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American Society of Dermatology, Inc.
A Voice for Private Dermatologists Since 1992
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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
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