Medicare is Turning 50

As of July, Medicare turns 50, In the journal Generations, “A Prescription for the Next Fifty Years of Medicare." Dean of Columbia University’s Mailman School of Public Health writes an article describing a prescription for the future of Medicare.

States that Medicare must evolve to improve senior health in the future. When Medicare bill was passed 50 years ago: millions of older adults in the US benefited. 

  • <90% of seniors have health insurance
  • As a result they are living longer, and healthier than in the past
  • This is worrisome for some people because the number of elderly people in the US is projected to double by 2050
  • Medicare must evolve to reflect evolving science and disease prevention in this population

The dean of Mailman was among many contributors and experts in aging, healthcare, and retirement policy, who participated in a public event at the Kaiser Family Foundation in Washington, D.C. Event was meant to discuss perspectives on expectations for the future of Medicare

Compared to the past:

  • We now know that prevention matters for disease
  • Prevention works at every age, especially in the elderly population
  • Prevention and health promotion would be a ‘new’ responsibility of Medicare moving forward
  • Changes that are reflective of scientific finding about disease control and condition prevention would mean:
    •  People have better health
  • Lower costs
  • Healthier seniors = fewer costly medical inventions


Clinical and population-based preventive strategies save 90% more lives and reduces costs by 30% in 10 years. In 25 years, preventative measure save 140% more lives and lower costs by 62%. Strong commitment to disease prevention is needed by Medicare executives to meet needs of aging population. According to article, there are 4 strategies for incorporating public health goals into Medicare:

1.      Start at Age 50. 

  • Medicare should cover adults from age 50 with the full set of vaccinations, screenings, and preventive services, oral healthcare, vision and hearing examinations, glasses, and hearing aids.
  • Medicare must also support needs like adequate incomes and affordable and safe housing.
  • This is to optimize people’s health to their mid-60s and beyond

2.      Prescribe Prevention. 

  • Medicare providers should prescribe community-based programs that support physical and cognitive health
    • EX. programs that support exercise in older adults

3.      Create a Cadre of Geriatric Health Professionals. 

  • Currently Medicare helps fund graduate-level medical education for hospital residents.
  • This should be expanded to both geriatricians and public health training in order to create a group of health professionals who are experts in geriatric health needs
  • Would help fill a gap for health professionals and extend care for seniors

4.      Coordinate Efforts. 

  • Medicare must work with CDC to track needs of seniors
  • Need info database analyzing effectiveness of specific prevention programs accessible to local and national program partners, as well as seniors themselves
  • The more people and providers know about the programs in their area, the more easily older adults can get care and support