Preserving and Strengthening Medicare

By Congressman Jim McDermott

These days in Washington, D.C., we’re having a big debate over Medicare – whether to dismantle it as Republicans would like to do or make some changes to keep it running smoothly.

In a way, today’s fight over ending or fixing Medicare is history repeating itself. But this fight is also something new. I think it’s an important discussion about our country’s values, and I think it’s a conversation in which every American needs to be participating.

When I graduated from medical school in 1962, I sat in the audience and listened to Dr. Edward Annis who was then President of the American Medical Association (AMA). He talked about the dangers of “socialized medicine” at a time when older Americans were finding it almost impossible to get private health insurance coverage. It was either too expensive or denied altogether, and about half of all seniors in the U.S. had no hospital insurance. It was a dark time in American medicine.

Just like today, the debate boiled down to providing secure, affordable health care or acceding to the interests of lobbyists and corporate money. Back then the most powerful doctors’ organization in the country was against any form of government guarantee of medical care for seniors, and they did almost anything to stop it. The AMA even went so far as to ignore the dangers of smoking cigarettes – they opposed the 1964 Surgeon General’s warning label on cigarette packs – in exchange for votes against Medicare from members of Congress who hailed from tobacco states.

Despite these efforts, Medicare was signed into law, and it established a basic social commitment in our country: when you get older, you’ll always have affordable quality health care. Today, more than 45 million seniors are enjoying the benefits of Medicare.

However, every few years since 1964, the Republicans have tried to repeal Medicare and break that commitment. The difference about today’s fight is that the Republicans may very well succeed – unless Medicare’s beneficiaries and supporters understand what’s at stake and speak out forcefully against the threat.

Republicans recently introduced legislation and an accompanying report that was artfully titled “A Roadmap for America’s Future.” To be clear, if the Republican plan was signed into law, it would end Medicare as we know it. The Republican plan would give each senior a fixed payment to buy insurance in the private market – any difference between the allowance and health care premium payments would come from seniors’ pockets.

Under the Republican plan, the guarantee of quality medical care would end, and tens of thousands of seniors wouldn’t be able to make their premium payments. While many would try to find coverage from private insurance companies, they would likely not succeed.

It’s important to note that seniors already spend close to a third of their income on health care, and that’s with the protection of Medicare. Under the Republican budget proposal, all risk and costs associated with Medicare, which is shared by all of us today, would be shifted to the pocketbooks of seniors.

It’s also important to understand that Medicare is not a profit-driven program unlike private insurance companies who do everything they can to maximize profits at the expense of patients and taxpayers. While Medicare has consistently held administrative costs to 2%, private insurance companies’ administrative costs and profits have often been higher than 30%.

In health care law that passed last year, my Democratic colleagues and I took several commonsense steps to extend the financial health of Medicare until 2029. We are continuing to fight for more reforms that would decrease costs and increase the quality of care that Medicare affords. Medicare is a program that should be strengthened – not destroyed.

And, the American people agree – a recent Washington Post/ABC poll showed that 78 percent of Americans oppose Republican cuts to Medicare. Yet, that hasn’t stopped the Republicans from marching ahead with their efforts to dismantle Medicare.

The truth is that our country has real budget problems to address. Current projections show that while the deficit will go down to about $533 Billion in 2014, it will go up thereafter, largely because of health care costs stemming from both Medicare and other programs.

There are, however, actions we can take to effectively reserve this long, steady rise of health care costs. We can and should do more preventive care, improve primary care, implement stronger payment reforms, as well as bargain more with doctors, drug companies and hospitals.

We could make these reasonable, effective reforms together, but instead Republicans are pushing to end the basic social commitment we established for seniors with the creation of Medicare.

This speaks to a larger issue.

It is common for a party who wins an election in big numbers to think that the public actually endorses their policies – the idea being, “The voters didn’t just put us in power, they love our ideas and want us to pursue them at all costs!” History, however, has shown that one doesn’t always equal the other.

Americans were upset about many things in the 2010 elections and voted accordingly; however, they certainly didn’t elect Republicans because they wanted to see Medicare dismantled.
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Congressman Jim McDermott (D-WA) is a physician as well as a senior member of the House Ways and Means Committee. Throughout his career as an elected official in the Washington State Legislature and U.S. Congress, his primary focus has been improving our health care systems to provide more affordable, effective and accessible care to all Americans.