Medicare

"I'm against this," said the President to his advisers, "but Dick is going to have to live with it, and maybe we'd better have a look." That was a month ago, when the hot election-year winds began to fan the long-smoldering campaign for federal medical aid for the aged. Since then, under Vice President Richard Nixon's direction, the Administration has been hurriedly putting together a medical-aid program to compete with the highly publicized Democratic Forand bill (TIME, May 9), which calls for compulsory old-age medical insurance hitched to increases in the social security tax. Last week Health, Education and Welfare Secretary Arthur Flemming displayed a package neatly tagged "Medicare," which, when unwrapped, looked as much like Pandora's box as the Forand bill--if for different reasons.

Medicare met the President's two basic objections to Democratic programs: 1) it was a voluntary system, not compulsory, and 2) it put the responsibility for administration on the states and not on the social security system. It is designed to cover all persons over 65 with incomes below $2,500 for an individual or $3,800 for a married couple. Each member pays an annual $24 enrollment fee. An individual would pay the first $250 ($400 for a man and wife) of each year's medical bills. After that, Medicare would pay 80% of these services annually: 180 days of hospital care; 365 days of home care; required surgery; up to $200 for laboratory and X ray; physicians' and dentists' care; up to $350 worth of prescribed drugs; private nurses and physical-restoration treatment. Aged people on state or local relief would get all this care at no cost.

Surprised by coverage more sweeping than the Forand bill, members of the House Ways & Means Committee asked what Medicare would cost. Secretary Flemming's guesstimate: $1.2 billion annually, split fifty-fifty by federal and state governments. What would it cost by 1970? Flemming shrugged, said his staff was still calculating. "This is the worst kind of fiscal irresponsibility," cried Virginia Democrat Burr Harrison. "This Townsend Plan-Rube Goldberg scheme is more socialistic and more unsound than the Forand bill." Quipped another Democrat: "This plan calls for everything except prenatal care for persons over 65." Chairman Wilbur Mills, an Arkansas Democrat who has long supported Ike's crusades for a balanced budget, was boiling mad. So, privately, were the Administration's Treasury and Budget watchdogs ("pure politics"), who had been overruled in the intramural debate.

Some congressional Republicans, caught in the Administration's policy turnaround, said noncommittally that Medicare "deserved study." House G.O.P. Leader and Budget Crusader Charlie Halleck admitted sadly that it was a "budget buster." Arizona's Barry Goldwater raised the cry of "socialized medicine," called the plan part of a "dime-store New Deal." The American Medical Association damned it from the one side as unnecessary, while the A.F.L.-C.I.O.--which has led the political crusade for the Forand bill--damned it from the other as political. New Jersey's Democratic Governor Robert Meyner called it "absolutely stupid," and New York's Governor Nelson Rockefeller said that the states would have a hard time ever making it work. Medicare neatly defused the political bomb contained in the Forand bill. But all those who had an interest in a sound program hoped that Congress would not try to put together a slapdash measure from a number of different plans, but would wait until after the election.

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