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Public Law 89-97
Medicare and Medicaid
1965
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Society of "have and have nots"
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Look at our
elderly. Look at our poor. By the 1960s, the U.S. healthcare
system was minimally available to meet the needs of these large
numbers of individuals. Many workers and their families were
covered by health insurance throughout their employment years.
What happens when these workers retire? Although they receive
Social Security benefits at age 65, many individuals cannot enjoy a
happy retirement life because they have no insurance to cover their
healthcare needs. Purchase of an individual health insurance
plan for an elderly person is astronomically expensive and so most
of the elderly (prior to 1966) were uninsured and vulnerable to
lose all their life savings with one major illness. Our
country also had a large number of persons who were not working and
were very poor. Children in these families did not have access
to regular healthcare and preventative vaccinations. Pregnant
women often received no prenatal care. The economically poor
had a substantially shorter life span than the average U.S.
population and this group experienced many uncontrolled chronic
diseases. This was an awful position for an affluent country. |
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Social Security Act - Title 18 and Title 19
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President Johnson
introduced the concept of the Great Society. Congress
responded by passing amendments to the Social Security Act (Public
Law 89-97). In July 1966, the U.S. activated a federally
funded program to provide healthcare services to the elderly; this
is called Medicare (Tile 18 of the Social Security Act). The
U.S. also activated in January 1967 a federal and state partnership
program to provide healthcare services to the poor; this is called
Medicaid (Title 19 of the Social Security Act).
Throughout the years, both programs have
changed from the initial design. Today there is a managed care
option within each program. President Bush recently announced
his goals and the framework to modernize and improve the programs.
New direction of the government agency managing the system (Centers
for Medicare and Medicaid Services; formerly called HCFA) is to
implement a quality initiative and health outcomes focus to give new
direction to the system. |
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Major concerns today
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A major consumer
concern about the Medicare program today is insufficient coverage
for prescription medications. A major consumer concern about
the Medicaid program program today is the large number of uninsured
not eligible for the program. This number is estimated to
exceed 40 million people living in the U.S. There is great
political interest about the cost and financial burden of these
programs. Prospective payment systems have been developed and
implemented; these systems have helped to control the escalation of
operating costs. Some experts still predict that the Medicare
and Medicaid systems will bankrupt the government. |
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