This is an archive page. The links are no longer being updated.
REMARKS BY: DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES PLACE: Medicare Anniversary, Washington, D.C. DATE: July 12, 2000
In 1949, he introduced into Congress the very first national health care bill specifically targeted to senior citizens-called "Post Hospital Care for the Aged." Unfortunately, the landmark bill received little support, and Humphrey would have to wait many long years to see his dream become reality.and his vision become law. He would have to wait until America was immersed in the promise and potential of President Lyndon Johnson's "Great Society." He would have to wait for victory in a slow-and often difficult- political battle. He would have to wait until July 30, 1965. On that date, President Johnson traveled to the Truman Library in Independence, Missouri to sign the Medicare Bill into law.to change forever what it means to be elderly and disabled in America.and to prove that our nation can be good as well as great.
Although Humphrey's dream of medical care for the elderly and disabled culminated on that humid July day, the story of Medicare-its journey from idea to institution-is deeply rooted in the politics and policies of the twentieth century. So it's only fitting that on this, Medicare's 35th Anniversary, we briefly pause to reflect on the journey that we celebrate today.
During the darkest days of the Great Depression, President Franklin Roosevelt understood that too many Americans were not only ill-housed and ill-fed-but just plain ill. That's why, during the 1930's, FDR supported the principle of national health insurance. But it was Roosevelt's successor-Harry Truman- who truly raised the banner of national health insurance by becoming the first President to publicly endorse-and passionately fight for-such a program. To paraphrase what President Johnson said during the signing ceremony, Harry Truman did more than give his opponents hell-he gave the American people hope. Unfortunately, the time wasn't right, and Truman would later recall that his biggest disappointment as President was his failure on national health insurance. But if he had lost the battle-the war was far from over.
Social Security expert Wilbur Cohen-a future Secretary of Health, Education and Welfare-and other Truman Administration officials, began to focus on the needs of the elderly. Back in 1934-when Cohen was only out of the University of Wisconsin a few months-he had helped draft the original Social Security Act. Cohen speculated that many seniors-who had the least resources but the most health care needs- were facing a gradual decline into a twilight existence of illness and isolation. Under his leadership, the Truman Administration came up with a new and fairly radical idea: Guaranteed hospital care for everyone on Social Security. Cohen called it "America's form of national health insurance." A bill-which certainly would have passed Hubert Humphrey's moral test-was drafted and filed in Congress in 1952. The road to Medicare was now paved.
Over the next twelve years-with Wilbur Cohen serving as its faithful guardian-the Medicare bill evolved and changed. Both President Kennedy and President Johnson dedicated themselves to its passing-and to ensuring that not a single elderly person suffered the indignity and infirmity of an untreated illness. Finally, with the support of compassionate and courageous individuals in Congress-including another future HHS Secretary, then Senator Richard Schweiker-the spark that Harry Truman and Hubert Humphrey first ignited became a beacon of hope for every senior citizen.
It must have been a bittersweet victory for the "Man from Independence" when President Johnson signed the Medicare bill in Truman's presence-and handed him and Mrs.Truman Medicare Cards Number One and Two. Musing about the long road that brought them to that day, Johnson would remark during the signing ceremony that, "We marvel not simply at the passage of this bill.what we marvel at is that it took so many years to pass it."
The difficulty of Medicare's journey can only be matched by the difference Medicare has made in the lives of the elderly and disabled. The phenomenal difference it made reminds me of a story about the famous writer, Somerset Maugham. Maugham was asked to address a group on his 80th birthday. When the author was introduced, he began by saying, "Old age has many benefits." And he suddenly stopped. Maugham looked around. He fidgeted. He sipped some water. At last, he said slowly and dryly, "Old age has many benefits.I'm just trying to think of some."
Maugham was trying to be funny. But when he made that remark a half century ago-as many of our centenarians can attest-there was a sad ring of truth in his words. At the time, growing old meant poverty. Growing old meant disability. And growing old meant going without health insurance. In 1964, only 50 percent of America's seniors had insurance for hospital care. Too many had to choose between saving their health-or spending all they had saved. Too many had to watch the spark of hope fade as they sank into the darkness of poverty. And too many had to bear the pain of an untreated illness-and a seemingly uncaring nation. They were members of our "Greatest Generation"-the one that restored the American dream and destroyed the Nazi nightmare-yet our country seemed to quietly forget about their sacrifices and service.
At the time, the lives of millions of older America seemed scripted for an unhappy, undignified ending, but, then-with a stroke of President Johnson's pen-the script was totally re-written. As Senator Russell Long of Louisiana commented during the Congressional Medicare debate on July 6, 1965: ".the pending [Medicare] bill will be the largest and most significant piece of social legislation ever to pass the Congress in the history of our country. It will do more immediate good, for more people, who need the attention of their government, than any bill that Congress has ever enacted." He couldn't have been more right.
