It is Sunday, October 26 and there are just 6 days until I officially join the Medicare ranks.  Today we remember the birthdays of Desiderius Erasmus, Mahalia Jackson and Pat Sajack.  On this day in 1863 the worldwide Red Cross was organized in Geneva, in 1941 US savings bonds went on sale and in 1970 the “Doonesbury” comic strip debuted in 28 papers.  In Austria, it is National Day, in Benin and Rwanda it is Armed Forces Day and in New Zealand tomorrow will be Labour Day.

I would like to take some time to address the momentous occasion I mentioned earlier.  On November 1, I will officially be on Medicare.  So, what is Medicare?  In 1965, under the leadership of President Johnson, Congress created Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history. Before Medicare's creation, approximately 65% of those over 65 had health insurance, with coverage often unavailable or unaffordable to the rest, because older adults paid more than three times as much for health insurance as younger people. Medicare spurred the racial integration of thousands of waiting rooms, hospital floors, and physician practices by making payments to health care providers conditional on desegregation.

 Medicare has been in operation for well over 45 years and, during that time, has undergone several changes. Since 1965, the provisions of Medicare have expanded to include benefits for speech, physical, and chiropractic therapy in 1972. Medicare added the option of payments to health maintenance organizations in the 1980s. Over the years, Congress expanded Medicare eligibility to younger people who have permanent disabilities and receive Social Security Disability Insurance payments and those who have end-stage renal disease. The association with HMOs begun in the 1980s was formalized under President Clinton in 1997. In 2003, under President George W. Bush, a Medicare program for covering almost all drugs was passed (and went into effect in 2006).

Since the creation of Medicare, science and medicine have advanced, and life expectancy has increased as well. The fact that people are living longer necessitates more services for later stages in life. Thus in 1982, the government added hospice benefits to aid the elderly on a temporary basis. Two years later in 1984, hospice became a permanent benefit.

Part A is largely funded by revenue from a 2.9 percent payroll tax levied on employers and workers (each pay 1.45 percent).  Until December 31, 1993, the law provided a maximum amount of compensation on which the Medicare tax could be imposed each year, in the same way that the Social Security tax works in the United States.  Beginning in 2013, the 2.9% Part A tax continues to apply to the first $200,000 of income for individuals or $250,000 for couples filing jointly and rose to 3.8% on income in excess of those amounts to help partially fund the subsidies included in PPACA.

In 2011, Medicare spending accounted for about 15 percent of the federal budget, and this share is projected to increase to over 17 percent by 2020.  The retirement of the Baby Boom generation—which by 2030 is projected to increase enrollment from 48 million to more than 80 million as the number of workers per enrollee declines from 3.7 to 2.4—and rising overall health care costs pose substantial financial challenges to the program. Medicare spending is projected to increase to just over $1 trillion by 2022. Baby-boomers health is also an important factor: twenty percent have five or more chronic conditions which will further add to the future cost of health care.

So there you have the short version of what Medicare is all about.  I hope you found it informative and will still remember it when you turn 65.

And now for something completely different.  This past week the lovely Elaine and I had a chance to introduce a young man to our little slice of the US.  He is from Iowa and had never flown before.  To add to the excitement(?) of flying for the first time, his first flight was on a rather small plane out of Burlington, Iowa.  He was traveling with our good friend Paul, who has made this trip a number of times and to him it was just another trip.  To someone who had never broken the bonds of earth and been hurtled into the sky in a machine that defied gravity, this was an amazing journey.  Brett was amazed by the trip and seeing the New York skyline as they came in to land at Newark airport.

The next day, we all traveled into New York City.  We went by way of the Lincoln Tunnel which he found very interesting.  We showed him the line in the tunnel that let us know when we were in New York.  We drove through the city and made our way to the Freedom Tower.  After parking the car we walked to the tower itself and went to the 911 Museum.  Brett was not the only one overcome by this exhibit.  It was very emotional to see the pictures and videos.  It was incredible to see the beams of steel bent into a horseshoe shape and to realize the destruction that took place that day.  It is one thing to have watched the news and experienced the drama as it unfolded – we could see the smoke from our front walk.  It was something entirely different to be in this place and feel the devastation.

From there, we went to the Empire State Building.  We went to the 86^th floor observatory and marveled at the amazing view.  It was fun to watch and listen to someone who had never experienced this type of thing.  He was amazed at the sheer scope of the view from all sides and the perspective it gave to seeing New York.  Some of the other highlights of his trip included seeing Liberty State Park, Radio City Music Hall, Rockefeller Center and going to see “Wicked” on Broadway.

We topped the trip off by taking him down the shore to Seaside Heights.  He had never seen an ocean before and we were able to go down on the beach and walk for a bit.  While most of the stands on the boardwalk were closed, he was able to get a sense of what it was like.  Fortunately, one stand was open and he was able to have a slice of pizza, standing on the boardwalk, watching the ocean.  I am sure it is a trip he will not forget soon.

This week our fact tells us that Colgate faced big obstacles marketing toothpaste in Spanish speaking countries.  Colgate translates into the command “Go hang yourself.”  Imagine the advertising slogan, in Spanish, “Teeth not clean and white?  Try Colgate.”