When another landmark health bill passed, in 1965, it was with less drama

When the time came for final House action on the landmark health-insurance bill, the vote itself was something of an anticlimax. 

While there was last-ditch opposition from Minnesota’s Republican delegation, the state’s Democratic congressmen voted “yes” and the legislation was easily approved on a vote of 313 to 115.

Unlike the high drama surrounding the House vote on the 2010 health care overhaul bill, congressional approval of the bill establishing Medicare was pretty much a foregone conclusion by the time the legislation reached the House and Senate floors in 1965.

Long a goal of liberal Democrats, national health insurance — at least in a limited form — became a political reality with the Democratic sweep of the 1964 elections. That year saw Lyndon Johnson gaining 61 percent of the popular vote in his lopsided win over Barry Goldwater. At the same time, Democrats increased their margins in the House and Senate, giving them a lock on both houses.

GOP alternative: Eldercare
Sensing that the political tide was running against them in 1965, House Republicans opted to deflect rising public support for national health insurance by fashioning an alternative to Medicare that they dubbed “Eldercare.” The Republican plan would have established a means-tested program that enabled low-income seniors to obtain federal subsidies for privately administered health insurance. But Eldercare was strictly voluntary and lacked the mandatory feature of Medicare’s Part A hospital insurance with its payroll-tax funding mechanism.

Minnesota’s four House Republicans supported their party’s alternative, but the Eldercare plan lost on a test vote of 236 to 191 when it reached the House floor on April 8. In statements to the Minneapolis Tribune after final House passage that same day, members of the Republican delegation justified their vote against Medicare — but in terms that were considerably more moderate than those used by their modern counterparts who opposed this year’s health-reform legislation.

Rep. Clark MacGregor
Minnesota Historical Society
Rep. Clark MacGregor

After the Medicare debate in 1965, the Third District’s Clark MacGregor said he supported using general revenue funds to partially subsidize health-insurance coverage “for older persons who want and need it. This is far preferable to this compulsory plan where the rich and the poor pay the same taxes and benefits are available to people who don’t want or need them.”

The First District’s Al Quie echoed MacGregor’s views. “I support improvements in the Social Security plan and the voluntary medical plan in this bill (Medicare)” Quie said. “However, I am opposed to the compulsory payroll tax system as a principle. I felt the only way I could dramatize this was by voting against the bill after the Republican plan was defeated.”

DFLers were jubilant
In contrast to their Republican colleagues, Minnesota’s DFL congressmen were jubilant when the Medicare bill cleared the House. “This is going to be the biggest step forward in social legislation since Congress passed the first Social Security act in 1935,” declared the Fourth District’s Joseph Karth.

“This is not just a bill for the very poor but for many persons whose savings are wiped out and who are made wards of the state as the result of major needs,” added Karth, in terms that could have been repeated during this year’s congressional debate by Betty McCollum, the DFLer who now represents the Fourth Congressional District.

While the Medicare bill targeted the elderly, a politically acceptable demographic group, the 1965 legislation, in the context of its time, was more far-reaching in its extension of federal authority than the more controversial Obama administration health-care overhaul plan. Medicare, the “single-payer” of its era, established a major new federal entitlement funded by a permanent tax increase that applied to virtually all working Americans.

A more muted opposition
But then, unlike today, Republican opposition was relatively muted and low key. During the floor debate on Medicare, House Republican Leader Gerald Ford urged support for his party’s substitute measure, but said that it would be understandable for some members of his party to vote for the Democrats’ bill since it contained a number of provisions originally supported by Republicans. While Ford voted against adoption of the Medicare bill, 65 Republicans — nearly half of his caucus — voted with the Democrats on final passage.

That summer, after a companion bill easily cleared the U.S. Senate, both houses of Congress were able to reconcile their differences and send the landmark legislation on to the White House.

On July 30, 1965, with Vice President Hubert Humphrey standing by, President Lyndon Johnson signed Medicare into law, creating this country’s first federally administered national health-insurance system.

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Comments (6)

  1. Submitted by John Olson on 03/30/2010 - 12:27 pm.

    In 1965, you had three television networks, a bunch of newspapers and radio and the wire services. No internet. No C-SPAN. No 24/7 cable news talking heads. You had a far better chance of having more timely information on the price of pork bellies at the South St. Paul stockyards than pending legislation in Washington.

    Only the most senior of the Members of Congress tended to have the ear of the wire services and national media of the day.

    Since media opportunities were not as plentiful, Members of Congress probably spent far more time tending to their constituents’ letters (not e-mails) and their responsibilities. Today, it seems as if many Members of Congress are more concerned about how many appearances they can make in the media instead of concentrating on their legislative work.

  2. Submitted by Thomas Swift on 03/30/2010 - 12:44 pm.

    One wonders if the benefit of hindsight doesn’t have more than a little to do with the public’s outrage.

    After all, in 1965, Social Security was still solvent, SSI taxes and benefit age hadn’t been raised several times in a desperate attempt to keep it afloat. No one was predicting that the spiffy new Medicare program would be flat broke in just 40 years time, either.

    Now we know all of this, and are standing witness to yet another Democrat congress foisting another gargantuan socialist entitlement program upon us in the dead of the night.

    As they say, if you’re not mad as hell, you’re not paying attention.

  3. Submitted by Bernice Vetsch on 03/30/2010 - 03:30 pm.

    Thomas: In 1983, Alan Greenspan, with others, prepared Social Security for the retirement of the Baby Boomer generation by raising slightly the percentage of payroll taxes withheld for SS. The result was a huge lock box full of bonds to completely finance Social Security (when combined with ongoing payroll deductions). To his everlasting discredit, George Bush spend much of it on phony wars and tax breaks for the rich.

    There is now a coming Bush-shortfall that can be easily met, as the president has suggested, by: (1) lowering the rate of taxation to give poor and middle class earners a break, and (2) making ALL income taxable, including that from investments, on earners in the highest brackets.

    Medicare, too, can be fully funded in the same way, but billions can also be saved if Congress will change the law to require (instead of forbid) Congress to negotiate volume discounts on drugs.

    The new health care legislation provides for billions of savings by cutting the excess government payments to Private Fee for Service insurers that cover niceties like gym memberships and eyeglasses by taking money from regular Medicare that funds no such goodies.

  4. Submitted by Ginny Martin on 03/30/2010 - 03:44 pm.

    Thomas: Is that why people are shouting kill healthcare reform–but save my Medicare?

  5. Submitted by Ginny Martin on 03/30/2010 - 05:02 pm.

    Wait, I wrote that incorrectly. I should have remarked on all the people yelling, Don’t let the government take over my health care, and Don’t let anyone touch my Medicare.

  6. Submitted by Thomas Swift on 03/30/2010 - 05:05 pm.

    Ginny, I’ve heard that statement repeated from leftists, but I have yet to hear it, or read it from the organized opposition of which I’m proud to be a member.

    I’m sure that there must have been some confused soul somewhere that said it though; ’cause, like, leftists would never make stuff up.

    Yes, Bernice…they raised the SSI tax and the benefit age; that is what I said alrighty. And yes indeed, the left is frozen over to raise them more.

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