Since 1965-largely thanks to Medicare-access to health care for seniors has increased by one-third.the poverty rate has dropped significantly.and older Americans are enjoying not just more years in their lives-but more life in their years.
Additionally-since 1972-the promise of Medicare has also included Americans with disabilities, and those with end-stage renal disease. By improving access to health care, financial security, and overall quality of life for the disabled, Medicare helped ensure that no American was left out.left behind.or left on the sidelines.it cast the light of national concern on those who-for too long-had lived in the shadows of our national consciousness.and it made the American dream more accessible for those with disabilities. The number of the disabled enrolled in Medicare has grown from two million in 1972-to more than five million today. And over the life of the program, more than 93 million Americans- including almost 10 million with disabilities- have been able to access the humanity and healing of modern medicine.and bring our nation a little closer to passing Humphrey's moral test.
But anniversaries are not only a time for celebration-they're also a time for reflection. So today we need to examine not only Medicare's past-but its future. The great New York Times reporter, Max Frankel, happened to be present at the signing ceremony in 1965. Shortly after Johnson put down his pen, Frankel approached the President and said, "My mother thanks you." "No," Johnson replied, "It is you who should be thanking me."
Johnson was referring to the fact that-thanks to Medicare-young families and young people would no longer have to bankrupt their own savings-and dreams-providing for the medical needs of older family members. But I think Johnson meant something more. He understood that Medicare is a living program- one whose promise will be just as important for each succeeding generation of Americans. But if we are to keep that promise for future generations-for our children and grandchildren-then we must continue to strengthen and modernize Medicare. My extraordinary predecessor, John Gardner-HEW Secretary during the height of Johnson's Great Society-certainly understood this when he noted, "Medicare was a great turning point.but it has to be continually revised."
A program designed for the 20th century must be reinvented for the 21st century. That's exactly what we've been trying to do for the past seven-and-a-half-years. Because of President Clinton's economic and health care policies, we extended the life of the Medicare Trust Fund for 26 years-until 2025. We launched the biggest crackdown on fraud, waste and abuse in Medicare's history-and restored over two billion dollars to the Trust Fund. In October, the Work Incentives law the President signed lets people with disabilities work and keep their Medicare for eight-and-a-half-years-This is a good first step-but we've proposed to extend their benefits for life. We've strengthened Medicare's management.we've modernized our payment system-and-perhaps most important-we've added new preventive benefits.
We all know that disease prevention and early detection can substantially reduce life-threatening illness. That's why the President worked with Congress to add several new preventive benefits to Medicare, including mammograms; bone density measurements; flu and pneumonia shots; colorectal cancer screenings and glucose monitoring for diabetics. These new benefits are helping prevent and detect diseases at early stages-when they're most treatable.and they're helping to reinvent Medicare for the 21st century.
To complement these benefits, today I'm pleased to announce our new "Smoking Cessation Project." This program will test specific strategies to help older Americans in selected states quit smoking-and the information we gather could lead to a smoking cessation benefit in the Medicare program. Additionally, I'm also happy to kick-off the second year of "Screen for Life"-our national colorectal cancer action campaign. Colorectal cancer is the second leading cause of cancer deaths among Americans. The ultimate message of our campaign is that it doesn't have to be. Colorectal cancer screening saves lives-and Medicare can help pay for the test.
Of course, if we truly want to ensure the promise of Medicare for future generations-if we truly want to modernize the program-then we must still add the one benefit that has become an essential element of high-quality medicine: prescription drugs. When Medicare was created, no one could have imagined the role that prescription drugs would eventually play in modern medicine. I don't have to tell you that medications are as important today as hospital care was in 1965. We need an affordable, accessible, comprehensive prescription drug benefit-and we need a drug benefit now. I can think of no better-no more fitting way-to honor Medicare's 35th anniversary.and to fulfill Hubert Humphrey's moral test.
The addition of a prescription drug benefit will undoubtedly enhance the promise of Medicare. It's a promise that we-as a nation-cannot break. Harry Truman himself certainly understood the importance of Medicare to our country when he commented, "this signing of the Medicare bill.puts this nation where it needs to be-to be right."
Truman, and the heroes of '65 knew that Medicare-along with Social Security-would be the twin pillars supporting the true equality of all Americans. Truman and the heroes of '65 knew that Medicare proved not how good we are-but how good we can be. Truman and the heroes of '65 knew that Medicare-by promising the best health care in the world for older and disabled Americans-advanced the very promise of America itself. And, above all, Truman and the heroes of '65 knew that Medicare confirmed the greatness of America. It confirmed that we, as a nation, would never turn our heads away from those who were sick or suffering.That we would never refuse to extend a helping hand to the helpless.And that we would heed the words of Hubert Humphrey and never harden our hearts to those who are living in the dawn, in the twilight, or in the shadows of life.
To Hubert Humphrey, Harry Truman, Lyndon Johnson and all the heroes of Medicare, my mother thanks you-and I thank you.