Sylvia Mathews Burwell

Before Medicare and Medicaid were created 50 years ago, our nation was a very different place for many.

Seniors had to rely on strained savings or their families’ goodwill to get by. Those who had neither were left to a life of poverty and insecurity.

Families, even children, were at the mercy of charity and chance when it came to their health.

And those with disabilities struggled to get any care at all.

Medicare and Medicaid put an end to this injustice and transformed health care in our country. No other program has changed the lives of so many of our families, friends, and neighbors. No other program has given so many hope.

Today, about 1 in every 3 Americans has health coverage through Medicare and Medicaid. About 55 million seniors and those with disabilities depend on Medicare to get the preventive services that protect them from getting sick. It helps them stay mobile and independent. It gets them the treatments they need when they need them.

And more than 70 million Americans children, pregnant women, people with disabilities, and hardworking low-income folks — many who work full time — have that same sense of security thanks to Medicaid.

These programs are a lifeline, and they are needed now more than ever.

For 50 years, Medicare and Medicaid have shown how effective policy can dramatically improve the lives of millions of Americans. But they have served another vital role in our health care system: a catalyst for change.

Medicare and Medicaid are helping to lead the way, with help from the Affordable Care Act, to a system that delivers better care, spends our health care dollars more wisely, and puts educated and empowered consumers at the center of their care to keep them healthy.

By leveraging Medicare and Medicaid’s market influence, and using new tools given to us by the ACA, we are working to pay providers for quality of care rather than quantity of services, unlock health care data, and find better ways to provide care.

In January, we announced historic goals to move Medicare payments to focus on how well—rather than how much—providers care for patients.  And just a few weeks ago, we announced a new payment model to encourage better coordination among providers and greater focus on patient outcomes.

Medicaid is driving innovation as well. Working closely with states, we’re opening new horizons of coordinated, quality care for people who use this program. For example, Missouri’s Health Home programs and Minnesota’s Hennepin Health are both lowering the need for costly hospitalizations and raising the health outcomes of people with health conditions like diabetes and heart disease.

For half a century, these programs have been at the center of our nation’s healthcare. Today, they’re also at the forefront.

Fifty years ago, we made a promise that, in a country where so many have so much, we would not let insecurity and indignity become the destiny of the most vulnerable among us. Now, more than ever, it is our obligation to honor that commitment by strengthening and improving the quality and value of care that all Americans receive.

Sylvia Mathews Burwell is the U.S. Secretary of Health and Human Services.