Anniversary Post: Medicare and Medicaid

Medicare and Medicaid 50th Anniversary

On this day in 1965, Lyndon Johnson signed the Social Security Act of 1965 — thus creating Medicare and Medicaid. It is hard to imagine what we would do today if it weren’t for these programs. The society has changed so much since that time. Workers who get pensions are now incredibly rare. What would the elderly do for healthcare? What’s more, the ability of anyone to get treated at just about any hospital is due to the fact that hospitals that take Medicare are required to treat all patients. I’d like to think that if we didn’t have Medicare, we would have had to have come up with something similar. But there’s no certainty of that.

What’s more, Medicare could never be passed today. But in 1965, it was a different matter. In both the House and the Senate, it passed with overwhelming support from the Democrats and about half of the Republicans. So yes, even back then, a lot of the Republicans were jerks. But that’s the thing: the parties were diverse then. Since then, all the jerks in the Republican Party stayed, and all the jerks in the Democratic Party moved over to the Republican Party. Now it is as pure in its makeup of jerks as it is its makeup of whiteness — not perfect, but close!

As I noted last week, the Republicans still want to kill off Medicare, Jeb Bush Wants to End Medicare Like Them All. They always claim this is because it isn’t sustainable and that it is inefficient. Of course, the real reason that they want to kill it and Social Security is because they are prime examples of extremely efficient government programs that are popular. And the Republicans have always claimed that — contrary to all evidence — the government is always the problem. Paul Krugman provided this graph on the issue of sustainability:

Medicare Costs

And he provided the next graph that shows that actually Medicare has consistently kept costs down compared to the private insurance industry:

Medicare Cost Growth

So at 50 years old, Medicare is looking pretty good. But don’t expect conservatives to stop ranting about how it is killing us. And don’t think for a moment that if the Republicans get control of Washington in 2017 that they won’t turn Medicare into a block grant and then starve it to death. They are eager to do it. Government may not always be the problem, but if we put the Republicans in charge, they will make sure the government is always the problem.

Happy birthday Medicare and Medicaid!

2 thoughts on “Anniversary Post: Medicare and Medicaid

  1. I remember reading, as a youngun, Dr. Noam saying the rich want to do away with Medicare and Social Security because they instill a feeling of community; that we don’t let the little old lady down the block starve. And I thought, “eh, isn’t that a bit much? Saying the rich hate the idea of socialism so much they’d kill off a popular program just because they want to destroy empathy?”

    Of course I wasn’t reading closely, and Dr. Noam was right. Rich people don’t have these grand anti-socialist schemes in mind (well, some do, but not the average rich moron.) But rich conservatives (and many poor conservatives) do want to kill community empathy wherever they find it. They may not know what socialism actually is, but they do know what “government” and “progressives” and “liberals” do when they can; take surplus wealth away from people who would be perfectly happy hoarding it. And put it to some better use. (That the plans of liberals aren’t perfect doesn’t matter much; wealth is pretty useless when it’s hoarded, so almost any plan is better than letting Scrooge McDuck dive into his piles of coins.)

    Of course a society without empathy is pretty grim, unless you live barricaded physically and emotionally from the ramifications. And ultimately I think that’s a lot of what “freedom” means to conservatives (or “the good life” to the VSP, TedTalks crowd.) It’s being separated from the pain of others, except in a condescending, “I do a charity fundraiser once a year because it makes me feel fuzzy inside” sense.

    In a way that’s very appealing.

    I’ve long been trying to understand the conservative, non-empathetic mind. How it pops up everywhere in every society. You can establish a pretty good system, like the Scandinavian one, and inevitably there are going to be people who want to tear it down because it’s not “free” (although the conservative notion of “freedom” strikes me as very constrictive; you have to think and live in very specific ways to enjoy the benefits.)

    Maybe it has something to do with the fantasy of avoiding pain. How if you can do the right things, you can never feel bad or sad. That’s not evil; it’s just trying to deal with the human condition in a very convoluted fashion. Ultimately an impossible one. I’m not putting this very well, but it’s just something I’m starting to formulate in my wee little mind.

    It is one thing I like very much about “Last Week Tonight.” When the show is very good, like last Sunday’s piece on mandatory minimum sentences, it simply says “this is insane.” Not “this is wrong because it happens to people who resemble you.” Just “this is insane.” That’s the right approach.

    • I’ve long argued that the hatred of unions is mostly about the hatred and fear of solidarity. And you are totally right about “freedom.” Humans have been successful enough that everyone in the world could be totally self-actualized — with no need to do anything but that which gives their lives meaning. But we don’t. It is more important to have a constantly increasing GDP than to have improving standards of living. And we in America are the worst. True freedom is being able to do what you want. But the American idea of freedom is that you shouldn’t be limited in how you starve to death.

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