Celebrating the 50th anniversary of Medicare and Medicaid

July 31, 2015 § Leave a comment

By Robert J. Master, MD, Chief Executive Officer of Commonwealth Care Alliance

Medicare and Medicaid both turn 50 years old this week. The anniversary is particularly significant for those of us who remember the time prior to Medicare and Medicaid when so many elders went without needed care and where most younger individuals with involved disabilities were, for the most part,50 yrs nameless, faceless, and dependent on segregated institutions or a myriad of county, state, and charity programs. The fact is that prior to Medicare and Medicaid, care was not an entitlement but a byproduct of whatever public generosity or charitable instincts that existed. As a result, services were highly variable with respect to availability, quality, geography, and the condition or disability being treated.

With the launch of Medicare and Medicaid and the continuous evolving social contract between these public programs and the American people, all that has changed.

Most recently, and most significantly, the Affordable Care Act has taken this evolving social contract to entirely new levels through its commitment to make Medicare and Medicaid the engines of equity and fundamental care delivery transformation for the most marginalized and poorly cared for public payer beneficiaries – those who are dually eligible for Medicare and Medicaid with the greatest unmet needs, poorest care, and highest cost.

So today with 55 million Medicare beneficiaries, 77 million Medicaid beneficiaries, and over one trillion dollars in annual Medicare and Medicaid spend, these public programs would be unrecognizable to those who founded these programs 50 years ago. But what has remained a constant over these past 50 years are the problems that Medicare and Medicaid are attempting to solve: bringing health care to those who do not have it and promoting lives of independence, autonomy, and self-determination for the most vulnerable in our society.

As we celebrate the 50th anniversary of Medicare and Medicaid, let’s take pride in how far we have come, while also reflecting on how far we still have to go to realize the full promise of these landmark public programs. For those of us working at Commonwealth Care Alliance, it is a true privilege to come to work every day in service of realizing that promise.


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