On July 30, 1965 President Johnson signed the Medicare bill, but it was John F. Kennedy both as senator and President who was instrumental in getting a Medicare bill passed. Not only did Kennedy campaign on Medicare in 1960, he took the American Medical Association head on in their campaign against it. President Kennedy reached out to every day Americans and enlisted their support as U.S. citizens to petition the government and bring government insurance for the elderly to America. Although the bill that Kennedy campaigned on did not ultimately pass, it opened the door for the final Medicare bill in 1965.
In 1962 there were 16 million men and women over the age of 65, and while generally people agreed that some assistance was needed where was a wide divergence on how it should be done. Many argued that the focus should be on the prevention of illness, and that support should be whenever possible restricted to serious illness or long-term care in home or using out-patient services. Most agreed that while govt. paid medical care should include medication, they did not agree that it should cover physicians' and surgeons' fees. For some this was just a matter of cost, but for others it was an ideological opposition to the financing of medical care of the aged through Social Security.
The debate over government health insurance was not new. In 1937, Dr. Thomas Parran of the Public Health Service was the first publicly to suggest that a government health insurance program be limited (at least at first) to social security programs, but interest waned. Then in 1950, when the idea of a National Health Insurance program surfaced, Federal Security Administrator Ewing introduced a more modest proposal that would cover Social Security recipients only. It was viewed as a much less costly program and would allow the Government to gain experience in this field. In 1952, President Truman's Commission on the Health Needs of the Nation endorsed the proposal, but in an election year Truman himself was unwilling to support the proposal. General Eisenhower was flatly opposed to the socialization of medicine, but in campaign speeches he had promised to do help the needy citizens meet the cost of medical care especially in their last years. As President, Eisenhower promoted the idea of limited government reinsurance program, or "pooling" proposals, but these were not seen as adequate alternatives, and the debate over government health insurance had become academic.
After a short period of quiet, the idea re-surfaced in 1956. Representative Aime J. Forand of Rhode Island introduced a beneficiary-only health insurance program. This time, the proposal had support from the AFL-CIO, who committed it's 14-million-member labor federation to an all-out battle for Government health insurance. Government health insurance now had what it needed, support from boots and voters on the ground. And for the time being, the proponents also had a powerful ally in the American Hospital Association. Hospitals had for years bore the brunt of the difficulties the aged were experiencing trying to meet their medical expenses, and by 1958 were at least willing to support labor's effort to call attention of this problem to the Federal Government. It was not a full-throated endorsement, but in a letter from Kenneth Williamson, AHA’s associate director said his organization was willing to accept it, after all other possible solutions were "fully explored and found wanting". Williamson addressed the letter to Congressman Wilbur D. Mills, the ranking Democrat on the Ways and Means committee. In the same letter he urged Congress to consider the problem and hold public hearings. On the other side, the American Medical Association (AMA) was gearing up for the fight against Government Health Insurance. Members of the AMA House of Delegates met in 1957 and resolved to defeat the Forand bill. The tide turned in 1958, when AMA and the AHA along with the American Nursing Home Associations and the American Dental Associations met together to form a Joint Council to seek ways of dealing with the problem of elderly care without resorting to Government action.
Over the next couple of years, pressure for some kind of congressional action increased and in 1960, it became a election issue. In response to this unrelenting pressure, Democrat Wilbur Mills of Arkansas, the new Ways and Means Committee Chairman began to search for a compromise. Mills introduced a bill that greatly expanded the program of medical vendor payments provided under State-run public assistance programs and created a new category of assistance called "medical indigency" for elderly people who might not otherwise qualify for welfare in their states. On the House side, Mills worked with the AMA to create a bill that was much more moderate in both cost and scope than the Forand Bill. On the Senate side, the Finance Committee modified the bill and renamed it to the "Kerr-Mills" bill. The Kerr-Mills bill swept through the Senate by a vote of 91-2. Many Democrats were bitterly disappointed though in the bill, and vowed to continue the fight for a full-fledged government health insurance program for the elderly. Chief among these Democrats was Presidential candidate and Senator John F. Kennedy. Kennedy made "Medicare" as the proposal came to be called, a major issue in his presidential campaign. Kennedy joined the chorus of Democrats in attacking the Kerr-Mills bill as being insufficient to deal with the problem at hand.
After his inauguration, President Kennedy sent a special message to Congress on health and introduced a bill that was to be sponsored by Senator Anderson and Representative Cecil King, but more pressing needs of a declining economy and foreign affairs pulled his attention away. During this lapse, the AMA launched an all-out campaign against the Kennedy's early efforts and in support of the Kerr-Mills Act. Aside from many radio and TV commercials, the campaign also distributed several million pamphlets. Organized labor on the other side fought back with their own efforts to support the Anderson-King bill. They enlisted popular physicians such Dr. Benjamin Speck. As the debate heated up, President Kennedy used his bully pulpit to try and sway public opinion. On May 20, 1962 President Kennedy spoke to a crowd of almost 20,000 people in New York's Madison Square Garden. The speech was broadcast live on network television and reached an audience of an estimated 20 million persons.
After introducing the bill as common-sense legislation that would protect the elderly in cases of prolonged sickness, Kennedy used his Madison Square Garden speech to combat the AMA campaign. He pointed out that the "AMA is doing very well in its efforts to stop this bill". Kennedy told the crowd, "the doctors of New Jersey and every other State may be opposed to it, but I know that not a single doctor — if this bill is passed — is going to refuse to treat any patient." Kennedy spoke of letters that were pouring in to his office, at least half of which "on this issue and others, is wholly misinformed." Kennedy reminded folks that what the United States is talking about doing, most of the countries of Europe did years ago. It was John F. Kennedy against the AMA, and he asked the people for their support. President Kennedy asked U.S. citizens all around the nation to use their right as a citizen to petition the government to pass a Medicare bill.
Eight months later, Kennedy once again used his bully pulpit to urge Congress to pass a Medicare bill. In his final State of the Union Address, President Kennedy gave one more plea for Medicare.
"Our working men and women, instead of being forced to beg for help from public charity once they are old and ill, should start contributing now to their own retirement health program through the Social Security System."
President Kennedy never did see the Medicare Bill pass before his untimely death in November 1963. In 1965, Wilbr Mills and the House Ways and Means Committee drafted a new bill that included Medicare and it was signed by Lyndon B. Johnson on July 30, 1965.
References
Presidency.ucsb.edu. (2019). Annual Message to the Congress on the State of the Union. | The American Presidency Project. [online] Available at: https://www.presidency.ucsb.edu/documents/annual-message-the-congress-the-state-the-union-3 [Accessed 15 Apr. 2019].
JFK'S "HEALTH CARE" SPEECH FROM MADISON SQUARE GARDEN (MAY 20, 1962). (2013). [video] Available at: https://www.youtube.com/watch?v=VXUJErr_vfo [Accessed 15 Apr. 2019].
Ssa.gov. (2019). Social Security Online History Pages. [online] Available at: https://www.ssa.gov/history/corningchap4.html [Accessed 15 Apr. 2019].
The New Republic. (1962). Medical Care for the Aged. [online] Available at: https://newrepublic.com/article/122397/medical-care-aged [Accessed 15 Apr. 2019].
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