July 30 is a
big day in American insurance history; the day President Lyndon B. Johnson signed
the Medicare health insurance program for elderly Americans, into law. At that point in our history it was the
closest the U.S had come to National Health Insurance. It wasn’t easy getting there.
For years, groups,
parties and presidents had been advocating for some form of coverage for health
care in the U.S without success. As
early as 1915, Progressive groups were trying to put together national health
insurance programs. The draft
legislation was initially supported by the American Medical Association and
opposed by organized labor who believed it would undercut the benefits they
were negotiating for union members and by the insurance industry because it
contained a burial provision which compete directly with their products. It died completely during the First World War
when opponents were successful in associating it with the German national
Harry Truman proposed a national health insurance plan to be run by the federal government in 1945.
It was designed as a plan that would be optional but open to all Americans and would
cover the cost of medical expenses and give provide cash balance to replace
wages lost due to illness or injury. The
proposal predated the McCarthy era by a few years, but concerns about Communism
were widespread at the time and opponents characterized the plan as
“socialized medicine” and called Truman White House staffers
“followers of the Moscow party line”.
As the Korean War heated up and fears of communism grew, Truman’s plans
died in congressional committee.
Even as Truman’s
large scale national health insurance plan was failing, an alternate plan was
being born out of the Social Security Administration. Social Security had been designed as a
program to support the elderly, but rising health care cost were consuming the
benefits – and this was the late 1940’s.
Representatives from social security argued that a system of health
insurance for the elderly was necessary because workers were no longer covered
by employer based plans. The idea was
supported by a number of studies that identified and quantified the problem and
by the late 50’s a package designed for social security beneficiaries was
making its way in Congress. It was also meeting
bill to get close to consideration was the Forand Bill which would have created
a Medicare like program. Those in opposition
included the America Medical Association, the National Chamber of Commerce, the
National Association of Manufacturers, the Health Insurance Association of
America, the Pharmaceutical Manufacturers’ Association, and the American Farm
Bureau Federation and plenty more.
Republicans opposed it generally and evidently Eisenhower was prepared
to veto it if it passed. The Forand Bill
died but made enough headway to create some serious further efforts. The Kerr-Mills Bill that evolved out of the
concerns addressed by Forand was a program
of medical vendor payments to be provided through state-run public assistance
programs for the “medically
indigent.” was passed in 1960.
was the first crack in the wall, it was not what the backers of a national health
insurance program for seniors wanted.
John Kennedy made “Medicare” a part of his campaign for the
presidency. The battle over Medicare
continued for four years after Kennedy’s election with the AMA and other groups
fighting for and against. The final
passage of Medicare came in a rush early in the Johnson administration. Johnson’s huge plurality in the 1964
elections had pulled along a democratic majority and the first national health
insurance program in the United States was passed in early July 1965. The Medicare
program that provides hospital and medical insurance for Americans age 65 or
older, was signed into law as an amendment to the Social Security Act of 1935.
Some 19 million people enrolled in Medicare when it went into effect in 1966. In 2011 Washington insurance included 983,167
Medicare enrollees and the U. S. Total was 47,672,971enrollees.
bill-signing ceremony, took place July 30, 1965 at the Truman Library in
Independence, Missouri. At the
ceremony, former President Harry S. Truman enrolled as Medicare’s first
beneficiary and received the first Medicare card. Johnson made this effort to
recognize Truman who had long been an advocate of national health insurance.