Just for the Record

For more than two decades, Congress has been wrangling about federal medical care for the aged. In his 1960 campaign, John Kennedy vowed without qualification that his Administration would persuade a Democratic Congress to pass a medicare bill, to be financed under the social security system. But Kennedy reckoned without the opposition of Arkansas' Democratic Representative Wilbur Mills. Mills was not against medicare itself, but he certainly was against any sort of program that would--as he thought--wreck the sound financing of the whole social security program. And as chairman of the House Ways and Means Committee, Mills could and did prevent passage of the Kennedy program.

Prognosis: Poor. This year, previewing the national campaign, Lyndon Johnson was painfully aware that Kennedy's medicare pledge remained unfulfilled. If for nothing but the record, he had to make one last, desperate try. Last week he did. In the Senate, Administration forces won approval of a social security-financed medicare plan by a nip-and-tuck vote of 49 to 44. But the prognosis for House approval of the Senate's action was poor.

As passed by the Senate, and attached to a House-approved bill raising social security taxes and benefits for 20 million Americans, the plan calls for: 1) hospitalization for those over 65, ranging from 45 to 180 days a year, at a total cost to the patient ranging from nothing to $92.50 annually; 2) nursing-home care up to 60 days without cost; 3) home visits by nurses, therapists and other specialists, except physicians, up to 240 times a year without cost; 4) outpatient diagnostic services, with the patient liable only for the first $20 cost in each 30-day period; and 5) a plan under which those on social security who care to may pay about $2 a week for a private insurance plan providing medical and surgical care by physicians of their own choice. To pay for the program, the Senate voted to raise the social security tax, paid half by the employer, half by the employee, from the present 7.25% to 10.4% of salary.

Tame Republicans. As usual, the Senate's lopsided Democratic majority could not impose its will without help from tame Republicans. Joining 44 Democratic Senators in voting for the medicare package were New York's Jacob Javits and Kenneth Keating, New Jersey's Clifford Case, Maine's Margaret Chase Smith, and California's Thomas Kuchel. Voting no were 16 Democrats--all Southerners, with the exception of Ohio's Frank Lausche--and 28 Republicans, including G.O.P. Presidential Nominee Barry Goldwater, who flew in from Phoenix to cast his "nay," then flew out again.

Now the plan goes to a House-Senate conference, where Old Medicare Foe Mills will probably thwart the Administration's plans. Even so, Candidate Johnson will be sure to blame Republicans during the next few months.

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