A Brief History
On July 30, 1965, President Lyndon B. Johnson signed the Social Security Act of 1965 into law, establishing the Medicare and Medicaid programs the American people have come to take for granted.
Medicare was and is a program to provide health coverage to people over 65 years old and older, many of which were retired and no longer getting health insurance through their employer. Medicaid was and is a program to provide health insurance to those people too poor to afford it. The final bill passed the House of Representatives by a 307 to 116 vote, and passed the Senate by a vote of 70 to 24.
Largely a program of the Democratic Party, various proposals of this sort had been championed as far back as Teddy Roosevelt, and came up again under President Franklin Roosevelt and President Truman. The 1964 landslide election of Lyndon Johnson to the White House carried over into a large majority of Democrats in Congress as well. The inevitability of such a bill passing caused a redirection of effort by those opposed to such programs into trying to mold the bill into compromise form. The American Medical Association among others attempted to get their agenda included in the bill.
These programs have become such a huge part of the American medical scene that in 2010 over 47% of hospital costs in the US were paid by Medicare. About 48 million Americans (8 million of which are disabled rather than elderly) are on Medicare. Not a total “giveaway,” Medicare only pays about 48% of the health care costs of those enrolled. (Many enrolled people have supplemental health insurance to help pay the balance.)
Medicaid is a Federal program that is run via each State, and is currently available to those who make up to 133% of the Federal Poverty Level of income. Eligibility for Medicaid is somewhat complicated and varies by state, but is mainly for poor children, parents of poor children, and poor disabled people. The number of citizens on Medicaid fluctuates throughout the year, but at any given time over 50 million Americans are enrolled in the program. About 9 million Americans are enrolled in both programs at the same time. A difference between Medicare and Medicaid is that Medicaid provides dental care while Medicare does not.
The budget for Medicare and Medicaid is a staggering $831 billion, by far the most expensive Federal program after Social Security at $845 billion. (Defense is $596 billion, numbers are for 2014.) Whether or not the programs are “fair” is debatable, and are the subject of heated political maneuvering. Do they do enough, not enough, or too much? Most people enrolled in the programs are (not surprisingly) for them and would like them expanded, while those not enrolled (ie., paying the taxes for them) are often not so enthusiastic.
Question for students (and subscribers): So, do you think this is an anniversary to celebrate or a day to mourn? Let us know your opinion of these massive programs in the comments section below this article.
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For more information, please see…
United States. Public law 89-97, 89th Congress, H.R. 6675, July 30, 1965: an act to provide a hospital insurance program for the aged under the Social security act, … the Old-age, survivors and disability… University of Michigan Library, 1965.