly, medical costs have rapidly increased in the last 40 years. Many expensive, new treatments are not available, which were not known about when the scheme was set up.
Those responsible for the fund have predicted that if present trends continue the health insurance fund will become insolvent in 2019. One can therefore expect that in the next decade the U. S. Federal government will see fixing this Medicare crisis as one of its top domestic priorities.
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