By R.C. Braun, MD

In 1935 President Franklin D. Roosevelt signed into law the bill establishing the Social Security Administration. It was bitterly opposed by many as an intrusion of government into the lives of private citizens. As originally envisioned it was a very imperfect and incomplete plan, with many defects. Many millions of needy citizens were not included.

There have been many changes in Social Security since 1935. For the most part, these have been positive changes such as adjusting costs and benefits and including more people. This has been an ongoing evolution. Still today there are imperfections and inequalities, such as the lower contribution rates for the wealthy.

There are still some people who oppose Social Security and say: “I don’t need it and I don’t want it.” But the vast majority of senior Americans are dependent on it. It has made life easier for our entire society. Very few people today would agree to its abolition.

In 1965, President Lyndon Johnson signed into law the establishment of Medicare, to provide access to affordable health care for seniors and persons with disabilities. Again it was opposed by many, and there were attempts to repeal it. This program also has gone through many changes since 1965, some to make it more efficient, or to add benefits, some to lower costs. And there have been recognized abuses and wastes.

Nevertheless, Medicare has been remarkably effective in bringing access to health care to millions of persons who otherwise would have had to do without care. The increasing life expectancy of Americans is the lasting legacy of Medicare.

However there are still many who grumble about Medicare. Even persons who use and benefit from Medicare complain: “Get the government out of our lives!” However today it would be hard to imagine what life would be like for many persons without Medicare.

Is history repeating?

On March 23, 2010 President Barak Obama signed health care reform into law -- the Patient Protection and Affordable Care Act. Again, this was a very controversial act, fraught with omissions, ambiguities, inconsistencies, and concessions to special interests. Again there has been talk of repeal, or of opting out of its provisions.

But passage of this bill came after many years of almost universal recognition of the serious inadequacies and injustices of our health care system, and after a number of failed efforts at reform by Congress. There has been great pressure on Congress to simply JUST DO SOMETHING!

The major opposition to this bill has been spearheaded by businesses in the health care field which anticipate losing some of their enormous profits, especially the drug and health insurance industries. Major concessions have been made in an attempt to keep them “on board,” but the handwriting is on the wall. They recognize that their dominant role in controlling health care in this country will necessarily and inevitably diminish.

As with Social Security and Medicare, we can anticipate many changes in the present health reform legislation, changes which will modify, clarify, and improve its provisions for the betterment of our health and our country.
Braun is a medical doctor in Pleasant Hill.
Copyright (C) 2010 by Tennessee Editorial Forum. 8/10