Politics and health care share a long history
November 2018 Dallas Medical Journal 3
President’s Page
S
Since the beginning of time, politics and health care have
walked hand in hand. This is true in the United States and
in every other nation in the world. So, it should not be a
shock to taxpayers that changes in the political leadership
in our country will result in changes to the structure and
direction of the healthcare system. Although the goal
of some of these changes is to improve services, many
are solely for political goals. With this, we have lost the
essence of why a healthcare system was created.
The History
President Teddy Roosevelt introduced the concept of
health care and a national health insurance system
when he was running for the presidency in 1912. Not
much happened for many years until Harry S. Truman
became president and proposed to Congress a national
health coverage plan for all individuals. In his message
to Congress in November 1945, he said every American
should have the right to adequate medical care. In a
follow-up message to Congress about health and disability
insurance in May 1947, he began with, “Healthy citizens
constitute our greatest national resource.” In addition,
“The welfare and security of our nation demand that the
opportunity for good health be made available to all,
regardless of residence, race or economic status.”
But it was not until 1965 that the beginning of our
healthcare system became real. On July 30, 1965,
President Lyndon B.
Johnson signed HR
6675 in Independence,
Missouri. At that time,
former President Truman
was issued the first
Medicare card. Medicare
and Medicaid were
enacted as Title XVIII
and Title XIX of the Social
Security Act and included
healthcare coverage for
all Americans who were
at least 65 years old. With
this act, Medicare became
the largest insurance
company in the nation.
President Johnson signs the bill establishing Medicare and
Medicaid on July 1965.
Since then, Congress has enacted several major changes
in the Medicare and Medicaid system, changing the
direction and improving coverage of services. These major
changes have included coverage for individuals with some
long-term disabilities, the addition of Medicare Advantage
programs, prescription drug coverage, and the Affordable
Care Act of 2010, moving the needle closer to a valuebased
system.
So, where are we now? Where do we go? It is obvious
that we never will be able to separate politics from
health care, but we should look at the opportunities this
presents. Transformational changes always take time. As
physicians, our highest priority should be on patient care.
We should not wait for people in Washington to find all
the answers. They do not have them — it’s that simple.
We can work together to improve our healthcare
system. Our leaders need us, whether they acknowledge
this or not, and we need them. On Nov. 6 we will
elect leaders for our nation. It is our responsibility as
physicians to elect leaders who follow some of the same
pathways as were blazed back in 1945 — leaders who
show they can work across party lines and collaborate
with each other. As consumers of this health care, we
have many things in common, despite our political
preferences. We need politicians who can change their
attitudes and support what is necessary. Elect candidates
who support improving our healthcare services and
making health care affordable for all. Our leaders must
understand the issues and be willing to find options. We
Ruben L. Velez, MD can do this. Let’s move on. DMJ