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MEDICARE, IMPERILED BY TRUMP, TURNS 60  
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F. Douglas Stephenson
August 6, 2025
Informed Comment
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_ Project 2025, framed by former Trump administration staffers and
secretly endorsed by Trump himself, proposes changes in Medicare
benefits that could destroy Medicare as we know it. _

, Photo by National Cancer Institute on Unsplash

 

Sixty years ago, July 30, 1965, at the Harry S. Truman Presidential
Library in Independence, Missouri, former President Harry S. Truman
and his wife, former First Lady Bess Truman, became the first
recipients of the new Medicare health insurance program. President
Lyndon Johnson and the U.S. Congress enacted Medicare under Title
XVIII of the Social Security Act to provide health insurance to people
age 65 and older, regardless of income or medical history and Medicaid
for those whose incomes were below specific levels. 

Medicare was a momentous act because it provided new health insurance
for people ages 65 and older and the disabled regardless of income or
medical history. In the sixty years since, Medicare has become living
proof that public, universal health insurance is superior to private
insurance in every way. Medicare is more efficient than private health
insurance and is administered at a cost of 3 percent to 4 percent, as
opposed to private, for-profit health insurance, which has
administrative costs above 15 percent.

Following the successful 1965 grassroots campaign to enact Medicare,
many also believed that the dream of a full national, single-payer
health insurance system that included all age groups, “Medicare for
All”, was right around the corner. Unfortunately decades later,
Medicare still has not been expanded. Most of the changes have been
contractions with higher out-of-pocket costs for beneficiaries and
repeated attempts at privatization by Big Pharma, Big health insurance
industry companies/oligarchs/profiteers and their champions in the
White House and Congress.

Big insurance and Big Pharma continue opposing legislation for the
new, improved Medicare for All because these resistant, self-serving
industries have the most to lose if their huge profits are redirected
to direct patient care for all. Individual and corporate predators
regard democracy, government and community as obstacles to their greed
and avarice, always placing profits over individual patients, families
and public health. It’s no wonder so many beholden members of
Congress want to protect the interests of Big Insurance and Big
Pharma, industries who spent $371 million on lobbying in 2017 alone. 

THE BIG HEALTH INSURANCE/BIG PHARMA/CONGRESSIONAL PROFITEERING
COMPLEX:

 The Heritage Foundation’s Project 2025, framed by former Trump
administration staffers and secretly endorsed by Trump himself,
proposes changes in Medicare benefits that could destroy Medicare as
we know it. Instead, we must fight back and expand Medicare. Although
health insurance affordability for the majority of US citizens still
remains elusive, President Trump’s health insurance plan still wants
to shift many more dollars into private, Wall Street insurance
industry hands. The takeover of public health insurance, as with
Medicare Advantage plans and others, by private Wall Street entities
continues apace as Republicans/Trump propose to increase taxes and
give it to the private profit insurance industry—the basic source of
our profound administrative waste, along with the costly
administrative burdens they place on the delivery system that requires
large profits. Profiteering continues unabated as private insurance
sells us services we don’t need/want , such as deductibles and other
cost sharing, maintenance of narrow networks, requiring prior
authorization with increased administrative costs, excessive ongoing
paperwork/documentation requirements, all while avoiding paying for
surprise bills and other denied benefits.

Dealing with Covid-19 could have been more life-saving if Medicare for
All had been in place. A New York Times editorial , ‘Health Care for
Some is a Recipe for Disaster’, stresses the importance of covering
everyone. Even before Covid-19 was known to humans, Northeastern
University professor of public health, Wendy Parmet, presciently
warned that the push to exclude immigrants from access to health care
services would be both dangerous and quixotic. “None of us can be
self-sufficient in the face of a widespread epidemic,” she wrote in
2018. “That is just as true for noncitizen immigrants as
everyone.” In any pandemic, self-sufficiency can be self-deluding;
everyone’s  health, citizens, immigrants,  etc. alike is only as
good as our most vulnerable neighbor’s.

Truly a recipe for disaster, vested interests reject the science of
public health epidemiology by asserting that only an incremental
approach to health insurance reform is possible or acceptable. So,
what are we willing to settle for, should we just settle for what we
can get? Lower the expectations, turn down the public heat and keep
waiting?. Gradualism, baby-steps, extending health insurance coverage
to some, but not all, is the mantra of the day; ‘Medicare for
Some’, but not ‘Medicare for All’, is fawned over by
politicians, profiteers and advocacy groups alike while reducing
communities resources to deal with dangerous epidemics and other
health problems.

