History of SSA During the Johnson Administration 1963-1968
OPERATING METHODS
SSA PUBLIC INFORMATION ACTIVITIES {1}
In late 1963, the Social Security Administration was about in the
middle of the longest interval since 1950 without any major legislative
changes in program. This was significant for its public information
activities because frequent change and expansion of programs always
has a major impact on what the people need to know--requiring revision
of all information materials, re-direction towards the people, the
groups and organizations that need information, and the resulting
increase in administrative resources assigned to these efforts.
It was not until mid-1965 that the most extensive program changes
in 30 years radically changed the kinds and volume of public information.
Nevertheless, the years 1963 and 1964 were busy. SSA's continuing
public information objective to "Let the people know about
their rights and responsibilities under the program" was not
being easily or adequately achieved. While millions of people were
being informed, surveys and studies showed that many other millions
did not understand the programs, nor were they all taking the necessary
actions to obtain their rights and exercise their responsibilities.
SSA's general policy to use all the major mass communications media--since
almost all the population had a personal stake in the programs--was
coupled with efforts to improve the use of each of the media. And
these efforts were carried out with continuing emphasis on the role
of the social security district offices in working with the media
and other communications channels in their local communities. Furthermore,
these efforts required the adaptation of materials and activities
to the diverse groups participating in the programs. For example,
not only were there pamphlets appropriate for college graduates
but the Social Security Administration in 1963 was pioneering among
Government agencies in producing publications appropriate for use
in adult literacy classes. Also, during 1964 and along with other
agencies, the SSA completely reviewed all its publications as a
part of the project which President Johnson initiated to reduce
the volume and cost of publications and to improve their quality
and effectiveness.
Two special events in 1964 are worth noting as examples of the widespread
value of public information activities. The New York World's Fair
opened in April, and at the last minute the SSA obtained space for
an exhibit in the Federal Pavilion--the only Federal agency to be
so privileged. In September in Washington, the International Social
Security Association held its general assembly in the United States
for the first time. SSA's Office of Information supported this meeting
with special publications, press coverage, film showings, and a
large interagency exhibit on United States social security programs.
More significant in terms of world-wide recognition of public information
in social security administration was the fact that for the first
time in its history the international gathering had a session on
public information. For this Roy L. Swift, SSA's Information Officer,
prepared a discussion paper on "Public Information and Public
Relations in the Field of Social Security." {2}
On the opening day of this assembly, a social security commemorative
postal card was issued by the Post Office Department,{3}
the first time such honor had been given to social security (the
original proposal had been for a commemorative postage stamp).
With or without legislation, 1965 was expected to be an historic
year for social security. Several events were given major attention
in public information activities to dramatize the increasing importance
of social security to the Nation and individuals. In January, 25
years of monthly benefit payments were completed, and special attention
was given to individual beneficiaries in local communities who had
received monthly benefits all those years, most notably Miss Ida
Fuller of Ludlow, Vermont, social security's "first beneficiary."
{4} In April, the program passed the 20-million
mark of beneficiaries receiving payments each month. Mr. William
J. Kappel of Fort Wayne, Indiana, was selected to represent the
20-millionth beneficiary, and President Johnson presented his first
check to him at a White House ceremony.{5} August
1965 was the 30th anniversary of the original Social Security Act.
Although this came after the enactment of the 1965 amendments on
July 30, President Johnson issued an anniversary statement, and
a special ceremony was held at Hyde Park, New York, in recognition
of President Roosevelt's leadership in social security. {6}
While these historic events and the historic 1965 amendments provided
the major themes for public information activities, there were many
other influences on SSA's efforts in 1965. Televeision was and remains
a major challenge in the ongoing "communications revolution",
and after several years of planning the SSA completed for educational
television a series of three half-hour programs for educational
television, which had been produced and were broadcast in cooperation
with the National Educational Television Center. {7}
Early in 1965 President Johnson initiated a Government-wide project
to "improve our public communications"--which is continuing
under the broader title of "improving service to the public".
In December1965, the new HEW Secretary, John W. Gardner, issued
new policies {8} to "re-orient Department
public information activities" which, among other things, decentralized
to the Social Security Administration more authority and responsibility
for its public information program--a change which had major benefits
as SSA undertook the extensive and intensive activities required
by the 1965 amendments. And as it embarked on these amendment challenges
in August, the SSA contracted for the first time with a private
public relations firm--T. J. Ross and Associates--to provide professional
counsel.
The 1965 social security amendments created the largest number of
public information tasks ever handed to the Social Security Administration,
and top officials recognized that these were critical to efficient
administration.{9} While there was much to tell
the public about changes in the retirement, survivors, and disability
insurance programs, the new two-part health insurance program for
the aged had to be given the highest priority.
