Table of Contents

Appendix A: Chronology of Significant Events Leading to Enactment of Medicare 1883 German national compulsory health insurance program enacted. 1902 First U.S. workmen's compensation law enacted (later declared unconstitutional). 1906 American Association for Labor Legislation (AALL) founded (disbanded in 1942). 1908 Workmen's compensation system established for Federal employees. 1911 British National Health Insurance program enacted. 1912 Social insurance, including health insurance, endorsed in platform of Progressive Party and espoused by its candidate, Theodore Roosevelt. December. Social Insurance Committee created by the AALL. 1913 AALL Social Insurance Committee report favors State-run compulsory health insurance. June. AALL sponsors First National Conference on Social Insurance, in Chicago. 1915 November. A "standard" health insurance bill is published for State consideration, by AALL. 1916 Congressional hearings on health insurance. December. American Medical Association (AMA) Social Insurance Committee, headed by Dr. Alexander Lambert, recommends compulsory, State-run health insurance.. 1917 June. AMA House of Delegates passes resolution stating principles to be followed in Government health insurance plans. October. War Risk Insurance Act. 1918 First Federal grants to States for public health services. November. California voters defeat a referendum to permit establishment of a State health insurance plan. 1919 April. New York State Assembly defeats a health insurance bill previously approved by the State Senate. 1920 AMA House of Delegates reverses position, declaring itself in opposition to Government health insurance. 1921 Sheppard-Towner act, providing Federal subsidies for State-run child and maternal health programs, enacted. 1927 Committee on the Costs of Medical Care established by several foundations to make comprehensive study of medical economics. 1929 Precursor of Blue Cross established at Baylor University. June. Sheppard-Towner act is allowed to expire. 1932 American Federation of Labor (AFL) endorses social insurance. October. Committee on the Costs of Medical Care final report endorses group practice and voluntary health insurance. 1933 Private hospital insurance approved by American Hospital Association (AHA), leading to establishment of Blue Cross. Federal Emergency Relief Administration (FERA) provides emergency medical care to the needy. 1934 June 29. Committee on Economic Security created by President Roosevelt. 1935 January 17. Report of the Committee on Economic Security sent to Congress without health insurance recommendations, but spelling out principles and promising further efforts to evolve a plan. February. AMA House of Delegates meets for "emergency" session. June. Health report of Committee on Economic Security, "Risks to Economic Security Arising Out of Illness," filed but not published. July 15. First Government health insurance bill introduced in Congress, the "Epstein bill" (S. 3253) sponsored by Senator Capper. August 14. Social Security Act signed into law; health insurance excluded. August 15. President Roosevelt announces formation of Interdepartmental Committee to Coordinate Health and Welfare Activities. First National Health Survey begun. 1937 Technical Committee on Medical Care established under Interdepartmental Committee. 1938 February. Report of the Technical Committee on Medical Care, A National Health Program, published. July 18-20. National Health Conference convened in Washington, D.C., under sponsorship of Interdepartmental Committee. 1939 February 28. Senator Robert F. Wagner introduces "National Health Bill" (S. 1620) incorporating recommendations of National Health Conference. AMA establishes "National Physicians' Commit-tee for the Extension of Medical Service" to fight Wagner bill. April 29-July 13. Hearings on Wagner bill; proposal dies in committee. 1942 Representative Thomas Eliot introduces a precursor of National Health Insurance (H.R. 7534). November. Beveridge Report advocates a comprehensive social welfare system for Britain. 1943 January. President Roosevelt, in his state of the Union message, calls for social insurance "from the cradle to the grave." March. Emergency Maternity and Infancy Care program (EMIC) enacted by Congress to provide health benefits for dependents of low-ranking servicemen. June 3. Original Wagner-Murray-Dingell bill, providing for comprehensive health insurance under social security (S. 1161 and H.R. 2861) introduced. Congress takes no action on proposal. 1944 January 11. President Roosevelt outlines in his state of the Union message an "economic bill of rights," including "the right to adequate medical care and the opportunity to achieve and enjoy good health." January 19. The Social Security Board, in its eighth annual report to Congress, specifically calls for compulsory National Health Insurance as part of the social security system. 1945 January 6. President Roosevelt in his state of the Union message again makes reference to the right to "good medical care" but again no specific recommendations are made. The California legislature defeats Governor Warren's State compulsory health insurance proposal. November 19. President Truman sends health message to Congress. Revised Wagner-Murray-Dingell bill (S. 1606 and H.R. 4'730) providing for National Health Insurance immediately introduced. 1946 May 3. Taft-Smith-Ball bill (S. 2143), authorizing grants to States for me.dical care to the poor, introduced as an alternative to administration bill; no action taken on either bill. Committee for the Nation's Health organized to promote Wagner-Murray-Dingell bill. Hill-Burton Hospital Survey and Construction Act passed. 1947 May 19. President Trurnm, in another special health message to Congress, again requests a National Health Program. S. 1320 introduced by Senators Wagner and Murray; Senator Taft's bill also reintroduced (S. 545). May-July. Hearings on various health proposals. No action taken. 1948 May l-4. National Health Assembly is convened in Washington under sponsorship of the Federal Security Agency. AMA launches a "National Education Campaign against National Health Insurance proposals. 