Assignment: Communists in Southeast
Forty-five years later, we must ensure this inviolable trust between America and
its citizens remains stronger than ever.
Barack Obama, 45th anniversary of Medicare
and Medicaid, July 30, 2010
00_Nowicki (2339) Book.indb 120 5/17/17 10:57 AM
C h a p t e r ➤ 6 : ➤ M e d i c a r e 1 2 1
IntroductIon President Lyndon B. Johnson and the 89th Congress changed the philosophy of healthcare in the United States from an individual responsibility to a social responsibility and changed access to healthcare from a privilege to a right for some Americans. The country’s empathy after the assassination of President John F. Kennedy in 1963 and President Johnson’s adroit legislative skills facilitated the passing of 12 major pieces of health legislation by Congress as part of President Johnson’s Great Society1 (Hepner and Hepner 1973). President Johnson signed Medicare and Medicaid into law as part of the Social Security Amendments of 1965 (P.L. 89-97). This chapter discusses Medicare, and the next chapter discusses Medicaid.
Many observers believe that President Johnson’s Great Society was built on the backs of future generations. When President Johnson assumed office in 1963, the economy was projected to soar to extraordinary levels by the end of the century. This projected growth in the economy would pay later for the “guns and butter” agenda of the president. This agenda included escalating the conflict in Vietnam while initiating significant social programs in the United States—a costly agenda funded without significant tax increases. President Johnson thought that proposing tax increases would have forced Congress to choose between fighting the Communists in Southeast Asia and fighting poverty in the United States (Peterson 1996).
Medicare was initially passed as two parts, Part A for hospital care and Part B for outpatient care, including physician care. The Balanced Budget Act of 1997 introduced Medicare Part C, which folded Parts A and B into a voluntary managed care program called Medicare+Choice (later changed to Medicare Advantage). The Medicare Modernization Act of 2003 introduced Part D, which included outpatient prescription coverage.
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