During the legislative process, newspapers and other media began
to use the term "Medicare" to describe the health insurance
program. At first the Administration opposed the term because the
legislative proposal was limited to hospital insurance. When the
legislative package was enlarged by the House Ways and Means Committee
to include the voluntary medical insurance(doctor bill) part, there
was less objection to the comprehensive term of "Medicare".
Also, by the time of enactment it was believed that most people
were familiar with this term from the media coverage and might not
understand the more "correct" title in the law. Advice
from the President's Committee on Consumer Interests and use of
the term "Medicare" by the President also persuaded the
Administration to adopt the popular term.
The most novel public information challenge was in the voluntary
medical insurance program. Never before had the SSA managed a "voluntary"
program of this size, involving getting information about the choice
to all people age 65 and over and getting a response by the March
31, 1966 deadline (later extended to May 31). The fact that over
90% of the aged elected this coverage was considered remarkable.
Another novel aspect of the Medicare program involved its administration,
in part, by private organizations--fiscal intermediaries for hospital
insurance and carriers for medical insurance to handle the bill-paying.
The law also provided that these organizations serve as communications
channels to the providers of health services--the hospitals, extended
care facilities, home health agencies, physicians, etc. This created
a new dimension to the public information program. This arrangement,
as well as the audience of the entire health-care community, also
enlarged the "professional relations" function, which
had already existed to some degree in the disability insurance program,
as a distinct and important part of the overall public information
and public relations activities.
What President Johnson later called "a massive program"
of public informatirn was well under way in the fall of 1965 and
built up the start of the program on July 1, 1966. The details of
this program have been described elsewhere.{l0} The
volume of activity reached new highs for the SSA. More than 250
million copies of pamphlets were printed--5 to 6 times as many as
in prior years. Also, in the fiscal year 1966, about 60 national
press releases were issued--6 times the average of earlier years.
The staff of the Office of Information about doubled, and its operating
budget was three times any earlier year.
President Johnson and other top officials took an active interest
in public information activities and often spoke on developments.
On March 6, 1966, he issued a proclamation to make March National
Medicare Enrollment Month. On April 7, 1966, the President asked
a number of questions of the Secretary of HEW on the status of preparations
for the start of Medicare, and his first question was: "Are
persons covered by Medicare fully informed of their benefits?"
On May 24 the Secretary replied that "A great deal of progress
has been made toward this goal". The Commissioner of Social
Security supplemented the Secretary's report, saying that "One
of our most important jobs... was the job of informing people...
Our information program has been of critical improtance... Of course,
it will not be possible to fully inform everyone ahead of time about
every possible facet of the program". And the President, in
speaking to a June 15 meeting of medical and hospital leaders,reported:
In the past year, through a massive program, we have tried to reach
virtually every American over 65 years of age with news about medical
care. We may not have reached every one of them. But more than 90%
of them--between 17 and 18 million have signed up for elective medical
benefits.
The interest and concern of top officials reflected, in part, intensive
coverage by the media of Medicare developments. Each step of the
planning and preparations had been followed closely by newspapers,
radio, television, and magazines. There were fears that the complex
operations would not work well and that old people would besiege
doctors and overcrowd hospitals.When July 1 came, however, observers,
including the news media, reportedthat the start was unexpectedly
smooth.{11}
This did not mean that the public information job was done: Beneficiaries
needed their questions answered; explanations needed to be given
of situations that; were not yet working as well as desired; and
preparations continued for the start of the extended-care-facility
benefits six months after the rest of the program, on January 1,
1967. Furthermore, after a year of giving Medicare the highest priority,
it was essential to offer a more balanced public information program
which covered the cash-benefit programs of retirement, survivors,
and disability insurance.
Even before Medicare started, public interest in further social
security changes remained high in 1966. Congress in the spring added
a new program of special payments to people age 72 and over beginning
in November, and partly due to the public information activities
on this, almost twice as many as originally estimated eventually
became entitled to benefits. Then, in October, President Johnson
spoke at the annual Social Security Administration Awards Program
in Baltimore and surprised many by making a major speech advocating
significant increases in social security benefits. The proposals
eventually resulted in the 1967 amendments.
Accompanying the new high level of Social Security Administration
public information activities required to reach the larger number
of people participating in social security programs came other adjustments:
- In November 1966, representatives of Negro-oriented newspapers and radio stations met with SSA public information staff to provide advice on reaching their readers and audiences
- During 1967, regional conferences were held with the professional relations and public relations officials of all Medicare's intermediaries and carriers to discuss their communications responsibilities and activities.
- Early in 1967, the Social Security Administration issued a Public Information Handbook to provide a training and reference guide to field staffs
- Late in 1967 public information responsibilities were assigned to a staff assistant to each of the Regional Commissioners to provide regional services and coordination.
