Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care

393 Pages·2016·2.13 MB·English

by  Alan B. Cohen

MEDICARE AND
MEDICAID AT 50
President Lyndon B. Johnson signing Medicare and Medicaid into law on July 30,
1965 at the Harry S. Truman Library in the presence of former President Truman,
former First Lady Bess Truman, Vice President Hubert H. Humphrey (right), and
First Lady “Lady Bird” Johnson (left).
M E D I C A R E A N D
M E D I C A I D   AT   5 0
AMERICA’S ENTITLEMENT PROGRAMS IN
THE AGE OF AFFORDABLE CARE
EDITED BY
ALAN B. COHEN
DAVID C. COLBY
KEITH A. WAILOO
JULIAN E. ZELIZER
1
1
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Library of Congress Cataloging-in-Publication Data
Medicare and Medicaid at 50 : America’s entitlement programs in the age of affordable care / edited by
Alan B. Cohen, David C. Colby, Keith A. Wailoo, and Julian E. Zelizer.
p. ; cm.
Includes index.
ISBN 978–0–19–023154–5
I. Cohen, Alan B., editor. II. Colby, David C., editor. III. Wailoo, Keith, editor.
IV. Zelizer, Julian E., editor.
[DNLM: 1. Medicaid—history. 2. Medicare—history. 3. Health Policy—history—United
States. 4. History, 20th Century—United States. 5. History, 21st Century—United States.
W 250 AA1]
RA412.4
368.4′200973—dc23
2014042846
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
Rashi Fein
1926–2014
This volume is dedicated to the memory of Rashi Fein, PhD, Professor of the
Economics of Medicine, Emeritus, at the Harvard Medical School. Rashi, our
longtime friend and colleague, passed away on September 8, 2014.
He was closely affiliated with the Robert Wood Johnson Foundation Scholars in
Health Policy Research Program for more than 20 years, serving as chair of the
National Advisory Committee for eight years (1994–2002). He cared deeply
about fostering the development of young scholars.
For more than six decades, from positions in the public, private, and academic
sectors, he was a prominent participant in health policy efforts, including
the development and early implementation of the Medicare and Medicaid
programs. His chapter in this volume is a fitting capstone to a stellar career
in academia and public service, and we are grateful to have his wisdom grace
these pages.

CONTENTS
INTRODUCTION: MEDICARE, MEDICAID, AND THE MORAL TEST OF
GOVERNMENT  XI
Alan B. Cohen, David C. Colby, Keith A. Wailoo, & Julian E. Zelizer
PART I
ORIGINS, VISION, AND THE CHALLENGE TO IMPLEMENTATION
1
THE CONTENTIOUS ORIGINS OF MEDICARE AND MEDICAID  3
Julian E. Zelizer
2
CIVIL RIGHTS AND MEDICARE: HISTORICAL CONVERGENCE
AND CONTINUING LEGACY  21
David Barton Smith
3
THE EARLY DAYS OF MEDICARE AND
MEDICAID: A PERSONAL REFLECTION  39
Rashi Fein
4
THE ROAD NOT TAKEN: WHAT HAPPENED TO MEDICARE
FOR ALL?  55
Jonathan Oberlander and Theodore R. Marmor
viii • CONTENTS
PART II
THE REMAKING OF VALUES, RELATIONSHIPS, AND SOCIETY
5
THE TRANSFORMATION OF MEDICAID FROM POOR LAW LEGACY
TO MIDDLE-CLASS ENTITLEMENT?  77
Jill Quadagno
6
HOW THE COURTS CREATED THE MEDICAID ENTITLEMENT  95
Sara Rosenbaum
7
MEDICARE AND THE SOCIAL TRANSFORMATIONS OF
AMERICAN ELDERS  119
Mark Schlesinger
PART III
RETRENCHMENT, REFORM, AND REACTION
8
THIRD RAIL OF POLITICS: THE RISE AND FALL OF MEDICARE’S
UNTOUCHABILITY 147
Mark A. Peterson
9
MEDICARE INNOVATIONS IN THE WAR OVER THE KEY
TO THE US TREASURY  169
Uwe E. Reinhardt
10
MEDICAID RISING: THE PERILS AND POTENTIAL OF
FEDERALISM  191
Frank J. Thompson
CONTENTS • ix
11
INDEPENDENCE AND FREEDOM: PUBLIC OPINION AND
THE POLITICS OF MEDICARE AND MEDICAID  213
Andrea Louise Campbell
PART IV
THE ROAD TO AFFORDABLE CARE
12
THE ERA OF BIG GOVERNMENT: WHY IT NEVER ENDED  233
Keith A. Wailoo
13
THE MISSING PIECE: MEDICARE, MEDICAID, AND
LONG-TERM CARE  253
Judith Feder
14
FROM SERVANT TO MASTER TO PARTNER?: MEDICARE, COST
CONTROL, AND THE FUTURE OF AMERICAN HEALTH CARE 273
Jacob S. Hacker
PART V
LOOKING AHEAD
15
MEDICARE IN AMERICAN POLITICAL HISTORY: THE RISE AND
FALL OF SOCIAL INSURANCE  297
James Morone and Elisabeth Fauquert
16
BUILT TO LAST?: POLICY ENTRENCHMENT AND REGRET IN
MEDICARE, MEDICAID, AND THE AFFORDABLE CARE ACT 319
Paul Starr