Public Comment

On July 30 this year throughout the country the nation will be celebrating the 50th birthday of Medicare, which, as you know, serves mainly senior citizens. An important component in this celebration is demanding Medicare for All. A major celebration will take place in Frank Ogawa Plaza in Oakland beginning 11am.

But 50 years ago President Johnson on the same date signed not only the Medicare bill. He signed into law Medicaid, which is a much larger program. Moreover, Medicaid provides services that are not available to Medicare recipients, including the availability of long term care facilities. Yet Medicaid is being ignored by senior organizations, labor unions, faith based and community organizations They act as if the program does not exist. 

What is the explanation for this unusual omission? The explanation is at the roots of our class related culture. Unlike Medicare, which is an insurance program for those who have paid into Social Security, Medicaid is needs tested. It is a program entirely for low income Americans who must prove that they and their family members are poor. Clearly, poverty earns the poor and the programs that mainly serve them a very low status reputation. 

Not least, the medical profession is unhappy about Medicaid, whose members receive only about 60% of the reimbursement that Medicare pays. For this reason, many doctors either refuse to accept Medicaid patients or take very few. Moreover, they influence many others who work in health related occupations. 

The potential consequences of ignoring Medicaid is it makes the program more financially vulnerable. In these conservative times, all our social programs are financially threatened. But more so with Medicaid whose recipients have the least clout. And they receive little or no support from those organizations and individuals who are more fortunate and influential. 

I have raised this issue with many progressive organizations, hoping that they would reconsider. But I have had no luck. Some who defended their position claimed that their interest was primarily to advocate Medicare for All. But even so, that certainly doesn't justify completely ignoring the same birth date of a medical program which unlike Medicare covers recipients of all ages. 

Also, keep in mind that many seniors who currently depend on Medicare will eventually depend on Medicaid in order to receive long term care, including nursing home facilities. Clearly, there is something seriously wrong with a celebration that favors the insured at the expense of those who can least afford medical care