Congress created Medicare to provide health insurance to people age 65 and older.  Join Active Minds as we explain the history, current, and future state of this important social program.  We will cover how and why it was created, how it has evolved, significant additions (like Part D) and how it has changed as a result of the Affordable Care Act.

Key Lecture Points

  • On July 30, 1965, President Lyndon Johnson signed into law amendments to the Social Security Act, creating Title XVIII, commonly known as Medicare.  Medicare has made access to health care a right for Americans once they reach age 65, thus improving the health and longevity of older Americans.  In 1965, the average life expectancy for an American was 70.2; in 2015, it is 78.9.
  • Initially, Medicare provided for a compulsory hospital benefit (Part A) and a voluntary doctor’s office benefit (Part B). Since its establishment in 1965, Medicare has been expanded and modified significantly.  Notably, Medicare has come to cover non-elderly individuals with disabilities and it has come to cover prescription drugs (Part D).
  • While Medicare is praised as one of the most successful federal programs, it has also faced criticism as a result of the financial pressures it places upon the federal budget.  In 2014, Medicare expenditures accounted for 14% of the entire Federal Budget.  As the Baby Boom generation age into retirement at a rate of 10,000 people a day, many are concerned that Medicare funding will place an ever increasing burden upon the nation.
  • In 2010, The Affordable Care Act (ACA) directed the Centers for Medicare and Medicaid Services (CMS) implement new approaches for Medicare to pay doctors, hospitals, and other providers and to bring about changes in how providers organize and deliver care.  Since implementation of the ACA, per beneficiary spending on Medicare has gone down suggesting that the future of Medicare funding may not be as bleak as some had predicted. 

Exploration Questions

  • In what ways does the history of the Medicare program (including the way it has been altered since its inception) set the stage for the present-day challenges Medicare faces?
  • What are the advantages of having private insurers as an element of the Medicare program?  Disadvantages?

Reflective Questions

  • How has Medicare improved the quality of life for seniors?
  • Is it possible to significantly reduce Medicare fraud?

More to Explore

  • Government website on Medicare Click here
  • Kaiser Family Foundation Analysis of Medicare Click here

Books for Further Reading

  • Cohen, Alan B.  Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care.  Oxford University Press, 392 pages.  Scholars in politics, government, economics, health policy, and history offer a comprehensive assessment of the evolution of these programs and their impact on society -- from their origins in the Great Society era to the current battles over the Affordable Care Act.
    Click here to order