An Open Letter to the President on Medicare’s Birthday

Dear Mr. President, Secretary Sebelius, Majority Leaders Reid and Cantor, Speaker Boehner and Minority Leaders McConnell and Pelosi,

We write to you on the occasion of Medicare’s 47th birthday to share our deep concern about increasing threats to both Medicare and Medicaid and to urge the immediate expansion of Medicare to everyone in the United States followed by its improvement. The implementation of the Affordable Care Act is not the solution; when it is fully implemented tens of millions will be left without insurance, tens of millions more will be left without adequate insurance and the cost of health care will continue to skyrocket. Forty-seven years of experience proves that Medicare is not the problem, but is the solution to the health care crisis in America.

For many of the most vulnerable among us, Medicare and Medicaid are their last protection from financial and medical catastrophe. Unfortunately, these vulnerable patients are not represented in health policy discussions. Instead, policy is dictated by special interests profiting from our health care system, not by those depending upon it to stay alive.

We call upon you to end the partisan and corporate influences that replace the best medical interests of our patients with the financial interests of those whose primary need and goal is to maximize profit, not to promote prevention and assure patient care.

Health care costs more in America than it does anywhere else in the world. Among the industrialized nations, we rank at or near the bottom on almost every measure of public health. Millions of us have limited or no access to health care, resulting in tens of thousands of unnecessary deaths and hundreds of thousands of family bankruptcies; these consequences are not found in other industrialized nations. Our country is heading in the wrong direction. We need immediate action.

We need a health care system that provides access to every one of us, no matter how sick, poor, old, or unemployed we may be. We need reduced costs. We need improved health for all people in the United States, not just the most fortunate.

The recent Supreme Court decision on the Affordable Care Act unhappily codifies into law an approach that fails to meet any of these health care needs:

• At its best, the ACA will leave 30 million Americans without health coverage. Another 40 million will be under-insured and therefore at risk for financial catastrophe or death when they get sick. Both numbers will increase as states opt out of the Medicaid expansion.

• With no restriction on prices charged by insurance companies, many people will find even the lowest tier policies unaffordable. Others will be unable to afford deductibles, and with that unable to afford necessary care. And still more will be bankrupted by out-of-pocket expenses when they get sick.

• As Medicare spending decreases, out of pocket expenses will rise. Patients will be compelled to defer health care until they are desperately ill, further eroding public health in America.

• The ACA will not slow the soaring costs of American health care. These costs exact a terrible toll on our economy. Small businesses struggle to survive if they choose to provide benefits to their employees. Large businesses cannot compete in international markets. Entrepreneurs refuse to start new businesses for fear their families will lack access to health care.

Instead of relieving our families and businesses from higher costs and diminishing access, the ACA entrenches the worst aspects of our health care system:

• Private health insurance companies are enshrined as the only portal through which most patients can access health care. We already know that because of the current system of more than a thousand insurance plans, the associated administrative waste consumes 31% of total health care spending. If this administrative loss were invested in health care, we could provide comprehensive care to every person with no additional funding.

• The ACA reduces Medicare costs by paying providers less, a tactic encouraging providers to avoid Medicare patients.

• The Supreme Court decision on the ACA allows states to cut Medicaid enrollment and services without penalty, leaving millions of Americans with inadequate or no access to care.

• The ACA encourages continuation of inhumane cost-shifting to patients in the form of compulsory purchase of expensive policies, higher deductibles, and higher co-pays.

• Millions of people will remain dependent upon employer-sponsored private insurance for health care access, continuing the pattern of labor-management negotiations becoming battlegrounds.

America needs cost-effective universal health care as exists in every other industrialized country. No other nation uses our unique private insurance system which penalizes the sick by charging them more, by reducing their benefits, or by denying care altogether. None allow private insurance companies to place profit over coverage. All of them encourage health care by reducing or eliminating deductibles and co-pays. And all of them provide better care to more people for less money than we do.

Instead of greater privatization of our health care system, we implore you to immediately extend Medicare, our cherished national public insurance, to every person in the United States and then work to improve it. Making Medicare universal would:

• Insure health care access to every American regardless of health, wealth, age, or employment.

• Create the opportunity to fund health care with progressive taxes designed to spare struggling families and small businesses.

• Reduce costs of health care by eliminating the extraordinary and unnecessary administrative waste generated by the private health insurance industry.

• Increase the financial health of our families by sparing them the specter of bankruptcy if any member should have a serious accident or illness.

• Eliminate labor-management disputes over health care benefits.

• Reduce fraud by using consistent forms throughout the country.

• Allow patients to choose their physicians, rather than having insurance companies choose for them.

