Should Medicare be lowered to age 50?

As we celebrate Medicare's 50th birthday and the impact it has had on Americans health and longevity, we must look ahead into the next 50 years to determine how Medicare can continue to deliver among major demographic shifts, according to Linda Fried, MD, MPH, dean of the Mailman School of Public Health at Columbia University in New York.

Dr. Fried's recent article in the Journal of the American Society on Aging underscores the demographic, epidemiologic, scientific and technological transformations we have seen since 1965 and how they should shape the next incremental adjustments to the program.

In the last 50 years, she wrote, we have added 30 years to our life expectancy, the Baby Boomers are beginning to age out of the workforce, chronic diseases and geriatric conditions now drive seniors' health status, and we now have more knowledge of the science behind preventive medicine and the tools to help implement it.

To adjust the Medicare program for the next 50 years, Dr. Fried made the following four recommendations.

1. Extend Medicare to cover all adults ages 50 and older. This coverage should include vaccinations, screenings and preventive services. Even though people are living longer, Dr. Fried believes we should push the Medicare age down to better prevent diseases and conditions. "There is strong evidence now that those who turn age 70 in good health are positioned for longer and healthier future lives — at no additional cost to Medicare."

2. Eliminate silos of prevention by integrating systems between Medicare, Medicaid, Public Health and the Administration on Aging. Examples of this integration include chronic disease self-management workshops, physical activity programs aimed at seniors and mechanisms to engage older at-risk adults in healthcare through home-based screenings and other programs.

3. Emphasize health professional training in geriatric care. Medicare should help expand the support for geriatrics education of graduate medical and public health professionals, according to Dr. Fried.

4. Share data collection and referrals. Dr. Fried also recommends creating a comprehensive database for patients, family members, community health workers, healthcare providers and health systems that would include information on the needs, services, demonstrations, outcomes and programs within Medicare, the Centers for Disease Control and Prevention, the AOA and Medicaid.

 

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