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July 19, 1995, Vol 274, No. 3 >
ARTICLE | July 19, 1995

The Compromise and the Afterthought: Title and subTitle BreakMedicare and Medicaid After 30 Years FREE

Emily Friedman
[+] Author Affiliations

Ms Friedman is contributing editor of Hospitals and Health Networks and the Healthcare Forum Journal and is a contributing writer for Health Management Quarterly.

Reprint requests to 851 W Gunnison, Unit G, Chicago, IL 60640 (Ms Friedman).


JAMA. 1995;274(3):278-282. doi:10.1001/jama.1995.03530030098045
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References

IT HAS BEEN an eventful time since, on July 30,1965, then-President Lyndon Baines Johnson signed Public Law (PL) 89-97, the Social Security amendments that brought into being the Medicare and Medicaid programs. The legislation represented an unrivaled turning point in American health policy. It embroiled the American Medical Association (AMA) in the fight of its political life—which it lost. It changed how hospital, medical, and other health care services were financed; altered the shaky relationship between the federal government and the states; and spawned a long parade of political, financial, social, and moral events that continues to unfold today.

Deep Roots  Its roots ran deep.1-5 Politically, they reached back to the unsuccessful presidential campaign of Theodore Roosevelt in 1912; he included in his Progressive ("Bull Moose") platform a call for "health insurance for industry" that would guarantee coverage for working Americans. He lost the election to Woodrow Wilson.That

