Medicare history dates back to 1945 when President Harry Truman first asked Congress to establish a national health insurance scheme. His plan was for all people to receive comprehensive and prepaid medical insurance through the Social Security System. As the years passed, the field of recipients was narrowed until it was only social security recipients who stood to benefit. When it was discovered that only 56% of people aged 65 or older had health insurance, President John F. Kennedy lobbied for health insurance for the aged.
However, the Medicare program provision of social health care for the poor and aged did not become law until 1965. On July 30 President Lyndon Johnson signed Medicare and Medicaid into law as part of his "Great Society" and ex President Truman was the first person to receive a Medicare card in recognition of his role in establishing the program. Approximately 19 Million people enrolled in the system during the first year.
Over the years, there have been several key developments and changes during Medicare history in the US. In 1972 changes to the system were expanded to cover two high risk groups. These were disabled persons 65 and under who had been receiving cash benefits for 24 months, and persons with end stage renal disease. The Medicare services were also expanded to include speech therapy, some chiropractic services, and physical therapy. The Supplemental Security Income program was established and those recipients became automatically eligible for Medicare.
In 1983 a prospective payment system was introduced and most federal civilian employees were now covered. By 1984 remaining federal employees, including the President, were covered. In 1986 hospice benefits were made permanent and in 1988 there was a major overhaul of the entire Medicare and Medicaid system so that prescription drugs were covered; this was repealed in 1989. 1992 physician services based on fee schedule were added and in 1997 Medicare+Choice was enacted before being refined in 1999.
The next major overhaul of the Medicare system was when George W. Bush signed the Medicare Prescription Drug Improvement and Modernization Act into Law on December 8 2003. This was a landmark legislation that offered better benefits, prescription drug benefits, and increased health care choices for seniors and people living with disabilities.
Changes made in 2005 impacted on eligibility requirements and the Deficit Reduction Act now requires that anyone seeking to claim Medicare has to prove they are a United States citizen or resident alien. In 2006 the voluntary Part D outpatient prescription drug benefit was made available to people with private drugs plans and Medicare Advantage Plans.
During his election campaign in 2008 Barack Obama called for further reforms of the Medicare system to guarantee coverage irrespective of health status, as well as introducing uniform premiums not dependent on income. In 2009 Barack Obama instigated some further reforms to the system to extend coverage to millions more children. On March 23 a health care reform bill was signed into law by President Obama.
Despite the checkered Medicare history, in the US today the scheme is the biggest source of funding for medical and health related services for people living on a low income in the US. With a rapidly aging population, the scheme's nursing home coverage is expanding at a huge rate, which could prove problematic to future federal and state budgets.
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