Medicare, just over 50 years old, is a great success. Older Americans on Medicare are spending less time in the hospital and living longer. The cost of a typical hospital stay has actually come down over the past 15 years, according to a study in the Journal of the American Medical Association.

Researchers looked at the experience of 60 million older Americans covered by traditional Medicare between 1999 and 2013, and found that mortality rates dropped steadily during that time, and people were much less likely to end up in the hospital. If the rates had stayed the same in 2013 as they had been in 1999, there would have been almost 3.5 million more hospitalizations in 2013.

The average cost of a hospital stay has dropped too, from $3,290 to $2,801 in inflation-adjusted dollars over the 15-year period for patients in the traditional Medicare program. 
The improvement is put down to measures designed to boost patients’ health, from prevention programs to advances in medical care, and also to shifting from hospitals to less expensive outpatient clinics.

Costs really are being contained, but more and more people are turning 65 and becoming eligible for the service. That growth continues to drive up the overall cost of the program, even as that average cost per illness or hospitalization comes down. And as older Americans live longer lives, they use Medicare for more years than previous generations did. (based on a NPR article in 2015).

So why not gradually extend Medicare downward in age until everyone is included in an efficient health system? This (a single-payer system) was proposed during the debate on Obamacare, but it was fiercely opposed by insurance companies and doctors, and you can understand why. Medicare does remunerate doctors at a very low rate, and many doctors are refusing to accept Medicare patients. I have some sympathy with them, but nonetheless recall the British National Health Service before the Neo-Liberals started to wreck it. Medicare is to similar the old NHS – inclusive of all income groups, efficient, and doing good while it is doing it.