Medicare needs improvement to provide these benefits. An improved Medicare program should:

• Include every person in the United States, giving them all equal access and benefits.

• Cover all necessary medical, dental, vision, mental health and long-term care with little or no patient cost-sharing.

• Negotiate fair prices for pharmaceuticals, medical devices and health services.

• Remove for-profit health facilities.

• Create an appointed board of patients and health professionals to determine benefits and payments based on need and evidence, not on politics.

• Assure guaranteed access to health care for all communities by defining global operating budgets for health facilities with separate capital budgets to facilitate better health planning.

America’s multi-decade experiment with market-driven care which emphasizes protection of for-profit industries has devastated our families, crippled our businesses, smothered our economy, and stolen our health. The ACA is a continuation of this experiment and medical ethics dictate that this experiment must be stopped.

We can no longer tolerate having the highest health care costs with the worst outcomes in the industrialized world. Our own publicly funded health care systems (Medicare and the Veterans Administration) can and do provide better care at lower cost to even the most vulnerable patients.

We cannot rely either on our private insurance industry or the ACA to remedy our crisis. We implore you to immediately protect, improve, and expand Medicare. Every person in the United States needs and deserves access to health care.

With concern,

Henry L. Abrons, MD, Berkeley, California; Pippa Abston, MD PhD, Huntsville, Alabama; Garrett Adams, MD, Louisville, Kentucky; Patch Adams, MD, Urbana, Illinois; Kris Alman, MD, Portland, Oregon; Paul Bigman, Business Representative, IATSE Local 15, AFL-CIO, Seattle, Washington; Mindy Blaski, MD, Seattle, Washington; Paul Blaski, Seattle, Washington; Philip Caper, MD, Brooklin, Maine; Claudia Chaufan, MD, San Francisco, California; Andy Coates, MD, Albany, NY, Mardge Cohen, MD, Boston, Massachusetts; Mary L. De Luca, MD, Albuquerque, New Mexico; Margaret Flowers, MD, Baltimore, Maryland; Elizabeth Frost, MD, Minneapolis, Minnesota; John Geyman, MD, Seattle, Washington; Leslie Hartley Gise, MD, Kula, Hawaii; Irene Gomez, Seattle, Washington; James S. Goodman, MD, Albuquerque, New Mexico; Jeoffry Gordon, MD, San Diego, California; Paul Gorman, MD, Portland, Oregon; Nancy Greep, MD, Los Angeles, California; Oliver Hall, JD, Washington, DC; Hedda L. Haning, MD, Charleston, West Virginia; Bruce Hector, MD, North Hills, California; David Himmelstein, MD, New York, New York; Paul Hochfeld, MD, Corvallis, Oregon; Michael Huntington, MD, Corvallis, Oregon; Dana Iorio, ARNP; Seattle, Washington; Joseph Q. Jarvis, MD, Salt Lake City, Utah; Jeffrey Kaplan, MD, Baltimore, Maryland; Stephen B. Kemble, MD, Honolulu, Hawaii; Jim Kratzer MD, MPH, Fresno, California; Don McCanne, MD, San Juan Capistrano; David McLanahan, MD, Seattle, Washington; George Martin, MD, Seattle, Washington; Samuel Metz, MD, Portland, Oregon; Russell Mokhiber, JD, Berkeley Springs, West Virginia; Kathleen Myers, DDS, Seattle, Washington; Eric Naumburg, MD, Columbia, Maryland; Clark Newhall, MD JD, Salt Lake City, Utah; Carol Paris, MD, Leonardtown, Maryland; George L. Pauk, MD, Phoenix, Arizona; Glenn Pearson, MD, Fort Collins, CO, Edward Pontius MD, Topsham, Maine Julie Keller Pease, MD, Brunswick, Maine; Ellen Punyon, Retired School Principal, Seattle, Washington; Richard Quint, MD, MPH, San Francisco, California; George Randt, MD, Cleveland,Ohio; Helen Redmond, LCSW, New York, New York; Katie Robbins, Mailman School of Public Health, MPH, Class of 2014, New York, New York; Cecile Rose, MD, MPH, Denver, Colorado; Johnathan Ross, MD, Toledo, Ohio; Rick Saling, CWA (for ID only), Seattle, Washington; Gordon Schiff, MD, Boston, Massachusetts; Ann Settgast, MD, Minneapolis, Minnesota; Elias Shaya, MD, Baltimore, Maryland; Diljeet Singh, MD, Chicago, Illinois; William Skeen, MD, Oakland, California; Paul Y. Song, MD, Santa Monica, California; Nancy Hewitt Spaeth, RN, Seattle, Washington James Squire, MD, Seattle, Washington; Karen Green Stone, Small Business Owner, Bloomington, Indiana; Rob Stone, MD, Bloomington, Indiana; Arthur J. Sutherland, III, MD, FACC, Memphis, Tennessee; Bruce Trigg, MD, Albuquerque, New Mexico; William Ulwelling, MD, Albuquerque, New Mexico; Robert Vinetz, MD, Los Angeles, California; John V. Walsh, MD, Cambridge, Massachusetts; Li-hsia Wang, MD, Berkeley, California; Daniel P. Wirt, MD, Houston, Texas; Steffie Woolhandler, MD, New York, New York; Kevin Zeese, JD, Baltimore, MD.


