Sixty one years ago, July 30, 1965, Congress enacted Medicare to provide health insurance for people ages 65 and older and the disabled regardless of income or medical history. At the Harry S. Truman Presidential Library in Independence, Missouri, former President Harry S. Truman and his wife, former First Lady Bess Truman, became the first recipients of the new Medicare health insurance program. President Lyndon Johnson and the US Congress enacted Medicare under Title XVIII of the Social Security Act.

Medicare was a momentous act because it provided new health insurance for people ages 65 and older and the disabled regardless of income or medical history. In the years since, Medicare has become living proof that public, universal health insurance is superior to private insurance in every way. Medicare is more efficient than private health insurance and is administered at a cost of 3-4%, as opposed to private, for-profit health insurance, which has administrative costs above 15%.

Following the successful 1965 grassroots campaign to enact Medicare, many also believed that the dream of a full national, single-payer health insurance system that included all age groups, “Medicare for All,” was right around the corner. Unfortunately decades later, Medicare still has not been expanded. Most of the changes have been contractions with higher out-of-pocket costs for beneficiaries and repeated attempts at privatization by Big Pharma, Big health insurance industry companies-oligarchs-profiteers, and their champions in the White House and Congress.

Big insurance and Big Pharma continue opposing legislation for the new, improved Medicare for All because these resistant, self-serving industries have the most to lose if their huge profits are redirected to direct patient care for all. Individual and corporate predators regard democracy, government, and community as obstacles to their greed and avarice, always placing profits over individual patients, families, and public health. It’s no wonder so many beholden members of Congress want to protect the interests of Big Insurance and Big Pharma, industries that spent $371 million on lobbying in 2017 alone.

The Big Health Insurance-Big Pharma-Congressional Profiteering Complex

The Heritage Foundation’s Project 2025, framed by former Trump administration staffers and secretly endorsed by President Donald Trump himself, proposes changes in Medicare benefits that could destroy Medicare as we know it. Instead, we must fight back and expand Medicare. Although health insurance affordability for the majority of US citizens still remains elusive, President Trump’s health insurance plan still wants to shift many more dollars into private, Wall Street insurance industry hands. The takeover of public health insurance, as with Medicare Advantage plans and others, by private Wall Street entities continues apace as Republicans and Trump propose to increase taxes and give it to the private profit insurance industry—the basic source of our profound administrative waste, along with the costly administrative burdens they place on the delivery system that requires large profits. Profiteering continues unabated as private insurance sells us services we don’t need or want, such as deductibles and other cost sharing and maintenance of narrow networks, requiring prior authorization with increased administrative costs, excessive ongoing paperwork, and documentation requirements, all while avoiding paying for surprise bills and other denied benefits.

No greater disconnect exists between the public good and private interests than in the voracious US system of for-profit Big Insurance and Big Pharma.

Dealing with Covid-19 could have been more lifesaving if Medicare for All had been in place. A New York Times editorial, "Health Care for Some is a Recipe for Disaster," stresses the importance of covering everyone. Even before Covid-19 was known to humans, Northeastern University professor of public health, Wendy Parmet, presciently warned that the push to exclude immigrants from access to healthcare services would be both dangerous and quixotic. “None of us can be self-sufficient in the face of a widespread epidemic,” she wrote in 2018. “That is just as true for noncitizen immigrants as everyone.” In any pandemic, self-sufficiency can be self-deluding; everyone’s health, citizens, immigrants, etc. alike is only as good as our most vulnerable neighbor’s.

Truly a recipe for disaster, vested interests reject the science of public health epidemiology by asserting that only a slow, incremental approach to health insurance reform is possible or acceptable. So, what are we willing to settle for, should we just settle for what we can get? Lower the expectations, turn down the public heat, and keep waiting?. Gradualism, baby steps, extending health insurance coverage to some, but not all, is the mantra of the day; "Medicare for Some," but not "Medicare for All," is fawned over by politicians, profiteers, and advocacy groups alike while reducing communities resources to deal with dangerous epidemics and other health problems.

Virtually all the risky gradual reforms being touted would reinforce a dysfunctional health insurance system with as many standards of insurance as there are dollars to purchase them. It would further lock us into an obsolete private insurance-based model that holds everyone's health hostage to profiteering HMOs and unaccountable big insurance companies for years to come. For these proponents of political expediency, the question remains: Who will be left behind while we wait? Every year many unnecessary deaths are linked to lack of........

© Common Dreams