For fifty years, Medicare has played a critical role in promoting economic security for older women in the United States. Today, Medicare serves 24 million women ages 65 and older, representing 56 percent of older adults enrolled in the program, and provides them with financial protection at a time in their lives when they have the greatest need for medical care and often the fewest family and economic resources. The passage of Medicare in 1965 marks a key milestone in women’s economic security and a major contribution to reducing income equality in old age between men and women.
Dr. Dorothy Rice, 92, was director of health insurance research at the Social Security Administration when Medicare was created. In this interview with Generations Guest Editor Tricia Neuman, Rice reflects upon her research and life’s work in the healthcare sphere. Neuman devised and posed the questions.
Medicare is a critical source of coverage for our nation’s older adults and for people with disabilities. Medicare provides health insurance protection and enables access to medical care for 54 million beneficiaries (U.S. Department of Health and Human Services, 2015). However, the coverage Medicare provides comes with premium and cost-sharing requirements as well as gaps in covered benefits, especially for long-term services and supports (LTSS).
When President Harry Truman proposed national health insurance, the American Medical Association (AMA) defeated him through an unprecedented $2.8 million public relations campaign that effectively branded his national health insurance proposal as socialized medicine—even as part of a Communist plot. While Truman’s proposal was killed, in 1946, Congress passed the Hill-Burton program to increase the number of hospital beds, especially in poor states.
At its 50-year mark, Medicare now covers 55 million people, provides insurance to one in six Americans, and accounts for 14 percent of the federal budget and 20 percent of national healthcare expenditures. This snapshot of Medicare-by-the-numbers reveals the program as firmly placed at the nexus of political will, social responsibility, and future sustainability. In our modern political climate, can we muster the will to retain this life-saving program at its current strength? Will impending demographics prove too unwieldy—or be manageable with substantial change?
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