The Evolution of Medicare


HEALTH INSURANCE for the aged, popularly known as Medicare, has had a broad impact on the living patterns of Americans, young and old. The legislation, which provides low-cost hospitalization and medical insurance for the Nation's elderly, directly aids nearly one-tenth of the population. Millions of younger people also benefit indirectly by being relieved of heavy financial responsibility when an aged member of the family encounters major health expense.

Though the program is still new, the idea of Government health insurance antedated the Medicare law by many years. The gradual evolution of this concept throughout much of this century provides an excellent case history illustrating box major social policy decisions in the United States are refined and shaped by the legislative process. From 1935, when the first health insurance bill was introduced in Congress, to 1965, when Medicare was passed, a whole generation of Americans acted and reacted to the various proposals. Through this process a program eventually emerged which proved acceptable to a majority of the public and its lawmakers in Congress.

The Evolution of Medicare was prepared by Peter A. Corning under a contract with the Social Security Ad-ministration. Although his opinions are not necessarily those of the Social Security Administration, his account is a valuable record of how one of our most far-reaching laws was conceived and enacted.

A professional journalist, Mr. Corning began the project while working with the Oral History Research Office at Columbia University on the early history of social security. He is presently completing the requirements for a doctorate in political science at New York University.

The author is grateful to the many people who aided him during his research and in the preparation of the manuscript. He especially wishes to thank Dr. Louis M. Starr and Mrs. Elizabeth B. Mason of the Oral History Research Office for their support; two colleagues, Professor Bernard Ross and Howard Rubin, for their assistance; Professors Clarke Chambers and Elizabeth Wickenden, among others, for reviewing the manuscript; and Robert Robinson and Robert Marsh of the ORS Publications Staff for editing assistance.


Assistant Commissioner for
Research and Statistics
March 1969