President Johnson's Health Care Programs eText - Primary Source

Primary Source

President Lyndon Johnson (left) signs the bill to establish Medicare, the federal government's system of health care for the elderly, on July 30, 1965. Vice President Hubert Humphrey (center) and former president Harry Truman (right) note the time. © BETT President Lyndon Johnson (left) signs the bill to establish Medicare, the federal government's system of health care for the elderly, on July 30, 1965. Vice President Hubert Humphrey (center) and former president Harry Truman (right) note the time. © BETTMANN/CORBIS. REPRODUCED BY PERMISSION. Published by Gale Cengage © BETTMANN/CORBIS. REPRODUCED BY PERMISSION.

President Lyndon B. Johnson's Remarks with President Truman at the Signing in Independence of the Medicare Bill, July 30, 1965


By: Lyndon Baines Johnson and Harry S. Truman

Date: July 30, 1965

Source: Johnson, Lyndon B., and Harry S. Truman. President Lyndon B. Johnson's Remarks with President Truman at the Signing in Independence of the Medicare Bill, July 30, 1965. Public Papers of the Presidents of the United States: Lyndon B. Johnson, 1965, vol. 2. Washington, D.C.: Government Printing Office, 1966, 811–815. Reprinted online at ; website home page: (accessed March 29, 2003).

About the Authors: Lyndon Baines Johnson (1908–1973) was born in Gillespie County, Texas. In 1937, he won election to the U.S. House of Representatives and in 1948 to the U.S. Senate, where he rose to majority leader. In 1960, he accepted John F. Kennedy's (served 1961–1963) offer to run as his vice president on the Democratic ticket. Kennedy's assassination in 1963 made Johnson president. Reelected in 1964, he retired from politics in 1969. Harry S. Truman (1884–1972) was born in Lamar, Missouri. In 1934, he won election to the U.S. Senate, and in 1944 he became Franklin D. Roosevelt's (served 1933–1945) vice president. Like Johnson, Truman assumed the presidency upon the death of the incumbent, when Roosevelt died in 1945; and, as was also the case with Johnson, Truman was subsequently reelected, holding office until 1953.

President Lyndon B. Johnson's Annual Message to the Congress on the State of the Union, January 17, 1968.


By: Lyndon Baines Johnson

Date: January 17, 1968

Source: Johnson, Lyndon B. President Lyndon B. Johnson's Annual Message to the Congress on the State of the Union, January 17, 1968. Public Papers of the Presidents of the United States: Lyndon B. Johnson, 1968–69, vol. 1. Washington, D.C.: Government Printing Office, 1970, 25–33. Reprinted online at ; website home page: (accessed April 1, 2003).


During the twentieth century, American businesses increasingly offered employees medical coverage as part of their compensation. However, this coverage usually ended with a worker's retirement. Yet it was during the retirement years, as people aged, that their medical expenses often surpassed their pensions.

Americans turned to the federal government for help. The liberal wing of the Democratic Party seized the issue of health care. This support allowed both President Harry S. Truman and Progressive Party candidate Henry A. Wallace to propose government-sponsored medical coverage for all Americans in the 1948 presidential election. Pundits predicted Truman would be defeated in the 1948 presidential election by Republican challenger Thomas Dewey, who opposed national health care. Truman's surprise victory led him to believe he had a mandate to guide a government-sponsored health plan through Congress.

He miscalculated. Congressional Republicans and conservative southern Democrats opposed the idea, and Truman left the White House in 1953 without any healthcare legislation. His successor, Republican Dwight D. Eisenhower (served 1953–1961), branded government-sponsored health care as socialized medicine, and the issue appeared dead. Eisenhower's successor in 1961, Democrat John F. Kennedy, supported government health care programs, but was unable to overcome opposition in Congress.

The absence of government-sponsored medical coverage for all Americans left the onus on businesses to insure their workers. The private-sector solution left retirees, children, and workers in low-paying service industries without insurance. If government were to make a difference, it would need to cover these groups, the most vulnerable in America's health care system.


Kennedy's assassination in 1963 brought Lyndon Baines Johnson, a dedicated advocate of government support for health care, to the presidency. Johnson had served in Congress since 1937 and had been Senate majority leader before becoming Kennedy's vice president. During his 23 years in Congress, Johnson had cemented friendships he could mobilize as president. As a southerner, he could more easily silence conservative opposition to a health care plan than Kennedy. Johnson could also call upon Congress to act on this issue to honor the memory and legacy of President Kennedy. Perhaps most important, Johnson understood that he could not push national health care legislation through Congress in a single thrust. His strategy would be to proceed in increments.

