Medicare and Medicaid evolved in dramatically different ways. Medicare, which provided health coverage for seniors, became the third rail of American politics. Medicaid, a state-based program that provided health coverage for the poor, existed in a political netherworld. All that is about to change.
While politicians debate the future of Medicare and Medicaid, few question that those programs are here to stay. It's easy to forget how controversial the idea of government healthcare programs was for most of the 20th century, and how many decades it took to enact the programs.
Medicare and Medicaid have precipitated the vast expansion—and even the creation—of many profitable industry sectors including hospitals, physician groups, managed-care insurers, home health, drug manufacturers, devicemakers and others.
Before Medicaid was established, low-income Americans had limited access to healthcare, relying heavily on charity care and public hospitals. "To be old and poor and sick was to suffer and to die prematurely,” said Trish Riley of the National Academy for State Health Policy.
Modern Healthcare has documented every Medicare and Medicaid milestone and challenge since Crain Communications purchased the magazine in 1976. This section commemorates the programs' 50th anniversary by providing some history and an overview of their challenges.
Douglas Holtz-Eakin, president of the American Action Forum and a former Congressional Budget Office director, writes that Medicare and Medicaid have an obligation to provide high-quality care to America's seniors and low-income beneficiaries, and they must be made financially sustainable.
Georgetown University professor and former HHS official Judy Feder writes that the 50th anniversary of Medicare and Medicaid enactment calls for a celebration. Medicare provides health insurance protection to virtually all older Americans and many workers who become disabled.
