Controversy surrounding Medicare today mostly centers on questions of funding the program going forward. The basic idea, however, has not only become accepted, it has become an integral part of American society, so much so that it is almost treated as if it were an indisputable fact of life such as gravity or air.
It is that kind of acceptance that supporters of the Affordable Care Act – Obamacare – hope to see as more and more Americans get health coverage through that program. Only time will tell, but they have history on their side.
Largely a health-insurance plan for the elderly, Medicare was enacted as an amendment to the Social Security Act of 1935. It was signed into law by President Lyndon Johnson on July 30, 1965, with former President Harry Truman at his side. The signing took place at the Truman Library in Independence, Missouri, after which Truman became the first American to sign up for the program. Johnson was honoring him as the first president to call for a national health-insurance plan, 20 years earlier.
Truman’s idea went nowhere in 1945. And 50 years ago, the idea of federally sponsored health care was still wildly controversial. The American Medical Association bitterly opposed Medicare, denouncing it as “socialized medicine.”
But in 1965, about half of all Americans older than 65 had no health insurance. With the passage of Medicare, 19 million Americans signed up for coverage to begin the next year.
Today, virtually all senior citizens have coverage. The Associated Press reports there are 56 million seniors and disabled people covered by Medicare. Critics still complain about its cost and make dire predictions about its future, but what politician wants to make 56 million enemies, especially in the demographic that most consistently votes?
A poll conducted by the Kaiser Family Foundation found strong support for keeping Medicare as is. Only 26 percent of those polled agreed that Medicare should be changed to “guarantee each senior a fixed contribution to the cost of their health insurance – a system known as premium support.” Seventy percent said, “Medicare should continue to ensure all seniors get the same defined benefits” – in other words, leave it alone.
The Kaiser poll found that Democrats, Republicans and independents all support keeping Medicare as is by 2-to-1 margins. Adults younger than 65 were more likely to support changing to a premium support system, but just barely – 28 percent vs. 18 percent.
One change that is popular is allowing the federal government to negotiate with drug companies to lower costs. That was supported by 87 percent of the public, including majorities of all political persuasions and across generations. (Of course, one reason for such broad and deep support is it is such an obviously sensible idea that only drug-company lobbyists could oppose it.)
Through the years, Medicare has been modified. Coverage was expanded to include disabled individuals younger than 65. Under President George W. Bush, prescription-drug coverage was added. President Obama’s health-care reform eliminated a gap in the drug plan called the “doughnut hole.” And, today, as baby boomers are reaching 65, Medicare enrollment is increasing by more than 2 million people per year.
The biggest change during the last half century, however, is not in Medicare itself, but in our appreciation of it. Federal health insurance for the elderly may have been controversial once; today, it is an everyday fact.