Johnson started by proposing aid for retired Americans, whom the private-sector solution had left without coverage. He also pushed for aid to poor families, the blind, and the disabled. He unveiled his plans for helping these groups, Medicare and Medicaid, during his 1964 presidential election campaign. His landslide victory gave him the power to push the programs through Congress, in the form of the Social Security Act of 1965. Political instinct led Johnson to sign the act in Independence, Missouri, the hometown of Harry S. Truman, with Truman at his side.

That day, Truman expressed pleasure at having lived long enough to see Medicare become a reality. He emphasized the justice of extending government-sponsored coverage to the aged. Johnson, for his part, praised Truman for having made medical coverage for Americans a priority.

Johnson then outlined Medicare's provisions. Taxes on both employers and employees would fund it. At age 65, Americans would begin to draw on its coverage, which would pay ninety days of hospital care per year, one hundred home visits by a nurse or physician, and beginning in 1967, one hundred days of nursing home care.

President Johnson continued to push for more federal health care aid even after Medicare and Medicaid were established. A 1967 bill raised benefits, and the government began to study the issue of expanding coverage to include the cost of perscription drugs. In his 1968 State of the Union Address, Johnson called for a third major step (Medicare and Medicaid being the first two) toward national health care. In his address, he asked Congress to expand government-sponsored medical coverage to all pregnant women and infants under the age of one.

Congress rebuffed Johnson. By 1968, Johnson's popularity had crumbled as a result of the bloody conflict in Vietnam. As American soldiers returned home in body bags, Americans turned against Johnson. With his support greatly weakened and conservative opponents strengthened, and with much of his attention centered on the Vietnam War, Johnson was unable to get his new health care program through Congress. Furthermore, with his presidency in shambles, Johnson withdrew from the 1968 presidential campaign. He would be replaced in 1969, by Republican Richard Nixon, without having achieved his goal of medical coverage for all Americans.

Although President Johnson was unable to create the broad national health care system that he had hoped for, Medicare and Medicaid marked an important shift in government policy. Although criticized for their cost and bureaucracy, they have been expanded several times since their creation. For instance, in 1981, Congress extended Medicaid benefits to poor pregnant women and infants, much as Johnson had called for in 1968. In the early twenty-first century, the question of expanding Medicare to cover the cost of perscription drugs remained a major political issue. Through it all, Medicare and Medicaid helped millions of Americans receive medical care they could not have paid for otherwise.

Primary Source: President Lyndon B. Johnson's Remarks with President Truman at the Signing in Independence of the Medicare Bill, July 30, 1965 [excerpt]

SYNOPSIS: In this excerpt, Harry S. Truman and Lyndon Baines Johnson celebrate the signing of Medicare into law. Both employer and employee would fund Medicare. At age 65, Americans would begin to draw on its coverage, which would pay ninety days of hospital care per year, one hundred home visits by a nurse or physician, and beginning in 1967, one hundred days of nursing home care.

President Truman: Thank you very much. I am glad you like the President. I like him too. He is one of the finest men I ever ran across.

Mr. President, Mrs. Johnson, distinguished guests:

You have done me a great honor in coming here today, and you have made me a very, very happy man.

This is an important hour for the Nation, for those of our citizens who have completed their tour of duty and have moved to the sidelines. These are the days that we are trying to celebrate for them. These people are our prideful responsibility and they are entitled, among other benefits, to the best medical protection available.

Not one of these, our citizens, should ever be abandoned to the indignity of charity. Charity is indignity when you have to have it. But we don't want these people to have anything to do with charity and we don't want them to have any idea of hopeless despair.

Mr. President, I am glad to have lived this long and to witness today the signing of the Medicare bill which puts this Nation right where it needs to be, to be right. Your inspired leadership and a responsive forward-looking Congress have made it historically possible for this day to come about.

Thank all of you most highly for coming here. It is an honor I haven't had for, well, quite awhile, I'll say that to you, but here it is:

Ladies and gentlemen, the President of the United States.

President Johnson: The people of the United States love and voted for Harry Truman, not because he gave them hell—but because he gave them hope.

I believe today that all America shares my joy that he is present now when the hope that he offered becomes a reality for millions of our fellow citizens.

I am so proud that this has come to pass in the Johnson administration. But it was really Harry Truman of Missouri who planted the seeds of compassion and duty which have today flowered into care for the sick, and serenity for the fearful.

It was a generation ago that Harry Truman said, and I quote him: "Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection."

Well, today, Mr. President, and my fellow Americans, we are taking such action—20 years later.

And we are doing that under the great leadership of men like John McCormack, our Speaker; Carl Albert, our majority leader; our very able and beloved majority leader of the Senate, Mike Mansfield; and distinguished Members of the Ways and Means and Finance Committees of the House and Senate—of both parties, Democratic and Republican.

There are more than 18 million Americans over the age of 65. Most of them have low incomes. Most of them are threatened by illness and medical expenses that they cannot afford.

