Medicare's Birthday: A Time to Remember a Civil Rights Trifecta

The Disease Management Care Blog is celebrating the 45th birthday of Medicare - and not because, thanks to the taxpayers and the kind folks at CMS, it has spent a lot of the government's money.

Readers may recall that it was signed into law by President Johnson as part of the Social Security Act of 1965. While other bloggers have used the date as an another excuse to recycle their opinions on the merits of Washington's expanding role in health care, the DMCB wanted to point out an enormous and underrecognized benefit of Medicare. It's in the area of civil rights.

After World War II, it was the armed forces in 1948 that, under President Truman's tenure, helped lead the way in desegregation. That not only led to a more effective fighting force, but was a watershed event in the welcoming of persons of color into the bounty of American society. Another major step forward in the area of education happened in 1955, when "separate but equal" segregation in our public schools was ended with the Supreme Court's Brown v. Board of Education of Topeka decision.

What few realize a trifecta in health care happened a few years later in the 1960's. With the passage of the Civil Rights Act in 1964, Title VI specifically prohibited all forms of discrimination in health care institutions without regard to their "race, creed, color, or national origin." Until Medicare kicked in in 1965, that's exactly what was going to continue in many of our nation's hospitals. In order to be able to participate in Medicare, 7000 hospitals had to become compliant with Title VI. They quickly fell into line. You can read about the massive undertaking by the newly appointed cabinet Secretary and what it took to succeed in this remarkably detailed article by Preston Reynolds that was published in the American Journal of Public Health back in 1997.

Happy Birthday Medicare!