Medicare celebrates 50th anniversary of bill signing
Fifty years ago, Americans were sharply divided on the bill that would provide health insurance to the elderly. Some groups thought it would cost too much. While others thought it didn't do enough. And some groups feared the possibility of socialized medicine. This bill was as hotly debated in its day as the Affordable Care Act was in 2010.
At that time, most in Congress believed the need was real. The number of Americans older than age 65 had increased from 3 million in 1900 to 15 million in 1950, according to the U.S. Census Bureau. Sadly, this group was the nation's poorest, with two-thirds having an income of less than $1,000 a year.
Only one in eight of America's elderly could afford health insurance.
This generation had started working during the Great Depression, when 70 percent of North Dakotans received some form of public assistance. They endured the hardships of World War II. Many of them had no big nest eggs. A hospital stay could wipe out their financial savings.
Many physicians weren't paid for services to the elderly because the elderly didn't have the money. Even so, the American Medical Association fiercely fought the legislation, fearing socialized medicine.
On July 30, 1965, President Lyndon B. Johnson signed Medicare into law. As a result, elderly Americans, including many North Dakotans, were now able to receive health insurance that they previously could not afford.
Uncertainty prevailed. Physicians and hospitals in North Dakota and nationwide wondered how the new law would affect them, how they would be paid and how long it would take to receive payment. With Medicare, they were now expected to submit insurance claims and needed to add staff to handle the paperwork. They, in turn, passed that cost to their patients through higher charges.
BCBSND was selected to administer Medicare in North Dakota and proudly processed North Dakota's first Medicare claim in 1966. The work was labor and paper intensive. Staff processed claims once a week by key-punching them. Notes were painstakingly copied from one piece of paper to the next. A total of 14,568 claims were processed in fiscal year 1966. Thanks to advances in technology, the process improved throughout the years. In 2001, BCBSND formed a subsidiary, now known as Noridian Healthcare Solutions, to handle the Medicare workload.
No doubt, Medicare has helped people 65 and older to get the health care they need throughout the years. Today, more than 110,000 North Dakotans receive health care services through Medicare.
You can learn more about the Medicare controversy in the 2004 article titled "Medicare: A look back to 1965" which was published in BCBSND's Healthcare Discussions magazine.