Medicare's Midlife Crisis by Sue A. Blevins

By Sue A. Blevins

Blevins examines the program's origins, its evolution, and destiny coverage strategies.

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44 While it’s common knowledge that organized medicine lobbied ferociously against the hospital insurance program for seniors (Medicare Part A), it is often overlooked that the AMA lobbied for the government health care program for low-income people (Medicaid). As William Pearman and Philip Starr have pointed out, ‘‘All interests seemed to be represented in some way. R. 6675) House of Representatives April 8, 1965 Democrats Republicans Total Yea Nay 248 42 65 73 313 115 Senate July 28, 1965 Democrats 57 7 Republicans 13 17 70 24 Total SOURCE: Barbara Dreyfuss, ‘‘Twenty Years Later: Key Players Reminisce,’’ The Internist, March 1985, p.

66 Insurance premiums were commonly paid weekly. 67 The remainder was spent on administrative costs and company profits. Supporters of compulsory health insurance argued that the costs would be better spent on direct patient care. The New Deal Another important period in the evolution of compulsory health insurance was President Franklin D. Roosevelt’s New Deal. 68 To mitigate the effects of the Depression, Roosevelt in mid-1934 established (through an executive order) a Committee on Economic Security to draft plans for a Social Security program.

80 Armed with new statistics, the proponents could more effectively promote their agenda. Consequently, ‘‘a new series of health insurance bills . . 81 While a federal compulsory health insurance program was not adopted until 1965, a program for low-income seniors was created in 1960 that provided subsidies for many, as discussed in the following chapter. In summary, early efforts to institute compulsory health insurance in the United States were fostered by several factors, including (a) the growing acceptance of compulsory health programs among other industrialized nations, (b) poor economic conditions during the Depression, and (c) large national studies sponsored by prominent foundations and organizations.

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