Medicare, Medicaid have improved lives
In the months after World War II ended in 1945, as troops were returning home to start families, go to college under the G.I. Bill or resume work on assembly lines or in other enterprises, President Harry Truman attempted to establish a benefit that would have made their lives, and those of other Americans, more secure – a national health insurance plan.
He was following the example set by Britain’s newly elected Labor government, which succeeded in establishing the National Health Service, which offers guaranteed health care to British citizens and still enjoys broad popularity. Truman didn’t experience similar success here, however, but he did at least live to see the day when senior citizens would have guaranteed access to basic health care.
On July 30, 1965, 50 years ago this month, President Lyndon Johnson traveled to Independence, Mo., to sign the law creating Medicare and Medicaid. The first Medicare card was issued to Truman, who at that point was 81 years old.
With a half-century having passed and the number of Americans who remember what life was like before Medicare shrinking daily, consider this sobering fact: Before Medicare, an estimated 56 percent of Americans had no health insurance at all. Medical bills could and would drain the bank accounts of the elderly, and 1 in 3 lived in poverty. Medicare played a pivotal role in changing this equation. Now, 46 million Americans benefit from it, and only 2 percent of American senior citizens do not have any health care coverage. It has lengthened lifespans by as much as five years, according to some estimates. Republican presidents expanded its reach, with Richard Nixon signing legislation allowing Medicare to cover people under the age of 65 with long-term disabilities, and George W. Bush adding the prescription-drug benefit. Even the most rabid Tea Partiers are loathe to slice away at, or eliminate, Medicare.
The concurrent creation of Medicaid 50 years ago was meant to meet the health care needs of impoverished Americans who did not have health care coverage through their place of employment. Operated jointly between the states and the federal government, it now covers more than 60 million Americans every month. It takes a sizable portion of some state budgets, but because it is a partnership between the states and the federal government, states can set their own standards on who gets covered. In many instances, that means only the poorest of the poor are eligible. The Medicaid expansion under the Affordable Care Act would have allowed additional people to sign up for coverage, but 21 states have not accepted the federal government’s funding for Medicaid expansion, with those states mostly being run by Republicans, and most of their opposition rooted in little more than hostility to President Obama. This has left too many Americans out in the cold, denied coverage that could improve their lives and health and help lift them out of poverty.
Fifty years later, Medicare and Medicaid are woven deep into the country’s social fabric. There may be revisions to them, but neither is likely to be abolished entirely.
Dwight Eisenhower famously remarked at one point during his presidency that any attempt to dismantle or eliminate so-called entitlements like Social Security and unemployment insurance would be foolhardy, and “you would not hear that party again in our political history.” If Eisenhower were around today, he would almost certainly add Medicare and Medicaid to that list.