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Medicare, Up Close and Personal


Several months ago, I began receiving a flood of letters and phone messages from health plans, insurance brokers and others, reminding me—as if I needed reminding—that I was about to turn 65. “It’s almost time!” they said. “Congrats in advance!”

They were concerned about my future health coverage and wanted me to get the most out of life. They understood my confusion and were there to help. Some even offered me a free meal.

“You have a limited window of time to enroll,” they warned. “You have options, we have answers. Give yourself the coverage you need. You owe it to yourself…”

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Joking aside, Medicare is about to get up close and personal for me. Until lately, I thought of it as a nebulous bureaucratic system I would need to engage with “one of these days.” Even as a communicator for a Medicare contractor, I sometimes found it hard to relate to the quality-of-care issues our organization grapples with every day. Now the program and its future have my full attention.

I believe it’s fair to say that Medicare has changed American life and individual lives as no other government program has. Over five decades, the expansion of Medicare benefits, coupled with medical advances, has enabled seniors to remain healthier longer and to live independently as they seldom could before, with positive ripple effects across our society. Americans of all political hues have come to take for granted the program’s multigenerational promise to ensure access to health care, at least for citizens of a certain age.

As a new beneficiary, I naturally hope that we as a nation will continue to meet that obligation by keeping the program solvent. That will depend not only on ensuring an adequate flow of tax revenues to support the demand for services, but on reining in health care delivery costs, stamping out Medicare billing fraud and using public resources as efficiently as possible.

At the same time, I will need to meet my own obligation as a patient—weighing the risks and benefits of various treatment options, determining how much autonomy I want in decision making and stating my wishes clearly. Near the end of my parents’ lives, 20 to 30 years ago, I saw them receive services and treatments that seemed of dubious value if not downright harmful. I now understand the cause as a failure of patient-centered care. The system likely cannot function sustainably unless patients are broadly engaged and empowered in their own care.

As a taxpayer, I hope the Centers for Medicare and Medicaid Services (CMS) will continue to use its market clout as the nation’s largest purchaser of health care to push for cost reduction through innovation in care delivery and payment. Down the road, I hope Medicare will become the platform for achieving universal health coverage for citizens.

Finally, I hope Medicare will continue to promote quality improvement through the Quality Innovation Network-Quality Improvement Organization program, activating clinicians and communities in every state to make care safer, more effective and less costly. I’ll feel more confident in the future of Medicare, and of health care in general, knowing that organizations like HealthInsight will keep working for positive change. In that sense, all Americans are Medicare beneficiaries.

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