Virtually all of us benefit from Medicare, directly or indirectly. Medicare is a lifeline that puts health care in reach of millions of older Americans. But it does much more: By helping older Americans stay healthy and independent, Medicare eases a potential responsibility for younger family members.
Knowledge that Medicare’s protections will be there when needed brings peace of mind to people as they get older.
Here are some of the many ways Medicare matters:
Medicare guarantees affordable health insurance. Before Medicare, almost 1 in 2 older Americans had no health insurance and faced a bleak future if they got seriously ill. Their choices often included wiping out their savings, taking money from their children, seeking welfare or doing without care.
Medicare delivers a guaranteed level of coverage to people who might not otherwise be able to afford it. And it helps insulate beneficiaries from rising health care costs. People enrolled in the program may still pay thousands of dollars a year for health care, but their access to health care is vastly better than before the program existed.
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Medicare provides a full range of services. Medicare helps people stay well: The program provides important preventive services and screenings at no charge. Medicare Part B offers a free wellness check-up annually, as well as periodic screenings for cardiovascular disease; cervical, vaginal and breast cancer for women; prostate cancer for men; diabetes; and depression. It also covers flu shots. And the Part D program can help pay for costly prescription drugs (both preventive and therapeutic treatments).
Finally, for the terminally ill, Medicare offers a hospice benefit that helps individuals get compassionate, end-of-life care, typically in their own home.
Medicare can lead the way to better care for everyone. It is pushing for better delivery of health care, with initiatives to improve quality and coordination, prevent avoidable readmissions to the hospital and reduce infections caught while at the hospital. Increasingly, it is paying doctors and hospitals for quality of care rather than the volume of services.
Medicare works efficiently. Its administrative overhead remains low compared with private insurance, and its spending per individual has risen more slowly than private insurance — climbing just 1.4 percent each year between 2010 and 2015, which is less than half the 3 percent growth rate in private health insurance. Overall, total Medicare spending grew less than 5 percent a year in that period, a significant decline from its 9 percent annual rate in the prior decade.
Medicare’s protections go to more than seniors. The program provides health coverage for 9.1 million disabled persons who in the past were typically unable to get approved for private insurance. Such individuals become eligible for Medicare if Social Security has classified them as disabled for 24 months. In addition, people younger than 65 who suffer from end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) may be eligible for Medicare.
Medicare helps fight poverty.
When Medicare was enacted in 1965 nearly 1 in 3 seniors lived in poverty. Older people were more likely to be poor than any other age group. Yet in its first 10 years, Medicare helped cut their poverty rate in half.
By helping people shoulder the potentially devastating costs of illness, Medicare plays a critical role in the financial security of older Americans, as well as their health security.