By Bob McCan
Fifty years ago, late in the afternoon of July 29, 1965, the phone rang in my office at the U.S. Office of Economic Opportunity. Blue Carstenson, Director of the National Council of Senior Citizens, was on the line. Blue had been a college student at Marshall, Missouri where I was his minister and mentor. He called to share the news with me that just a few minutes earlier the Medicare Bill had passed both the House and Senate, had been reconciled, and was ready to send to the White House for signing. Blue invited me to join the victory celebration at the Hilton Hotel at 16th and K Streets. I finished my busy day as Director of Older Persons’ Programs and joined the celebration.
That evening was an opportunity to rejoice and remember the long journey. Members of Congress reflected on their own stories and heaped praise on others who had taken the political heat. None spoke with greater joy than Vice President Hubert Humphrey, and Blue was praised for his single-minded pursuit of the prize.
While in graduate school Blue volunteered at the Stevenson headquarters in Chicago during the 1956 presidential campaign. There he met Congressman Jack Kennedy. They worked together and became friends. Blue traveled with Kennedy during the 1960 election campaign. One day Blue got a call from the White House. Kennedy wanted him to lead the National Council of Senior Citizens (NCSC) and build it into a strong lobby for Medicare. Blue said he had two goals: build NCSC to a million members if necessary and keep lobbying until Medicare passed. When Kennedy was killed Johnson asked Blue to double his efforts and pass Medicare as a monument to Kennedy.
Medicare passed because of the overwhelming victory of President Johnson over Senator Barry Goldwater in the 1964 election. Johnson asked America to embrace “the Great Society.” The passage of Medicare was a primary plank in his platform. Blue and the NCSC helped elect Congressmen who supported Medicare and led in the defeat of many who opposed.
President Johnson went to Independence, Missouri on July 30, 1965 and signed the Medicare bill into law in the presence of Harry Truman, the old warrior-champion for universal health care. In his address to the nation Johnson quoted from Franklin Roosevelt at the signing of the Social Security Act. Roosevelt had said, “The Social Security Act is a cornerstone in a structure which is being built but…is by no means complete.” Johnson continued, “Perhaps no single act in Roosevelt’s entire administration really did more to win him the illustrious place in history that he has, as is the laying of this cornerstone.” In regard to Medicare, Johnson concluded, “Those who share this day will…be remembered for making this the most important addition to the structure…”
The NCSC often said they had three obstacles to passing Medicare: Republicans, the American Medical Association and Wilbur Mills, (D-AR) Chairman of the House Ways and Means Committee and arguably the most powerful member of Congress. Mills, a southern Democrat, disdained Medicare, calling it “socialized medicine” but he was determined to shape the outcome. He had teamed with Senator Robert Kerr (D-OK) in 1960 to pass Medical Assistance for the Aging (MAA). It supported health needs of impoverished seniors by assisting states that chose to participate. But only half the states signed up and only four participated fully. Clearly, Democrats and the nation wanted more.
Wilbur Mills then introduced hospital insurance, Part A of Medicare, but more liberal Democrats also demanded coverage for doctors’ bills and other medical expenses. He added Part B, but the recipients had to request it and share in the cost by having a modest monthly amount deducted from their Social Security checks. The design was familiar, as Blue Cross (hospital) and Blue Shield (medical) used this two-part approach.
When Medicare became law in 1965, most seniors had no medical insurance and 30 percent of seniors lived in poverty. Today virtually every senior has medical care with only seven percent in poverty. What a difference Medicare and Social Security make!
Fifty years after Medicare the Affordable Care Act is law. It embodies a sweeping vision: health care for every citizen, improved quality of health care and control over the relentless spiral of rising health care costs.
Roosevelt rightly understood Social Security as a strong pillar that supported the American people. Johnson, likewise, saw Medicare as the second pillar. Obama understands the Affordable Care Act as the third essential pillar if the nation is to achieve Johnson’s vision of 50 years ago – “the Great Society.”