By Caleb Mills
In July of 1965, President Lyndon Johnson was done kidding around.
Fresh off the campaign trail, LBJ was basking in the glory of his recent
presidential victory, having obliterated Republican Senator Barry
Goldwater by a historic margin just a few months before. Sweeping both
Houses of Congress, the crude Texan had finally gotten the partners in
government he’d been searching for. Johnson had the momentum, and the
Republicans were sadly mistaken if they thought he was going to squander
it on a few mundane infrastructure maintenance projects.
Johnson was an imperialist in the most forceful sense of the word, an
idealist who’s distinctly rural personality complemented the
extravagance of his ideas and goals. From the outset, Johnson was
determined to enact a series of reforms that he envisioned as a second
New Deal. His talent had won him the number two spot on the democratic
ticket in 1960, but his unabashed ambition alienated many prominent
members of his party, most notably former Attorney General Robert
Kennedy. Yet through shared aspirations, it also united the rising
liberal coalition around his leadership. For the first time in the
decades-long struggle between the conservative and liberal wings of the
party, the latter held the upper hand, giving them immense power over
the direction of the DNC.
Johnson, as much as he tried, could never emulate the persistent
charm of his slain predecessor, a fact made all too clear to him by
progressives who were reluctant to trust him. So Johnson elected to show
them his strengths through more than just talk. In a matter of months
after his election, he passed the most aggressive and sweeping liberal
reforms in the history of the United States. A change was at hand, and
it was colored dark blue.
But it’s important to not let the significance of his victory
overshadow the real threats that once vowed to oppose it. Holdover
Dixiecrats may have been outsiders in the party of Johnson, but they
clutched to their power with renewed energy in the face of extinction,
guarding it with a selfish piety. Most of them hailed below the
Mason-Dixon, claiming solid holds on districts that practically operated
with a one-party system, designed to consolidate power for their
political overlords. But 1964 proved to be the beginning of the end for
that antebellum dynasty.
Although Johnson’s electoral fortunes had energized Democrats across
the country, southerners weren’t so receptive. While usually reliably
Democratic country, the south had been put off in recent years by
President Kennedy’s push for a Civil Rights Act. So while Democrats
might have scored big in 64’ nationally, they did so while being
deserted by the one group that had consistently supported them since the
age of Lincoln. Democrats failed to carry a single county in Alabama or
Mississippi that year, where they had trounced Republicans just four
years earlier with the help of independent candidate Harry F. Byrd.
This was the peril of a southern democrat; at the time, America’s
most politically endangered species. Abandoned by their counterparts,
shunned by the opposition, and bordering on traitorous in the eyes of a
nation. So realistically speaking, these developments weren’t the worst
of Congressman Wilbur Mills’s problems, but surely, they were near the
top of the list.
A Dixiecrat from Arkansas who chaired the powerful Ways and Means
Committee, Mills managed to survive his re-election with the help of
liberals like Johnson, but everyone in Washington knew better than to
see this as proof of an improved relationship between the two. For two
years now, Mills had consistently blocked dozens of Johnson’s Great
Society projects from going through his committee. The election added
two new liberal democrats as well as a pro-medical care Republican,
effectively deciding the fate of the chamber. Now, outnumbered by
liberals from his own party, Mills had no choice but to concede the
inevitable. The first order of business? A little-known government
insurance program that needed approval for a vote, otherwise known as
Medicare.
Medicare wasn’t anything new to America, at least theoretically.
Progressives had been chasing some sort of national healthcare system
since Theodore Roosevelt, and while it was eventually manifested through
the Affordable Care Act, the steps that were taken on the path to that
day in March of 2010 can be traced back to the early 1950s; oddly
enough, under a Republican President.
Dwight D. Eisenhower might have filled his cabinet with businessmen,
thundered down judgment on government overreach, condemned the New Deal,
and accused his predecessor of being a neo-socialist; but when it came
down to it, the Kansas native was a soldier, and that always trumped his
ideology no matter the circumstance. He entered the White House riding a
wave of conservatism built on the ideas of small-government,
privatization, and economic freedom. But that didn’t stop him from
lobbying Congress to create a federally funded government welfare
program aimed at providing free healthcare for U.S. veterans and their
families.
