This week is important in the history of American medicine. Thursday July 30, 2015, marks 50 years since President Lyndon B. Johnson signed the law establishing the Medicare program, making this its “golden anniversary.” As you know, Medicare is a social insurance program that helps to provide health and financial security for people ages 65 and older and younger people with permanent disabilities.

Prior to 1965, when I was a boy, roughly half of all seniors lacked medical insurance and now virtually all seniors have health insurance under Medicare. I remember very well my Uncle John, whom my dad assisted and who actually lived in a small house (perhaps, “shack” is a better description) behind our house. He certainly did not have insurance coverage, a primary care physician or a medical home, which are all things Medicare could provide him today.

Uncle John never lived to see Medicare. But today, Medicare provides health insurance coverage to more than 55 million people: 46.3 million people ages 65 and older and 9 million people with permanent disabilities under age 65. It pays for many vital health care services, including hospitalizations, physician visits and prescription drugs, along with post-acute care, skilled-nursing facilities, home health care, hospice and preventive services.

Medicare is expensive, as it comprises about 14 percent of the federal budget and just over one-fifth of total personal health expenditures. Each of us is contributing payroll taxes to Medicare as we look toward the day we will use it.  Therefore, we all should have a general familiarity with it and its purpose and be concerned with its effectiveness. We have had 50 years to study it, and I would have to say it has been a success.

Of course, it is not perfect. We often hear that it will begin running a deficit at some point in the future. Texas Tech Physicians knows from experience as a provider organization that its payments are not always adequate to cover expenses, and that out-of-pocket expenses can create problems for beneficiaries. However, despite these problems, Medicare has about a 92 percent satisfaction rate among those who are covered by it, which indicates it has fulfilled its promise for the most part.

Last week in this column, I wrote about insurance. Medicare is successful in spreading the risk for medical expenses broadly over a large population. It provides the benefit of safety net coverage for a part of the population that often needs help. I do think that perhaps it’s time to find a better way to better address the needs of the sickest 20 percent of Medicare beneficiaries who account for 80 percent of the cost of the program. But, that is a complicated subject and meant for another column.

In conclusion, I would not want to see half of today’s seniors in the same shape as my Uncle John was so many years ago, so I congratulate the program on its success. Happy birthday to Medicare!