Medicare turns 50

With the stroke of the pen LBJ gets health insurance to half of all Americans over sixty-five. Dr. Richard Castriotta with UT Health/Memorial Herman Hospital says it' was nothing less than a seismic shift in our society.

"It is a big anniversary that more people should make note of I think."

Before LBJ signed Medicare into law life expectancy was 78 for men and 82 for women. Now it's eighty-four for  men and eighty six years for women.  That's a pretty big deal right there, but Dr. Castriotta says that's not all it accomplished.

"Medicare might have been the single most important step in integrating our society. It certainly integrated out health care."

Here's why: Written into the law was a provision that federal money could not be spent in any way that would discriminate.

Passage of the law was not easy. Truman tried and failed. There was push back from the American Medical Association, and then-actor Ronald Reagan made a political spot condemning it as a step down the path to socialism.

So was desegregation the goal of the legislation or an unintended consequence?

"It was kind of a stealth consequence." says Patricia Gray the Director of  U of H's Health Law and Policy institute. She says not only were there financial incentives now to desegregate, but LBJ knew it would get less resistance than desegregating schools.

He also set up and office to enforce it, backed up by volunteers. Gray says it took a while to happen, and the struggle isn't over.

"Although health care is desegregated today, hospitals are desegregated today, nursing homes and physicians and other health care providers were not subjected to the same rules and both are still pretty much segregated today."

She also says there is still a discrepancy in outcomes, but that could be as much a consequence income disparity as race.