American Society of Dermatology
2721 Capital Ave.
Sacramento, CA 95816-6004
Phone: (916) 446-5054
Message: (561) 873-8335
Fax: (916) 446-0500
American Society of Dermatology, Inc.
A Voice for Private Dermatologists Since 1992

June, 1996

History Lesson
by Edward R. Annis, MD
Miami Shores, FL

The health care of the elderly must not be kept hostage to political ploys. False and misleading statements emanate from both Republicans and Democrats as partisan politics and the search for votes erodes both reason and common sense.

Paradoxes are widespread. Florida Democratic Congressman, Sam Gibbons, a short-time Chairman of the Ways and Means Committee, says there is no crisis. On Sunday, September l7, C-Span featured Democratic Congressional Minority Leader Richard Gephardt addressing an Economics Club, saying there would be no Medicare crisis if there were no tax cuts. Yet, it was the Clinton Administration appointees, three of the Cabinet members, who projected bankruptcy within 5 to 7 years unless substantial changes are made. Those conclusions were agreed to by Secretary of Health and Human Services Donna Shalala, Treasury Secretary Robert Rubin, and Labor Secretary Robert Reich.

On that same September l7 C-Span presentation, Minority Leader Gephardt blamed Republicans for having voted against Medicare when it was finally passed. That statement is probably correct, but its connotations raise the question as to why there ever was opposition from any quarter against so noble an objective as assuring health care for our older citizens.

It is important to recall a little history. Medicare-like legislation was promoted by powerful labor leaders, and others, throughout the Democratic Administrations of both Truman and Kennedy. Those efforts were defeated by bipartisan opposition which maintained that it violated common sense and fairness to tax younger workers of their wages to pay the hospital bills for everyone who reached their 65th birthdayÐthe rich as well as the poor, whether or not they needed help.

Strong opposition had been led by such Democratic leaders as Wilbur Mills of Arkansas, Chairman of the Ways & Means Committee, and Senator Robert Kerr of Oklahoma, Chairman ofthe equally strong Senate Finance Committee. Both leaders, however, knew that the needy elderly should not be overlooked and they proposed legislation which was met with favor by Republicans and Democrats.

The Kerr-Mills law provided federal matching funds for state-administered programs helping the aged who could not afford costly medical care. The legislation authorized federal grants to states to support state-run medical assistance programs for elderly persons who could establish a need. No one had to be destitute. Assets were not touched and low income alone determined eligibility.

Federal funds were provided at a 50:50 ratio for wealthy states and up to a split of 85:15 for poorer states like Mississippi.

In late 1960, before leaving of fice, Republican President Eisenhower signed the Kerr-Mills law. That soundly based legislation named after two powerful Democrats was passed overwhelmingly by both Houses of Congress.

Unable to maintain control because Kerr-Mills was not centered at the federal level, the H.E.W. bureaucracy, strongly peopled by labor socialists, attempted to place repeated obstacles to its implementation. Despite their vehement objections legislatures in 44 states had moved to implement the law and the remaining states were awaiting actions by their legislative bodies.

Because of widespread public support the future looked bright as medical capabilities continued to expand with new knowledge, new technologies, newer methods and fantastic new medicines.

Had it not been for the Kennedy assassination on November 22, 1963, the Kerr-Mills law could have continued its assurances of quality health care for all seniors in need of assistance and the crisis faced today could have been avoided.

Lyndon Johnson owed his subsequent election to strong labor union support and to Walter Reuther, its powerful leader. Elected with Johnson were 51 union-supported candidates. After the election the union circulated a leaflet with a picture of a joint meeting of Congress on the cover. The caption read: "Fifty-one Did It." It went on to praise the 51 union-sponsored members who helped make Great Society legislation possible.

Immediately after the passage of Medicare, Lyndon Johnson pressured health insurance companies to stop writing health insurance for anyone over 65. The 7.7 million who had been paying for their own insurance (my parents included) had their insurance canceled and they joined the other 16 million people who had become eligible for Medicare for which they had paid nothing.

It was during the turbulent times of the early sixties that American Medical Elected Leaders realized the importance