Politics of Federal Health Policy, 1960-75: A Perspective

Although the idea of establishing a Federal insurance program to cover the major costs of health care for the elderly was not new in the late 1950s, it was only when John Kennedy became a presidential candidate that the national debate on the issue began in earnest. But it would be almost 5 years later before the issue was finally resolved. During that 5-year period, the desirability of establishing such a program was to be a continuing debate that would be argued on broad philosophical grounds, not on the specifics of the bills introduced in Congress. The history of the actions taken, the hearings, the close votes in the Senate, and so on, has been covered in several books for those interested in that period. I do not cover all that action here. Instead, I do discuss how the committees of jurisdiction worked in early 1965 on fashioning the bill that finally became law. In this process, I concentrate more on the Committee on Ways and Means in the House than on the action in the Senate Finance Committee, primarily because Ways and Means formed the final shape of the program and secondarily because I was more closely involved with that committee during the period covered here-first as a member of the hospital insurance group in the Social Security Administration; second as the first chief of staff for the Health Insurance Benefits Advisory Council; third as a staff person in