3.7.10: Health Administration in America
In 1965 the Medicare and Medicaid bills were passed by congress and signed into law by president Lyndon B. Johnson. These were each amendments to the Social Security Act of 1935 which not only kept seniors out of poverty, but also allocated funds for state health departments and programs. Along with social security, unemployment, and other welfare programs, both Medicare and Medicaid are what are called government “entitlements”, funded at least partially by taxes.
Efforts to create a universal healthcare system - perhaps by expanding Medicare to those under the age of 65 - have been attempted since the late 19th century. Some of these efforts were both supported and opposed by labor unions, yet the majority of them have been fervently opposed by the American Medical Association (AMA) and health insurance lobbies. President Franklin D. Roosevelt originally intended to include healthcare in the New Deal in 1935, but removed it from fears of conservative politicians painting it as “socialist”. At the time, fears of anything considered remotely close to communism or socialism were high, and subsequent efforts to enact universal healthcare legislation were squashed (Palmer, 2009). It was only by focusing on the elderly and poor that Medicare and Medicaid were passed. Since then, these two programs have become increasingly viewed as invaluable by the public. Particularly since the 1970s, the costs of healthcare have increased over each decade, as well as the amount that both employers and individuals are required to pay for it (with premiums and deductibles). Administrative costs of privatized healthcare in the U.S. are the highest in the world. The debate over how to effectively regulate and/or provide healthcare continues to be at the forefront of political agendas (Reich, 2022).