REFERENCES

1 +
Weeks L, Berman HJ. Shapers of American Health Care Policy: An Oral History . Ann Arbor, Mich: Health Administration Press; 1985;.
2 +
Starr P. The Social Transformation of American Medicine . New York, NY: Basic Books; 1982;.
3 +
Harris R. A Sacred Trust . New York, NY: New American Library; 1966;.
4 +
Campion FD. The AMA and U.S. Health Policy Since 1940 . Chicago, Ill: Chicago Review Press; 1984;.
5 +
Friedman E. The Problems and Promises of Medicaid . Chicago, Ill: American Hospital Association; 1977;.
6 +
Fishbein M.  The Committee on the Costs of Medical Care. JAMA . 1932;; 99:1950-1952.
7 +
Public Law 89-97, Health Insurance for the Aged and Medical Assistance. 89th Congress, HR 6675, July 30, 1965.
8 +
Williamson K.  Medicare: vast new resource in health and welfare. Hospitals . 1965;;39:30.
9 +
Sanazaro P.  Federal health services R&D under the auspices of the National Center for Health Services Research and Development.  In: Flook EE, Sanazaro P, eds. Health Services Research and R&D in Perspective . Ann Arbor, Mich: Health Administration Press; 1973;.
10 +
DeLew N.  The first 30 years of Medicare and Medicaid. JAMA . 1995;;274:262-267.
11 +
Vladeck BV, King KM.  Medicare at 30: preparing for the future. JAMA . 1995;;274:259-262.
12 +
Rowland D.  Medicaid at 30: new challenges for the nation's health safety net. JAMA . 1995;;274:271-273.
13 +
Cohen W.  Experience teaches that NHI will be gradual: what I have learned.  In: Spiegel AD, ed. The Medicaid Experience . Germantown, Md: Aspen Systems Corp; 1979;.
14 +
Friedman E.  'An honest broker' for fine-tuning Medicare. Hospitals . 1984;; 58:102-105.
15 +
Rowland D.  Report from the front line: successes, limitations, and lessons learned from Medicaid.  In: Beyond Medicaid: Building a Health Care System for All Ages . Proceedings of a conference held June 10-11,1991, Washington, DC. Washington, DC: Generations United; 1991;.
16 +
Friedman E.  What Medicaid and Medicare did—and did not—achieve. Hospitals . 1985;;59:41-42.
17 +
Friedman E.  Private black hospitals: a long tradition faces change. Hospitals . 1981;;55:65-68.
18 +
Friedman E.  Medicare and Medicaid at 25. Hospitals . 1990;;64:38-54.
19 +
Levinsky NG, Rettig RA.  The Medicare end-stage renal disease program: a report from the Institute of Medicine. N Engl J Med . 1991;;324:1143-1148.
20 +
Friedman E.  Rationing and the identified life. Hospitals . 1984;;58:68.
21 +
Levinsky N.  The organization of medical care: lessons from the Medicare end stage renal disease program. N Engl J Med . 1993;;329:1395-1399.
22 +
Fox RC, Swazey JP. The Courage to Fail . 2nd ed. Chicago, Ill: University of Chicago Press; 1978;.
23 +
Friedman E. The power of physicians: autonomy and balance in a changing system. Paper delivered for the National Health Policy Forum 'Sages' series, Washington, DC, December 2, 1994. Washington, DC: National Health Policy Forum; 1995.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Weeks L, Berman HJ. Shapers of American Health Care Policy: An Oral History . Ann Arbor, Mich: Health Administration Press; 1985;.
2 +
Starr P. The Social Transformation of American Medicine . New York, NY: Basic Books; 1982;.
3 +
Harris R. A Sacred Trust . New York, NY: New American Library; 1966;.
4 +
Campion FD. The AMA and U.S. Health Policy Since 1940 . Chicago, Ill: Chicago Review Press; 1984;.
5 +
Friedman E. The Problems and Promises of Medicaid . Chicago, Ill: American Hospital Association; 1977;.
6 +
Fishbein M.  The Committee on the Costs of Medical Care. JAMA . 1932;; 99:1950-1952.
7 +
Public Law 89-97, Health Insurance for the Aged and Medical Assistance. 89th Congress, HR 6675, July 30, 1965.
8 +
Williamson K.  Medicare: vast new resource in health and welfare. Hospitals . 1965;;39:30.
9 +
Sanazaro P.  Federal health services R&D under the auspices of the National Center for Health Services Research and Development.  In: Flook EE, Sanazaro P, eds. Health Services Research and R&D in Perspective . Ann Arbor, Mich: Health Administration Press; 1973;.
10 +
DeLew N.  The first 30 years of Medicare and Medicaid. JAMA . 1995;;274:262-267.
11 +
Vladeck BV, King KM.  Medicare at 30: preparing for the future. JAMA . 1995;;274:259-262.
12 +
Rowland D.  Medicaid at 30: new challenges for the nation's health safety net. JAMA . 1995;;274:271-273.
13 +
Cohen W.  Experience teaches that NHI will be gradual: what I have learned.  In: Spiegel AD, ed. The Medicaid Experience . Germantown, Md: Aspen Systems Corp; 1979;.
14 +
Friedman E.  'An honest broker' for fine-tuning Medicare. Hospitals . 1984;; 58:102-105.
15 +
Rowland D.  Report from the front line: successes, limitations, and lessons learned from Medicaid.  In: Beyond Medicaid: Building a Health Care System for All Ages . Proceedings of a conference held June 10-11,1991, Washington, DC. Washington, DC: Generations United; 1991;.
16 +
Friedman E.  What Medicaid and Medicare did—and did not—achieve. Hospitals . 1985;;59:41-42.
17 +
Friedman E.  Private black hospitals: a long tradition faces change. Hospitals . 1981;;55:65-68.
18 +
Friedman E.  Medicare and Medicaid at 25. Hospitals . 1990;;64:38-54.
19 +
Levinsky NG, Rettig RA.  The Medicare end-stage renal disease program: a report from the Institute of Medicine. N Engl J Med . 1991;;324:1143-1148.
20 +
Friedman E.  Rationing and the identified life. Hospitals . 1984;;58:68.
21 +
Levinsky N.  The organization of medical care: lessons from the Medicare end stage renal disease program. N Engl J Med . 1993;;329:1395-1399.
22 +
Fox RC, Swazey JP. The Courage to Fail . 2nd ed. Chicago, Ill: University of Chicago Press; 1978;.
23 +
Friedman E. The power of physicians: autonomy and balance in a changing system. Paper delivered for the National Health Policy Forum 'Sages' series, Washington, DC, December 2, 1994. Washington, DC: National Health Policy Forum; 1995.

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