Preserving Medicare's Success, 43 Years Later

As popular as Medicare is now, it is hard to believe that it was once bitterly opposed. Medicare came into existence 43 years ago today, in the face of many who doubted that it could cover millions of people, provide them with excellent care, and keep costs low.

By now, though, Medicare has proven to be one of the most efficient ways of collecting and dispensing health care payments. It has meant peace of mind for generations of senior citizens and a boost to American industry, especially in the form of the wrap-around plans that have reduced health care costs for companies while actually increasing quality of care.

Today, Congress is debating the most significant reform to our health care system since Medicare. In fact, parts of Medicare itself may change -- which will give friends of the current broken status quo an array of scare tactics they can use to oppose health care reform as a whole.

The truth, though, is that doing nothing is no longer an option. Spiraling health care costs threaten to bankrupt our country and damage the well being of all Americans. Since 2000, family premiums have more than doubled, while wages have remained stagnant; just last year, employees' out-of-pocket health care costs were up more than 10%. Medicare shares the burden of those fast-rising costs; in fact, its current course is unsustainable, with its trust fund set to be exhausted in as little as eight years. For that reason alone, Medicare reform should go hand-in-hand with reform to bring affordable care to all Americans.

To save Medicare, we must make it more efficient -- but we also have to preserve what has made it so valuable for millions. Democrats are dedicated to protecting and improving Medicare, ensuring that all seniors have access to low-cost prescription drugs, improving low-income subsidy programs to make sure that Medicare is affordable to all, ending wasteful overpayments, and adding new consumer protections to private Medicare Advantage plans.

For years, physicians have treated aging patients as they've transitioned from private insurance to Medicare -- one of the services that make so many doctors pillars of their communities. But doctors also need new incentives to continue treating Medicare patients, which is why we're committed to improving payment rates for family doctors and other primary care physicians. We also want to eliminate the 21 percent cut in doctors' fees that is scheduled for 2011.

As we improve Medicare, we can also recognize that it has a lot to teach us about bringing quality care to millions of Americans. Those lessons will be vital to the health care reform debate. They include the importance of rewarding coordinated care, the harms of inaccurate payments and overpayments to private plans, and the need to make critical delivery system reforms to the way doctors are reimbursed. We have also learned that the fee-for-service system -- in which doctors are paid for procedures instead of health outcomes -- creates greater potential for fraud and abuse. Health care reform should tackle all of those challenges, while rewarding providers who give coordinated, quality care to patients at reasonable costs, with lower readmission rates.

This anniversary is a time to celebrate Medicare's many successes -- successes so many Americans have seen firsthand, in the lives of seniors who have received guaranteed, dignified health treatment. As far as we're concerned, that is something every American deserves. But preserving Medicare's success, and fixing our health care system as a whole, means that we need to face up to some urgent changes. With the largest generation of Americans set to retire, health care costs are set to skyrocket even further; without change, those costs are on pace to exceed the GDP of our entire country.

But now, while we can see that calamity coming, we have a chance to avert it. This summer, we have an opportunity to build a health care system worthy of all Americans. Doubters will tell us that it can't be done. But that's the same thing they said 44 years ago.