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Luskin: Medicare Revisited

10/24/12 7:55AM By Deborah Luskin
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(Host) Medicare was initially proposed as a national health insurance plan that would cover all Americans, not just seniors. Novelist, essayist and educator Deborah Lee Luskin thinks now's the time to bring the original plan for universal coverage back.

(Luskin) When my grandmother was born in Eastern Europe in 1900, her life expectancy was 48 years. Unlike her twin brother, she survived childhood, and immigrated to the United States at age nine. At 14, she left school and worked as a milliner. After she married, she helped my grandfather run a delicatessen. When that enterprise failed, my grandmother kept house in a five hundred square-foot apartment, raised two children, and sewed piecework for extra cash.

The first Medicare bill was signed into law the year my grandmother turned 65. Twenty years earlier, in 1945, Harry Truman had sought to establish a national health insurance plan.

The idea of universal health coverage was met with an outcry against socialized medicine, so the plan was modified to offer health benefits only to recipients of Social Security.

My grandmother was in the first cohort to receive Medicare benefits, beginning in 1966. By then, her life expectancy had increased to 73.8 years. She was seventy-three and a half when she died. As it was designed to do, Medicare paid my grandmother's late-in-life hospitalizations, which she would otherwise not have been able to afford.

According the National Academy of Social Science, "the Medicare program was modeled on the private insurance system in place in the 1960s," insurance that was aimed at covering only hospitalization for catastrophic illness. But in 1965, no insurance company would sell a policy to anyone over 65, thus the need for Medicare.

My mother received Medicare benefits until her recent death at age 87. According to the Life Expectancy Calculator at the Social Security website, I can expect to live another 28 years, twenty of them covered by Medicare - if it still exists.

Over the years, Medicare has slowly expanded coverage for medical office visits and for prescription drugs, but not adequately, especially considering the changes in medical practice and longer life expectancy.

Additionally, Medicare routinely underpays for services as part of the great cost shifting that's become routine in the financing of American healthcare.

Now, there are some who propose to privatize Medicare completely, shifting the entire burden of finding coverage to seniors.

It's a highly complex issue, but one that those of us who vote must understand as the political discourse heats up. Taxes support many things, from moon shots to cancer research, but not everyone goes into space or gets cancer - every one uses health care. Currently, only Americans over 65, the disabled, and the impoverished have national health insurance; those of us who work and pay for it don't.

So Medicare isn't perfect, but it's a good start. With expanded coverage and greater emphasis on health maintenance, Medicare could serve as the basis for the kind of universal health care that Harry Truman envisioned when he initially proposed National Health Insurance for all.

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