Medicare and Medicaid: The
Social Security Amendments of
Medicare stands second only to Social Security among social legislation passed in the twentieth century. Providing comprehensive medical coverage to individuals over 65, the program has not only assisted millions of senior citizens in obtaining health care, vastly improving their quality of life, it has also transformed the practice of American medicine. Medicare is the fastest growing, and perhaps the most complicated, of America's social insurance programs. Its complexity and price tag ensure that the program will continue to be hotly debated in coming years. Medicaid, a companion program that covers the health needs of the indigent, has similarly expanded in cost and coverage. It is today one of the major expenses of state governments, and lays behind many a budget battle. Yet it, too, has provided significant benefits to millions of Americans. In retrospect, that the United States would provide such programs may seem obvious. But, in fact, they were—and are—extremely controversial, and were enacted only after a bitter and protracted struggle of nearly 30 years.
That struggle began during the administration of Franklin D. Roosevelt. Roosevelt, as we have seen, had initially intended to include a health care plan in his Social Security program. He decided to drop the idea because its cost, complexity, and potential political opposition threatened to sink the entire bill. That did not stop his political allies, led by the New York Senator Robert Wagner, from introducing a first comprehensive health care bill in 1940. This bill died, as did the more ambitious Wagner-Murray-Dingell bill of 1943. Roosevelt then included medical coverage in his “Economic