When President Lyndon B. Johnson prepared to sign the Medicare and Medicaid programs into law on July 30, 1965, he wanted to honor the man who first proposed a national health insurance program in 1945.
Johnson gathered 13 US senators, 19 US representatives, Vice President Hubert Humphrey, and various cabinet secretaries and advisors and flew them all to Independence, Missouri, for a signing ceremony at the Harry S. Truman Presidential Library. It was Truman who "planted the seeds of compassion and duty" that led to the creation of the health insurance plan for the aged, Johnson told the packed auditorium.
Today, Medicare and Medicaid are the foundation of an enhanced health care security network that has substantially improved the well-being and longevity of the American people. They are the most salient, enduring, and popular pieces of Johnson's ambition to create a Great Society that used the country's material success "to enrich and elevate our national life, and to advance the quality of our American civilization."
Some 55 million Americans receive health insurance through Medicare. Most of them are over age 65, but many are younger people with disabilities. Medicare covers physician services, hospital stays, prescription drugs, medical equipment, and disease prevention.
Medicaid, known in California as Medi-Cal, is a joint federal-state program to provide health insurance to low-income people. Eighty million Americans were enrolled in state Medicaid plans at some point in 2014. Medicaid has been the main vehicle for expansion of insurance coverage through the Affordable Care Act.
A few months after the bill signing, Truman wrote to Johnson that the ceremony "was a profound personal experience for me. . . . The high point in my post-White House days." When the program got going the next year, Johnson gave Medicare cards No. 1 and No. 2 to Harry and Bess Truman.
In a television interview a few months later, Truman said, "Time will prove the Medicare program for our senior citizens as a great step forward, in meeting one of the most critical needs that confront most of our elder citizens. For many it is a step from charity, to security with dignity."
To celebrate 50 years of Medicare and Medicaid, various organizations, institutions, and advocacy groups are holding events or encouraging reflections on what the programs have accomplished and how they might achieve their goals more fully. CHCF has compiled the following list of resources for the benefit of California consumers, providers, health plans, policymakers, advocates, and journalists.
In the video below, CHCF's President and CEO Sandra Hernández, MD, provided keynote remarks at the Centers for Medicare & Medicaid Services Region IX Office's event to commemorate the 50th anniversary on July 30, 2015.
- The Kaiser Family Foundation held a forum on May 6, 2015, to discuss "Medicare and Medicaid at 50 and Beyond." The foundation's website includes a video, a timeline showing "The Story of Medicare," a handful of articles, and a special report on Medicaid at 50. A video of the May 6 panel discussion on the future of Medicaid is also posted on the site. Kaiser has been studying Medicaid closely for 25 years and has placed many resources on its website.
- The University of Southern California Leonard D. Schaeffer Center for Health Policy and Economics held a forum at The Brookings Institution in Washington on June 5, 2015, looking ahead at Medicare in 2030. The papers prepared by leading health policy luminaries, such as Alice Rivlin, Paul Ginsburg, and Henry Aaron, are available on the Brookings website.
- On April 15, 2015, the LBJ Presidential Library, in conjunction with the Aspen Institute and the Robert Wood Johnson Foundation, hosted a 50th Anniversary Medicare and Medicaid Summit in Washington, DC. Speakers included Gail Wilensky, administrator of the Centers for Medicare & Medicaid Services in the George H. W. Bush administration; Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation; Kathleen Sebelius, President Obama's first secretary of Health and Human Services; and Lynda Johnson Robb, President Johnson's elder daughter.
- Yale Law School held a conference on November 6-7, 2014, concentrating on the law of Medicare and Medicaid and how it has evolved. A news story about the presentations is on the law school website.
- The Centers for Medicare & Medicaid Services, which administers the giant programs, has its own countdown website with resources. The agency is inviting the public to share stories of how the programs have made a difference in their lives.
- The National Academy of Social Insurance is sponsoring a yearlong series of events covering every aspect of the programs. Lee Goldberg, vice president of policy, said NASI wanted to show the tremendous impact Medicare and Medicaid have had on the "health and welfare of seniors, and younger people, just in terms of life expectancy and health outcomes."
- NASI also wants to highlight some underappreciated historical aspects of the programs. "Medicare was really crucial to desegregation of Southern hospitals. It is one of the elements of social justice in this country," Goldberg said. Medicare has improved not just the lives of beneficiaries, but of their children, who "don't have to worry about saving up for their medical care anymore. You don't have to worry about them moving in with you, or coming to you for money for an operation. They have paid into a system during their working years that guarantees it."
- NASI invited its resident writer, Bob Rosenblatt, retired from the Los Angeles Times, to compose a week-by-week news summary of the legislative maneuvers that led to the passage of the law establishing Medicare and Medicaid in 1965. The series, written as live news stories, conveys a sense of the drama behind the scenes: the struggle between those who viewed Medicare as social insurance versus those who considered it a welfare benefit, the role of the American Medical Association, and the pressure of the labor unions. "Last week's was particularly good," Goldberg said. "The bill has passed the House, looked like smooth sailing, but ran into some trouble in the Senate Finance Committee. It is really prescient. The comparisons are very close to the present day."