  1. dan lafferty on July 30, 2012 at 6:29 pm

    it is easy to pay for: remove ALL loopholes and make it ALL GROSS income – INCLUDING INVESTMENT INCOME!!!

    let the top 20% pay their fair share!!!

  2. healthcare staffing fresno on August 6, 2012 at 12:17 pm

    This topic is good but I would like also to share to about At Interim HealthCare we understand how important it is to have someone you can depend on when you or someone you love wants to stay at home to maintain the highest level of health and independence. Our mission is to improve people’s lives and that is what we do every day.

  3. Alabama Medicare on August 7, 2012 at 8:19 am

    Excellent topic to read, how much insurance coverage commonly offer?

    • Lesa on August 8, 2012 at 1:09 pm

      One of biggest problems with the health care system today is The lack
      Of control and accountability in insurance companies.
      The annual rating go up, what’s covered goes down. And some even deny coverage
      considerind pregnancy a preexisting condition
      One of the best systems I have had the pleasure of belonging to is KAISER PERMANENTE MEDICAL CRMTER which is only available I’m one half of the country
      They should be every where

  4. Michelle Rosen on August 8, 2012 at 5:16 pm

    Medicare for All/Single Payer is the way the U.S. must go for moral/ethical as well as economic reasons. High-quality, affordable, accessible universal healthcare is a right, not a privilege for the wealthy. The U.S. can’t compete in a global economy where the other countries offer their citizens healthcare as a basic human right. It’s about time the U.S. caught up to the rest of the world before we become a Third World country, if that hasn’t already happened. Once you expand Medicare to all, regardless of age or preexisting condition (basing the premiums on income), you solve two problems: 1) Every U.S. citizen has high-quality, affordable and accessible healthcare and 2) Medicare remains solvent for generations to come. It’s way past time to stand up to the private, for-profit, excessively greedy health insurance companies and their lobbyists. If the politicians, who are in their pockets, won’t, then Americans will just have to take to the streets and demand it! It’s worked before in American history and can work again. Enough is enough!

  5. Michael M. T. Henderson on August 8, 2012 at 7:24 pm

    I agree wholeheartedly with Michelle Rosen, above. Single-payer, not-for-profit health coverage for all is the only moral, ethical, and economical way to go. It’s been demonstrated all across Europe, most of Asia, Latin America, Australia/New Zealand, and Canada. Those who say that single-payer is un-American are right; it is American to let your fellow citizens die for lack of health care, to follow our current system, quoting ex-Congressman Alan Grayson: (1) Don’t get sick; (2) If you do, die quickly. Now it’s time for us to join the rest of the modern world and agree that it’s morally imperative that we take care of each other, through the government, of, by, and for the people. What anti-Romneycare people, and maybe Republicans in general, don’t understand those prepositions. It’s not us vs. the Government: we ARE the government–unless of course our representatives sell their votes to the highest bidders. That’s another story.

  6. Marilyn Morton on August 9, 2012 at 5:16 am

    Many seniors take drugs that are not covered and therefore they never reach the donut hole. These are being eaten up by drug prices.
    Children who are less than 27 are unable to get insurance because their parents do not have it.
    I can go on and on with stories of people who fall through the cracks.
    We must a system that everyone is in fashioned after an improved Medicare.

  7. Marilyn Morton on August 9, 2012 at 5:18 am

    Many seniors take drugs that are not covered and therefore they never reach the donut hole. These are being eaten up by drug prices.
    Children who are less than 27 are unable to get insurance because their parents do not have it.
    I can go on and on with stories of people who fall through the cracks.
    We must have a system that everyone is in fashioned after an improved Medicare.

  8. San Patrick on January 25, 2013 at 7:16 am

    Thanks for sharing such a nice topic which us about Health. I listen from my forefathers that “Health is Wealth”. It is great saying.
    Sir Stamford at Circular Quay Hotel