Forty-five years ago this week, the first Medicare checks were delivered, and the United States made a great leap forward.

Before Medicare was implemented—as a social-welfare program designed not just to deliver care but to poverty—one in five Americans lived below the poverty line.

After the program was implemented, and after related “War on Poverty” initiatives were developed, that number was cut almost in half. Poverty among seniors dropped by two thirds.

Why? Before Medicare, millions of elderly Americans could not afford to buy healthcare. They did not have access even to basic care. When they needed treatment for the inevitable ailments that are associated with aging, they and their families spent down what meager savings that retained and a stumble into poverty soon followed.

Medicare broke the vicious cycle for the elderly, as Medicaid did for disabled Americans and their families.

For more than four decades, Medicare has kept millions of our senior citizens from living out their days in poverty,” explains one of the program’s steadiest champions, Congresswoman Tammy Baldwin, D-Wisconsin.

Medicare continues to serve the purpose for which it was created.

Indeed, so much good continues to come of this program—and of Medicaid—that it is difficult to imagine why anyone who seek to dismantle the program. But that is precisely what House Budget Committee chairman Paul Ryan, R-Janesville, is trying to do.

“On this anniversary that they should be celebrating, Republicans in Congress are working to privatize Medicare, cut benefits, and force seniors to buy insurance on their own,” Baldwin said Friday.According to the non-partisan Congressional Budget Office, under the Republican plan, most elderly people will pay more for medical care and get less than they do under Medicare. Not one dollar of that increase in beneficiary costs goes to reducing the deficit—it all goes to cover the higher costs of private plans that the Republicans would force seniors to join.”

Ryan has tried to obscure that reality. But his constituents are on to him. The congressman just received petitions signed by 60,000 citizens asking him to back off his plan to restructure Medicare as a voucher program that word turn federal money away from providing patient care and toward the accounts of private for-profit insurance companies.

Ryan will not listen to the people. The Budget Committee chair’s campaigns have been generously funded by those insurance companies. And he is not about the bite the hand that feeds his campaign kitty.

The congressman would rather gut Medicare and Medicaid than say no to the CEOs whose money aids his electioneering and that of his political allies.

The crude calculus in which Ryan is engaging is at odds with what is best for the nation, and with sound economics.

Undermining Medicare and Medicaid will not balance any budget or reduce any deficit. Ryan’s own plan does not propose to bring the federal budget into balance for more than a quarter-century.

All that Ryan’s plan will do is cause a rise in poverty and an ensuing decline in productivity—as families are forced to try and cover the catastrophic costs for their loved ones and for society that with result as Medicare and Medicaid collapse into dysfunction.

The fundamental reality of Medicare after forty-five years is that it has worked. A good program at its beginning has been made better. That does not mean that we should dismiss smart proposals for tinkers and twists, or supportive reforms and innovations.

Medicare has been harmed by the so-called “reforms” implemented during the Bush-Cheney era, particularly a prescription drug scheme that was designed to enrich pharmaceutical companies rather than to serve seniors or control costs. It has been battered by private-sector profiteering and the general inefficiency of the for-profit health care system.

The right reform now is not the Ryan plan. It is the proposal by Representatives Henry A. Waxman, Sander Levin, Pete Stark, John D. Dingell, George Miller and Rob Andrews that would save the government billions by reducing Medicare Part D drug costs for taxpayers. This legislation, the Medicare Drug Savings Act of 2011 (H.R. 2190), would save more than $100 billion.

How? By eliminating the sweetheart deal for brand-name drug manufacturers that was developed by the Bush-Cheney administration and its congressional allies and that allows these multinational corporations to charge Medicare higher prices for millions of low-income enrollees in the Medicare Part D program.

“Instead of making devastating cuts to programs that help low-income and middle-income Americans, as Republicans keep putting on the table, we should do what every other industrialized country does and ask the pharmaceutical industry, one of the wealthiest in the world, to chip in,” says California Congressman Stark, the ranking member of the House Ways and Means Committee’s Subcommittee on Health. “What’s more, the savings from this legislation could pay for a multi-year ‘doc fix’—something we tried to do in a comprehensive way but have had to address yearly so Medicare’s payments to doctors aren’t slashed.”

Medicare can be reformed the right way.

It is not broken. And it is not broke.

The only serious threat to Medicare’s future is Paul Ryan. If the House Budget Committee gets his way, the federal government will rob the elderly in order to pay off Ryan’s campaign contributors.

Medicare has a great history. And if Ryan’s plan is rejected, it will have a great future.

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