1949 April 22. President Truman, in another special message, calls again for National Health Insurance. Hearings held on the issue, but no action taken. May 31. Flanders-Ives bill (S. 1910 and H.R. 4918-4924), providing for Federal subsidies to private insurance companies, introduced. 1950 August 13. National Conference on Aging is convened by Federal Security Agency. August 28. Social Security Act amendments of 1950 include grants to States for "vendor payments" in behalf of welfare recipients. 1952 February 26. Federal Security Administrator Oscar Ewing publicly proposes enactment of health insurance for social security beneficiaries. April. Social Security Administration annual report (1951) recommends health insurance for beneficiaries. April 10. Senators Murray and Humphrey, and Representatives Dingell and Celler, introduce bills (S. 3007, H.R. 7484-5) embodying the beneficiaries idea. No congressional action taken. December. President's Commission on the Health Needs of the Nation endorses such a program. 1954 January. President Eisenhower proposes "re-insurance" measure, embodied in H.R. 8356 and S. 3114. Hearings in both houses. July 13. H.R. 8356 recommitted by House, ending action on proposal. 1956 June 7. Military "medicare" program enacted, providing Government health insurance protection for Armed Forces dependents. July 5. Insurance pooling proposal introduced (S. 4172). No action taken. 1957 AFL-CIO Executive Council decides to press for Government health insurance. August 27. Original Forand bill, to provide health insurance for social security beneficiaries, (H.R. 9467) introduced just prior to adjournment. December. AMA. House of Delegates resolves to defeat bill. 1958 June. Hearings on health issue in Ways and Means Committee result in committee request for more study by the Department of Health, Education, and Welfare. 1959 February 18 . Forand bill (H .R . 4700) reintroduced. 1960 March 14. Ways and Means Committee begins extended sessions on amendments to the Social Security Act. March 31. Ways and Means Committee votes on Forand bill in executive session; bill defeated 17-8. April. Senate Subcommittee on Problems of the Aged and Aging holds hearings, primarily on health needs of the elderly. May 4. HEW Secretary Flemming presents administration proposal for a Federal-State pro-gram of protection against the cost of long-term and expensive illness for low-income elderly. June 3. Ways and Means Committee's second vote on Forand bill; defeated again 17-8. Vote on stripped-down bill, providing hospital benefits only, also defeated, 16-9. June 13. After more than 3 months of deliberation, Ways and Means Committee reports Social Security amendments (H.R. 12580), including a new program of Federal grants to the States for medical services to the "medically indigent" elderly. June 29. The 1960 Annual Conference of Governors calls for congressional enactment of medical insurance for the elderly under social security. August 23. After rejecting a Kennedy-Anderson amendment embodying the health insurance approach, as well as a Javits amendment embodying the administration plan, the Senate approves a modified version of H.R. 12580, known as the Kerr-Mills bill. September 13. Kerr-Mills bill signed into law. 1961 January. White House Conference on Aging is convened in Washington, sponsored by the Department of Health, Education, and Welfare. January 10. Presidential task force on Health and Social Security for the American People recommends health insurance for the elderly under social security. February 10. President Kennedy sends special message to Congress on health. February 13. Representatirve King and Senator Anderson introduce an administration hospital insurance bill (S. 909 and H.R. 4222). July. American Medical Political Action Committee (AMPAC) established by the AMA. July. National Council of Senior Citizens for Health Care Through Social Security established to promote King-Anderson bill. July-August. Ways and Means Committee conducts hearings on Medicare bill (King-Anderson). No further action taken. 1962 May 20. President Kennedy addresses the Nation on the Medicare issue in a speech televised from Madison Square Garden. May 22. AMA's Dr. Edward Annis gives televised reply. July 17. Anderson-Javits amendment, a compromise Medicare measure attached to a welfare bill (H.R. 10606), tabled by Senate (52-48). 1963 February 21. President Kennedy sends special message to Congress on problems of the aged. Slightly revised King-Anderson bill (H.R. 3920 and S. 880) reintroduced the same day. November. Hearings in Ways and Means Committee on King-Anderson bill interrupted by assassination of President Kennedy. 1964 January. Ways and Means Committee completes hearings. February 10. President Johnson sends special message, "Health of the Nation," to Congress, advocating Medicare. June 24. Ways and Means Committee executive session decides to postpone action on Medicare. July 7. Ways and Means Committee reports Social Security amendments (H.R. 11865) which include a cash benefit increase but no health care proposal. July 24. H.R. 11865 passed by the House. August 6. Senate Committee on Finance begins hearings on H.R. 11865. August 20. H.R. 11865 reported by the Finance Committee without the addition of a health insurance provision. September 2. Medicare measure passes Senate (49-44) as a floor amendment to H.R. 11865. October 2. House-Senate Conference Committee deadlocks, being unable to resolve differences, between Senate and House versions of H.R. 11865. 1965 January. King-Anderson bill reintroduced (H.R. 1 and S. 1). March 23. Ways and Means Committee approves a Medicare measure, substituting the "Mills bill" (H.R. 6675) for the King-Anderson bill. April 8. Mills bill passed by House, 313-115. April 28-June 24. Senate Finance Committee holds extensive hearings and executive sessions. July 9. Senate passes bill, 68-21. July 14-21. House-Senate Conference Committee convenes to reconcile differences between Senate and House versions of H.R. 6675. July 27-28. Conference committee report is passed by House and Senate, respectively. July 30. Medicare (as part of the Social Security Amendments of 1965) signed into law by President Johnson.