The Journey to Medicare’s 58th Anniversary

July 27, 2023 F. Douglas Stephenson  INFORMED COMMENT

The most successful health insurance program, Medicare, was enacted in July,1965 to provide health insurance for people ages 65 and older and disabled regardless of income or medical history. Medicare is more efficient than private health insurance

The most successful U. S. health insurance program, Medicare, was enacted ln July,1965, to provide health insurance for people ages 65 and older and the disabled regardless of income or medical history. In the 58 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 percent to 4 percent, as opposed to private, for-profit health insurance, which has for-profit/administrative costs above 15 percent.

Medicare’s costs have risen more slowly than those of the private health insurance industry. Medicare provides better access to care, better financial protection and higher patient satisfaction. Although some have negative feelings toward government, and examples of government inefficiency exist, the record of private health insurers is far worse. Dozens of financial profiteering scandals have wracked private insurers and HMOs in recent years.


Following the successful 1965 grassroots campaign to enact Medicare, many believed that the dream of a full national health insurance system that included all age groups, “Medicare for All”, was right around the corner. Unfortunately five 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 and their champions in the White House and Congress.

Because the for- profit, private insurance industry so thoroughly dominates our national health insurance system, the basic concept and purpose of health insurance is defined by them. The U.S. subscribes to a private business model of health insurance that defines insurers as commercial entities. Private insurers maximize profits by mainly limiting benefits, maximizing health policy premiums or by not covering people with health problems. Like all businesses, their goal is to make money. Under the business model, the greed of casual inhumanity is built in and the common good of the citizens and nation is ignored; excluding the poor, the aged, the disabled and the mentally ill is sound business policy, since it maximizes profit .


“Money is like salt water. The more you drink, the thirstier you get”. Roman proverbs say that the more money a rich man has, the more driven he is to accumulate more. Limitless greed for money the Greek dramatists said, becomes a disease of the psyche. In the 388 B.C. play, “Ploutos”, Aristophanes writes that a person may become over-saturated with food….but no one ever has enough wealth. Wealth addiction is a greedy compulsion to obtain more and more wealth, and specifically obtain what belongs to others. The effect is to injure others because it is adversarial/harmful to society as a whole. The related condition of “affluenza” reflects an inability of wealthy/oligarchs to understand the consequences of their behavior because of financial privilege.