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Medicare Celebrates a Half Century

Give Medicare and Medicaid an AARP card — they’re turning 50 this year.

President Lyndon B. Johnson, with former President Harry S. Truman, signs the Medicare bill into law in 1965.

At a special program on Wednesday commemorating the upcoming 50th anniversary, experts spoke about how the two federal programs have transformed both the country’s health care system and the health of its older citizens.

“Medicare has been a health care lifeline for millions of older Americans and must be strengthened for the future,” AARP President Jeannine English said at the conference, sponsored by the LBJ Presidential Library, the Aspen Institute and the Robert Wood Johnson Foundation, with support from AARP.

Medicare and Medicaid together now provide health insurance coverage to some 112 million Americans. But it hasn’t been an easy road getting here, noted panelists at the commemorative event.

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Lynda Johnson Robb, a daughter of President Lyndon B. Johnson, who shepherded Medicare legislation through a balky Congress in 1965, said her father was driven to get the bill passed because of his childhood memories growing up in rural Texas.

“Daddy grew up knowing people who lost their farm and all their money paying their medical bills,” Robb said. “One-third of seniors lived in poverty. People couldn’t afford to get regular checkups and catch things early when they were less expensive to treat.”

Recalling stories of her father’s intense politicking to get the legislation passed, Robb said he also knew that “compromise was not the enemy.”

“That’s why Congress deserves a lot of credit for compromising yesterday,” she said, referring to the bipartisan repeal of an 18-year-old law that each year threatened to slash Medicare payments to doctors. The uncertainty and yearly wrangling over whether the cut would go into effect — or be deflected by a temporary “doc fix” bill — had caused many doctors to refuse to accept Medicare patients. President Obama signed the bill on Thursday.

But while the first half century of Medicare and Medicaid has been “a spectacular success,” AARP’s English added, “we recognize that challenges are looming.”

As numerous panelists pointed out, 10,000 aging boomers a day are signing up for benefits. By 2030, Medicare will be serving twice as many older adults — about 78 million — as it did in 2000.

The bulk of that will come from “two bulges” in enrollment, one from boomers born from 1946 to 1949, and a second from those born in the late 1950s to 1960s, said Gail Wilensky, former administrator of the Centers for Medicare and Medicaid Services.

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In addition, Medicare will be facing increased financial pressure as early as 2018, not only from these boomer bulges but also from people 85 or older, who will require a lot more care for chronic conditions, she said.

The good news, though, is that boomers seem to be healthier than their parents’ generation, so they may need fewer medical services in coming years.

Former Secretary of Health and Human Services Kathleen Sebelius noted that Medicare beneficiaries would be better served by a reimbursement system based on “the quality of care and the outcome for the patient” rather than the number of visits or tests that doctors provide. And she echoed English’s call for better coordination of care to reduce medical errors and unnecessary hospital readmissions.

“The golden anniversary of Medicare and Medicaid is a cause for celebration,” English said in closing, but Medicare’s next 50 years will require “fresh thinking and further innovations” to make sure they continue to fill their essential role.

Photo: AP Photo/File

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