Virtually all the risky gradual reforms being touted would reinforce a
dysfunctional health insurance system with as many standards of
insurance as there are dollars to purchase them. It would further lock
us into an obsolete private insurance-based model that holds everyones
health hostage to profiteering HMOs and unaccountable big insurance
companies for years to come. For these proponents of political
expediency, the question remains, who will be left behind while we
wait? Every year many unnecessary deaths are linked to lack of health
insurance coverage. Pandemics can quickly increase these numbers.

Big Insurance and Big Pharma dominate our government and public health
takes a back seat to the need for private profit. Many government
leaders from both political parties share the same ‘profits over
public health’ ideology, even though the Covid-19 pandemic clearly
showed how our economic system failed to serve our citizens by
allowing these groups to privatize, sabotage, fragment and cripple our
health, public health and other social services. Mzny of the changes
in traditional Medicare have been contractions with higher out of
pocket costs for beneficiaries and repeated attempts at privatization
by big pharma, and big health insurance. No greater disconnect exists
between the public good and private interests than in the voracious
U.S. system of for-profit Big Insurance/Big Pharma and their inherent
tendency to invent new needs, disregard all boundaries and turn
everything into an object for sale and big profit.

MEDICARE FOR ALL 2025 MEETS EIGHT HIGH STANDARDS: Medicare for All
Act-2025  is best solution because it meets eight basic standards: 

1). Health insurance coverage should be stable and permanent
throughout life.  M4A-2025 would be a single program—permanent
throughout life.

2). Employer-sponsored insurance can create problems such as job lock,
which many conservatives and progressives believe should be
terminated. M4A-2025 would end employer-sponsored insurance, and, for
most, M4A-2025 would be better.

3). Medicaid carries the stigma of being a welfare program which
results in legislative underfunding and neglect. M4A-2025 would fully
terminate the Medicaid program and move everyone into a universal,
comprehensive and equitable program.

4). We need a program that is affordable for each individual and for
society as a whole. M4A-2025 would achieve all goals of financing
reform without significantly increasing spending.

5). Patients should have free choice of their professionals and health
care institutions. M4A-2025 allows choices within the entire health
care system.

6). The privatization of public programs such as Medicare through
Medicare Advantage and Medicaid through private managed care programs
have proven to provide poor value for the taxpayer (obscured by cherry
picking and lemon dropping) and should be eliminated. M4A-2025 would
eliminate them.

7). Fragmentation results in dysfunctional financing of health care;
M4A-2023 would bring an end to it.

8). M4A-2025 is specifically designed to greatly reduce fragmentation
and its associated costs; health insurance industry profiteering is
ended.

SUMMARY

The major reason private health insurers are more expensive than
government health programs in the U.S. is due to profiteering and
administrative costs. Those extra taxpayer funds going to private
insurers include costs such as advertising/ marketing of their plans,
costs of contracting for restrictive provider networks, administering
prior authorization requirements, complex systems of processing claims
including denial of benefits, simple administrative costs of operating
large corporate entities, and distributing generous profits to their
executives and passive high profiteering by Wall Street investors.

The Medicare for All Act-2025, now filed in Congress, would much
better fill our health care financing needs without wasting hundreds
of billions of dollars on superfluous administrative costs and end
immense profiteering by private insurers and big pharma. The USA is a
country where health insurance for medical and mental health care is a
function of socio-economic status. Everyone knows that this inhumane
system should have been corrected long ago. 

The Medicare for All Act of 2025 would provide health coverage to
every U.S. resident—including comprehensive medical, dental, vision,
mental health, and reproductive care—with no out-of-pocket costs,
copays, or deductibles. By eliminating waste and corporate
profiteering in health care, the bill would save hundreds of billions
annually that could be invested in actual health care, resulting in
better, more equitable health outcomes. Please tell your legislators
that it’s time to end inadequate and dangerous health insurance
programs. Insist on real health insurance reform essential for
individuals and families. American history is filled with examples of
fundamental, democratic change brought about by successful mass action
and public pressure against the counseling of the go slow, vested
interest crowd. No more waiting! 

Please contact [[link removed]] your
legislators asking them to fully support Medicare For All 2025
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_F. Douglas Stephenson , LCSW, is a retired psychotherapist and
former instructor of social work in the University of Florida
Department of Psychiatry. He is a member of Physicians for a National
Health Program. [[link removed]]_

* Attack on Medicare
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