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Health Care in the Early 1960s
Rosemary A. Stevens, Ph.D.

My topic, health care in the early 1960s, has a double set of meanings for me. I am a historian, and the 1960s are now "history," ripe for new interpretations. Yet I was also an immigrant to the United States in 1961, fresh from working as an administrator in the British National Health Service. The period immediately before the Medicare legislation in 1965 shines in my memory with the vividness of new impressions: those of a young health care student trying to make sense of the U. S. health care system, and indeed, of the United States. The health care system and the United States as a society stand, in many ways, as proxy for each other, now as then: The whole tells you much
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And I worked so hard that I have pernicious anemia, $9.95 for a little bottle of liquid for shots, wholesale, I couldn't pay for it (Subcommittee on Problems of the Aged and Aging of the Committee of Labor and Public Welfare, 1959; Corning, 1969). Members of the initial Medicare population, born in the late nineteenth century, had survived two world wars, a major economic depression, and enormous changes in the organization of work, mass production, rapid urbanization, and modern communications. As beneficiaries of the 1935 Social Security legislation, they were members of a culture of entitlement. By 1964, 83 percent of the population 65 years of age or over were eligible for Social Security benefits; and there were almost three times as many aged Social Security beneficiaries as there were 10 years earlier.' Yet before Medicare there were no entitlements ' Not all those who were eligible for benefits received them; the comparable figures were 63 percent in 1960 and 74 percent in 1964 (U.S. Department of Health, Education, and Welfare, 1965).

for the potentially catastrophic burdens of hospital and doctors' bills. Government programs were segmented into programs designed for apparently "deserving" Americans, notably veterans and Federal employees, and for different categories of the poor, State by State, who were by definition "less deserving." Social class, like race, was a topic to which
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