How Medicare's past impacts your plan, system today

"Today, at this point in our history, we are privileged to contemplate new horizons of national advance and achievement in many sectors. But it is imperative that we give first attention to our opportunities-and our obligations-for advancing the nation's health. For the health of our people is, inescapably, the foundation for fulfillment of all our aspirations," said President Lyndon Johnson on January 7, 1965, in a speech to the U.S. Congress called "Advancing the Nation’s Health."

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In Johnson’s speech, he talked of the country’s ability to "conquer" smallpox, malaria, yellow fever, and typhus. He spoke of polio, which had taken 3,154 lives in 1952, and had taken only five lives in 1964. Over the course of 20 years, he said, the country had seen death rates due to influenza fall by 88%, tuberculosis by 87%, and rheumatic fever by 90%. 

During this speech, Johnson advocated for the creation of a program that would provide hospital insurance for the elderly under Social Security. He wanted to convince Congress to extend the promise of then-modern medicine to all Americans. What he got was passage of Medicare on July 30, 1965.

Medicare's early effects

Blumenthal, MDMedicare had an immediate impact on Americans 65 years of age and older-and this continues to be true today. "All of us with aging, sick parents rely every day on Medicare to keep their financial security and also our own because otherwise we would be paying those bills," says David Blumenthal, MD, president of the New York-based Commonwealth Fund. "Medicare benefits the elderly and their families every day, in terms of access to care and the quality of care and healthcare status. And that, I think, is an undeniable part of the Medicare legacy."

Early impacts of Medicare included an increase in the rate of hospital admissions per 100 elderly Americans, from 18 to 21 annually between 1963 and 1970. The number of elderly who had cataract surgeries doubled between 1965 and 1975. Further, the proportion of elderly patients who had contact with a physician increased from 68% to 76% between 1963 and 1970. 

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Longer-term impacts of Medicare include an increase in life expectancy for Americans at the age of 65 by 15% between 1965 and 1984 (at least in part due to the program); and, today, only 2% of the elderly are without health insurance-a dramatic increase over the 48% who lacked health insurance in 1962.

 

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