While the purpose of such a program was partially to stimulate the
meager ranks of the post-World War army, many small-government fiscal
conservatives in both the House and Senate expressed their disinterest
in pursuing such a political paradox that the program would assuredly
create. Undoubtedly, the conservative medical lobbying group known as
The American Hospital Association spoke for all of their Republican
supporters in Congress when they ardently declared
in a news communique that such a program would lead to “socialized
medicine without necessity of specific legislation for it” In their
mind, the limited support that veterans received was sufficiently
supplemented by charitable organizations, which simply wasn’t true.
In 1952, Defense Department officials reported
that out of the 200,000 expected births that would happen in military
households, only about 75,000 would be covered by limited government
resources. Furthermore, the Red Cross had informed
the government that it could only provide about 10,000 military
families in the same predicament with maternal assistance. The rest,
sadly, would be fending for themselves squeezing every last penny out of
very modest military salaries.
Despite the evidence, Republicans and the AMA succeeded in blocking
the legislation for many years. President Eisenhower, being all too
familiar with the struggle military families face in times of service,
proved a persistent advocate for the program. Three separate times, the
man who had liberated Normandy took to Congress to demand the bill get
the attention it deserved. Finally, in early 1956, Rep. Carl Vinson, a Georgia Democrat, adhered to the President’s call for action and proposed the Dependents’ Medical Care Act.
“Today it is estimated that only about 60 percent of the dependents
of our servicemen have medical care available to them in military
facilities. The remaining 40 percent must shift for themselves.” Under
the bill, “the medical facilities of the uniformed services would
continue the present practice of providing medical care to dependents….
In addition, and this is the important new feature of the bill,
provision is also made for supplementing and augmenting this program
through the use of civilian medical facilities.” The senior congressman declared in the chamber.
Labeled a “very liberal bill” by the Kilday Subcommittee, it finally
passed both houses of Congress with a few changes and was signed by a
proud President Eisenhower in June.
Mill eventually withdrew his opposition to Johnson’s bill but quickly
realized the scale that the program would amass in federal funds. With
the intent of satisfying the fiscalist that lay at his core, the crafty
congressman knew he couldn’t contain the damage from outside the
negotiating room. His position as chairman ensured that he’d be involved
somehow, and he was determined that if he couldn’t stop Medicare, he
was going to limit its prowess.
Over the course of the next couple of months, conservative Democrats
and Republicans alike began proposing competing versions of a
Medicare-like program. Some were genuine attempts at improved, others an
obvious ploy at dividing the vote. Eventually, Mills and fellow
lawmaker Wilbur Cohen came to a suitable compromise that combined three
of the largest competing versions.
The fact that it suited a small-government conservative politician
like Mills tells you how much the congressional liberals liked it.
Still, the road to history is paved with sacrifice. A Medicare proposal
passed the House 313-215 on April 8th. After passing the Senate, Johnson
enacted Medicare and her sister program, Medicaid, on July 30th. The
historical bill signing took place in Independence Missouri, with a
proud former President Harry S. Truman looking on.
Born out of compromise and ambition, America’s grand experiment with
government healthcare began. Its conception was anything but pure, and
its infancy anything but fair. However, the tenacity of its proponents
and the irrefutable success of the program over time secured it a
permanent spot on the national political stage, for better or worse.
However it’s done more than just survive, it’s changed us in ways we
still truly haven’t grasped.
Today, over 55 million
Americans rely on Medicare to cover their medical needs, making it the
biggest insurance provider in the United States. It’s been well over 50
years since the program’s inception, and it still plays a powerful role
in our political system at both the local and state level. In fact, in
some ways, it’s more prevalent of an issue today than it was when Lyndon
Johnson sat in the Oval Office, as the ‘Medicare for All’ movement led
by Sen. Bernie Sanders (I-VT) has clearly shown. The partisanship that
to this day surrounds these staples of American government breeds
inaccuracy from Washington to San Diego, in both parties and all walks
of life.
Americans have a tendency to regard historical monuments of the past
to be excluded as a species from another lifetime. We are perpetually
blinded by the cynicism of our leaders to the history being made right
in front of us.
We can debate the scope and power of these types of programs, healthy
change begins with genuine self-analysis. But to look upon Medicare
from a human perspective is to look upon the institutionalization of
kindness in modern governance. To realize that the welfare of the people
will always be more important than stuffy philosophy. That an ideology
which leaves the most vulnerable helpless has no place in a government
by the people. It’s to value every citizen from every walk of life;
something which we all can believe in.
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