A challenge constantly renewed: Medicare and the struggle for national health insurance

In 1965, Congress passed a single law that desegregated, overhauled, and modernized the nation's healthcare system while providing new services to one-sixth of the population. Medicare, as it had become known, was the culmination of more than fifty years of public debate and created, as social insurance, a basic floor of health benefits for the nation's elderly. Accordingly, this work essentially explores how the American government makes social policy.;While traditionally viewed as a liberal triumph, Medicare was, to the contrary, yet another mechanism whereby conservatives fought further movement toward a national government healthcare system for all Americans. As its primary author, Representative Wilbur Mills (D-AR), Chairman of the House Ways and Means Committee, wanted "to stop where this might lead" and gave the Johnson Administration far more than it had asked. After all, a small medical program would inevitably subject Congress to increasing popular demand for more benefits and broader coverage. Therefore, as the hearings in the spring of 1965 made clear, Mills wanted a more expensive program, with little financial surplus, targeted at the elderly and poor to deliver future Congresses from that temptation. Furthermore, Mills resisted, and successfully blocked, virtually all cost containment measures within the program to ensure its expense would financially hamper any larger program in the future. Ultimately, Medicare, while providing relief to millions, was designed specifically to preempt any further expansion of federal government involvement in the nation's healthcare system.