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New York Times, June 1965

By David Lipschutz, Center for Medicare Advocacy Senior Policy Attorney

In the run-up to the passage of a major expansion of health insurance coverage, a prominent and rising political figure urged people to oppose such expansion, and contact their members of Congress to express their opposition:

"Write those letters now; call your friends and tell them to write them. If you don't, this program I promise you, will pass just as surely as the sun will come up tomorrow, and behind it will come other federal programs that will invade every area of freedom as we have known it in this country…And if you don't do this and if I don't do it, one of these days we are going to spend our sunset years telling our children and our children's children, what it once was like in America when men were free."

This was not a Tea Party activist denouncing the Affordable Care Act (ACA).  It was Ronald Reagan in a 1961 recording sponsored by the American Medical Association meant to defeat passage of the proposed Medicare program. 

While similar rhetoric abounds today regarding ACA, Medicare is now widely recognized as a grand success for older people, people with disabilities, and the American healthcare system. Very few would openly decry Medicare as a threat to democracy. Yet Medicare has been increasingly privatized, and it remains under threat from those who wish to further morph the program into a private system. Such threats range from policies that continue to favor Medicare Advantage plans over traditional Medicare, to annual budget proposals that would turn Medicare into a voucher (or premium support) program, to the recently passed “Doc Fix” law that weakens coverage of future Medigap plans and increases the cost of Medicare Part B, further encouraging people to enroll in private plans.  

People who care about the soul of Medicare need to pay attention to these gradual but determined steps towards privatization and away from the original cost-effective, universal program. If we don’t, we may have to tell our children what it was like when once Medicare was real.

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