For all of 1967, public information activities continued on the numerous themes and messages of the existing programs. Nevertheless, {12} the 1967 year-long Congressional consideration of social security amendments caused some slackening of public information materials production--in order to avoid large supplies of obsolete informational materials. Usually, social security legislation had been enacted by late summer, but not this year. Recognition of the first year of Medicare received some attention in mid-year. In the fall there was concern over a critical article in the Reader's Digest, to which the then Under Secretary of HEW, Wilbur J. Cohen, replied.{l3} Although the Reader's Digest was incorrect and misleading, more responsible media and individuals were raising questions and making proposals affecting all "income maintenance" programs. An increasing need in public information was to explain program principles, philosophy, and issues. President Johnson had indicated early in 1967 that he would appoint a commission to examine all ideas, and he did so at the time he signed. the 1967 social security amendments (on January 2, 1968.)
The year 1968 started with one more peak of public information
activity--to explain the 1967 amendments. About 24 million beneficiaries
received larger payments early in March: This large number--they
make up about one out of nine of the total population--and the 20
million Medicare beneficiaries suggest why public information activities
for social security beneficiaries make up an increasing part of
the total effort. At the same time, the increasing contributions
which workers were paying--and particularly younger workers--caused
a decision to give special attention to the value of survivors and
disability insurance protections.
Early 1968 was also significant for public information because of
the first general enrollment period for the voluntary medical insurance
part of Medicare. Old people had until April 1 to enroll--or to
"disenroll"--and there were large-scale activities to
inform them of the reasons for enrolling and of their right to disenroll
if they wish. As in the earlier enrollment efforts in 1965-66, direct-mail,methods
of reaching this target audience had first priority--evidence of
the increasing use of data-processing computers to reach large groups
through mailings. Again, the enrollment activities were surprisingly
successful. About 600,000 additional persons enrolled in Part B,
bringing the total to about 18.6 million--or 95% of the total aged.
While the Medicare enrollment campaign illustrated the crucial role
of public ihformation activities in informing people so that they
can "act," the celebration of the 33rd anniversary of
the Social Security Act on August 14 illustrated the objective to
inform people about program principles, philosophy, accomplishments,
and issues.
But the major shift in public information policy in 1968 was towards more effective public information for the poor and the disadvantaged. Reflecting the Nation's concern, the Social Security Administration was examining its efforts for the poor and developing new public information materials and activities, new relationships with other organizations and agencies, and a large commitment of administrative resources to reach the poor in the inner cities, in the rural areas, and wherever they lived and worked.
Footnotes (Footnote numbers not same as in the printed version)
{1} Details are described in the Annual Work Plans
and Annual Work Plan Reports of the Office of Information for Fiscal
Years 1964 through 1969. Further historical background is in an article
on "A Quarter Century of Public Information" by Roy L. Swift
in the September 1960, OASIS.
{2} "Public Information and Public Relations
in the Field of Social Security," a discussion paper prepared
by Roy L. Swift for a roundtable discussion at the 15th General Assembly
of the International Social Security Association, September 1964,
Washington, D.C.
{3} Post Office Department General Release No.163
for September 2, 1964 Papers
{4}SSA release (HEW-D86) for January 31, 1965
{5} Public Papers of the Presidents - Lyndon B. Johnson,
1965, Volume 1, page 544, may 5, 1965.
{6} Remarks were made by Under Secretary Wilbur J.
Cohen, and Commissioner of Social Security Robert M. Ball, August
15, 1965. The President's statement on August 15 is in Public Papers
of the Presidents - Lyndon B. Johnson, 1965, Volume 2, page 88.
{7} "The Quest for Security" consisted of
three programs: "The Dependent Child"; "Ready for Edna";
and "In Case".
{8} December 21, 1965 Memorandum from the Secretary
on "Re-orientation of public information activities throughout
the Department".
{9} Some reference to these activities was earlier
discussed in the section on Medicare.
{10}During preparations, monthly reports were written
on public information activities for Medicare. See also "Launching
Medicare: the People Behind the Program" by Roy L. Swift, in
the July-September 1967 Civil Service Journal.
{11} "Editorial and News Reaction to the Beginning
of Medicare - July 6, 1966"was compiled by the Social Security
Administration and sent to the White House and Members of Congress.
{12} Every six months the Social Security Administration
issues a statement on public information themes. See Bureau of District
Office Operations Memorandum No. 236 (161-66), "Public Information
Themes for January-June 1967" and BDOO Memorandum No. 91 (56-67),
"Public Information Themes for July-December 1967."
{13} Statement by Wilbur J. Cohen, Under Secretary
of Health, Education, and Welfare, on Charles Stevenson's "How
Secure is Your Social Security" in the October 1967 Reader's
Digest.