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On Medicare milestone, a look at saving the system

St. Joseph News-Press (MO) - 7/29/2015

July 29--Lawmakers in Washington passed legislation that created Medicare in the summer of 1965. But President Lyndon Johnson got on a plane and flew more than 900 miles to sign the bill in Missouri.

The reason resided in Independence, Missouri. Former President Harry Truman, Mr. Johnson said, had planted the seeds for this social safety net that "flowered into care for the sick and serenity for the fearful."

With Mr. Truman at his side, Mr. Johnson signed the measure on July 30, 1965, 50 years ago Thursday.

The Missourian, then 81, got the first Medicare card. In the current fiscal year, about 55.2 million Americans get Part A or Part B Medicare coverage, or both.

That includes about 46.1 million residents in the age category and 9.1 million getting disability benefits.

Missouri has more than 1 million beneficiaries, about 17 percent of the population, and Kansas has more than 500,000.

The high level of participation, of course, puts a strain on the Medicare system that paid out $613 billion in 2014.

In a report put out this month by the Board of Trustees for Medicare programs, the Part A trust fund, the largest component covering hospital stays and skilled nursing facilities, fails the short-range test of "financial adequacy."

Further, the report said, the program does not "meet the trustees' long-range test of close actuarial balance."

By that, the fund's overseers believe money to pay beneficiaries will be depleted by 2030.

"Obviously, the demographics are challenging," Missouri Sen. Claire McCaskill, 62, said Tuesday. "My generation is going to be moving into the Medicare system, is moving into the Medicare system, and we are a large demographic bubble."

Census projections show that members of the baby boom generation -- those born between 1946 and 1964 -- will total 61 million by 2030. That's in addition to the 9 million or so Americans born before 1946 who will potentially draw from the system in 2030.

On Friday, Ms. McCaskill, the top Democrat on the Senate Special Committee on Aging, will hold a field hearing in St. Louis concerning the future of Medicare.

The senator said the hearing intends to get input from experts and beneficiaries about how Medicare can be strengthened in the coming years without growing unreasonably in price.

Such measures as reducing the duplication of medical tests and closing the coverage gap in Medicare Part D -- the so-called "doughnut hole" in prescription coverage -- can go some distance toward making care more efficient and bringing down costs, she said.

"There are two fronts," Ms. McCaskill said. "How do we make sure that seniors are getting what they need and the choices that they deserve? And how are we making sure that the program is affordable in the long run?"

A group known as the National Committee to Preserve Social Security and Medicare analyzed the trustees' report and concluded the long-term outlook for the program had improved, with spending per beneficiary growing more slowly than health spending overall.

The analysis insisted, however, that Medicare "faces a long-term financial challenge due to the large increase in the number of beneficiaries as baby boomers reach age 65 and overall health care inflation."

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(c)2015 the St. Joseph News-Press (St. Joseph, Mo.)

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