Medi­care/Med­i­caid ar­chi­tect sees vi­sion re­al­ized in many ways

Modern Healthcare - - COMMENT -

Re­gard­ing cov­er­age of the 50th an­niver­sary of Medi­care and Med­i­caid (Mod­ern Health­care, May 25, p. 13), in 1979 as an Amer­i­can Hos­pi­tal As­so­ci­a­tion/Blue Cross and Blue Shield As­so­ci­a­tion fel­low, I had the priv­i­lege of meet­ing Wil­bur Co­hen, the ar­chi­tect of Medi­care and Med­i­caid, and the first sec­re­tary of the Depart­ment of Health, Ed­u­ca­tion and Wel­fare un­der Pres­i­dent Lyn­don John­son (pre­de­ces­sor agency to HHS). I was so im­pressed by his pas­sion about ex­pand­ing cov­er­age to se­nior cit­i­zens and poor and dis­abled cit­i­zens of the U.S., who like all of us need health­care and ben­e­fit from the se­cu­rity of health in­sur­ance.

Mr. Co­hen’s vi­sion has been re­al­ized in many re­spects. Medi­care and Med­i­caid have pro­vided es­sen­tial ser­vices to mil­lions of Amer­i­cans, have fu­eled the ex­pan­sion of med­i­cal tech­nol­ogy, ex­panded the ca­pa­bil­i­ties of health­care providers, and have re­sulted in greater life ex­pectancy and ex­tended qual­ity of life for men and women in our coun­try.

I am sure that Mr. Co­hen did not fully an­tic­i­pate the cur­rent size and com­plex­ity of Medi­care and Med­i­caid, which now in­clude an enor­mous CMS in­fra­struc­ture, or how the health­care in­dus­try would drive costs to 17% of GDP. Medi­care and Med­i­caid have of­ten been crit­i­cized for the lack of re­al­is­tic fi­nan­cial plan­ning and the im­pact on fed­eral and state bud­gets, the un­funded costs of pro­vid­ing care in hos­pi­tals and physi­cian of­fices— which has shifted those costs to em­ploy­ers and in­di­vid­u­als in the com­mer­cial in­sur­ance mar­ket—and the reg­u­la­tory bur­den that has sig­nif­i­cantly in­creased the ad­min­is­tra­tive costs of health­care.

How­ever, the in­di­vid­ual pa­tient who now has ac­cess to high-qual­ity health­care never wants Medi­care or Med­i­caid to go away.

Nancy Sch­licht­ing

CEO

Henry Ford Health Sys­tem

Detroit

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