Devil in the Details: Disabilities and M4A

By Mark S. Alper

Medicare for All (M4A) will mean the difference between life and death for thousands of people. That is the highest stake in the campaign to win M4A. As a recipient of Medicare because I can no longer work, I write from frightening and painful experience.

But first, some background. Because Medicare as it now stands is often associated in the public mind with Social Security, there is an impression that it has a long and established history in the United States. In truth, Medicare has been in existence as a federal program only since 1965. It is a product of Lyndon B. Johnson’s “Great Society” vision, which was to be totally subordinated to the escalation of the Vietnam War within a few years. And it was bitterly and viciously opposed by the medical establishment and still bears the scars of that fight in some of its deficiencies.

James Thacher

Medicare was originally offered only to people over age 65 who qualified and who selected it. It consisted of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). In 1972, the program was expanded to include persons with disabilities and those with End Stage Renal Disease (ESRD) who required a kidney transplant.

The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) created the optional “Medicare D” plan to cover prescription drugs under the program for the first time. This eased, but did not eliminate, the heartbreaking problem of seniors on fixed incomes who were often forced to choose between spending their money on food or necessary prescribed medications. Medicare D coverage is provided by private insurance companies, and a cursory check of Medicare D premiums reveals an average premium of between $30 and $40 per month for coverage with an average annual deductible of $400.

Medicare premiums have also increased over the years. In 1986, the standard Medicare premium was $31.30 per month. Last year, it was $104.90 per month, and there was an additional increase this year to $134 per month.

Although I was born with a developmental mobility impairment, I was able to be gainfully employed until I was 52 years old and diagnosed with a degenerative back condition that further limited my already impaired mobility. One would think that getting Social Security Disability with a record of disability that dated back to my birth would be relatively easy. As the late George Carlin quipped during one of his routines, “Au contraire.” I had to enlist the assistance of Senator Bill Nelson (D-FL), and the senator and his staff were great advocates.

But, I could not receive Social Security disability benefits until six months after the 2012 onset of the disabling condition that prevented me from working, and I would not receive Medicare benefits until I had been receiving Social Security Disability payments for two years. This Catch-22, stipulated in congressional regulations, not the legislation, could bankrupt or kill a person. Fortunately, I was able to continue with the medical insurance I had been receiving from my employer for the two-year period, an option not available to most disabled people.

Medicare For All is a fight that needs to be joined. But it presents special challenges for disabled people, and a universal program will require remedial legislation on the congressional level with attention to the regulations that provide the foundations of the program.

Mark S. Alper has been a member of DSA and one of its predecessor organizations since 1977.

Talking About Socialism: Create Your Own Rap

April 26, 2018

8pm ET/7pm CT/6pm MT/5pm PST

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Join Steve Max, a founder of the legendary community organizing school, the Midwest Academy, to practice talking about socialism in plain language. Create your own short rap. Use your personal experience and story to explain democratic socialism. Prepare for those conversations about socialism that happen when you table or canvass. This workshop is for those who have already had an introduction to democratic socialism, whether from DSA's webinar or from other sources. Questions? Contact Theresa Alt <> 607-280-7649.

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New Member Call, May 27

May 27, 2018

May 27, 2018

9pm ET/8 CT/7 MT/6 PT

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You've joined DSA - Great! Now register for this New Member Orientation call and find out more about our politics and our vision. And, most importantly, how you can become involved.

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