And through this new law, Mr. President, every citizen will be able, in his productive years when he is earning, to insure himself against the ravages of illness in his old age.

This insurance will help pay for care in hospitals, in skilled nursing homes, or in the home. And under a separate plan it will help meet the fees of the doctors.

Now here is how the plan will affect you.

During your working years, the people of America—you—will contribute through the social security program a small amount each payday for hospital insurance protection. For example, the average worker in 1966 will contribute about $1.50 per month. The employer will contribute a similar amount. And this will provide the funds to pay up to 90 days of hospital care for each illness, plus diagnostic care, and up to 100 home health visits after you are 65. And beginning in 1967, you will also be covered for up to 100 days of care in a skilled nursing home after a period of hospital care.

And under a separate plan, when you are 65—that the Congress originated itself, in its own good judgment—you may be covered for medical and surgical fees whether you are in or out of the hospital. You will pay $3 per month after you are 65 and your Government will contribute an equal amount.

No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts.

And no longer will this Nation refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country.

And this bill, Mr. President, is even broader than that. It will increase social security benefits for all of our older Americans. It will improve a wide range of health and medical services for Americans of all ages.…

President Harry Truman, as any President must, made many decisions of great moment; although he always made them frankly and with a courage and a clarity that few men have ever shared. The immense and the intricate questions of freedom and survival were caught up many times in the web of Harry Truman's judgment. And this is in the tradition of leadership.

But there is another tradition that we share today. It calls upon us never to be indifferent toward despair. It commands us never to turn away from helplessness. It directs us never to ignore or to spurn those who suffer untended in a land that is bursting with abundance.…

And this is not just our tradition—or the tradition of the Democratic Party—or even the tradition of the Nation. It is as old as the day it was first commanded: "Thou shalt open thine hand wide unto thy brother, to thy poor, to thy needy, in thy land."

And just think, Mr. President, because of this document—and the long years of struggle which so many have put into creating it—in this town, and a thousand other towns like it, there are men and women in pain who will now find ease. There are those, alone in suffering who will now hear the sound of some approaching footsteps coming to help. There are those fearing the terrible darkness of despairing poverty—despite their long years of labor and expectation—who will now look up to see the light of hope and realization.…

There just can be no satisfaction, nor any act of leadership, that gives greater satisfaction than this.

And perhaps you alone, President Truman, perhaps you alone can fully know just how grateful I am for this day.

Primary Source: President Lyndon B. Johnson's Annual Message to the Congress on the State of the Union, January 17, 1968 [excerpt]

SYNOPSIS: In these excerpts, Lyndon Baines Johnson asks Congress to extend medical coverage to all pregnant women and to infants to age one. He informs Congress and the national audience that the United States, the world's richest nation, is ranked fifteenth among nations in infant mortality.

[Delivered in person before a joint session at 9:05 p.m.]

Mr. Speaker, Mr. President, Members of the Congress, and my fellow Americans:

I have come once again to this Chamber—the home of our democracy—to give you, as the Constitution requires, "Information of the State of the Union."

… Let me speak now about some matters here at home.

Tonight our Nation is accomplishing more for its people than has ever been accomplished before. Americans are prosperous as men have never been in recorded history. Yet there is in the land a certain restlessness—a questioning.…

Hospital and medical costs are high, and they are rising.…

Better health for our children—all of our children—is essential if we are to have a better America.

Last year, Medicare, Medicaid, and other new programs that you passed in the Congress brought better health to more than 25 million Americans.

American medicine—with the very strong support and cooperation of public resources—has produced a phenomenal decline in the death rate from many of the dread diseases.

But it is a shocking fact that, in saving the lives of babies, America ranks fifteenth among the nations of the world. And among children, crippling defects are often discovered too late for any corrective action. This is a tragedy that Americans can, and Americans should, prevent.

I shall, therefore, propose to the Congress a child health program to provide, over the next five years, for families unable to afford it—access to health services from prenatal care of the mother through the child's first year.

When we do that you will find it is the best investment we ever made because we will get these diseases in their infancy and we will find a cure in a great many instances that we can never find by overcrowding our hospitals when they are grown.

Further Resources


Adler, Gerry, et al. Medicare 2000: 35 Years of Improving Americans' Health and Security. Baltimore, Md.: Health Care Financing Administration, 2000.

David, Sheri I. With Dignity: The Search for Medicare and Medicaid. Westport, Conn.: Greenwood, 1985.


"Biggest Change Since the New Deal." Newsweek, April 12, 1965, 88–89.

"Medicare—How It Will Work." Business Week, July 31, 1965, 51–54.

"Medicare Is Launched Into a Shambles." Life, September 3, 1965, 52–58.


Centers for Medicare & Medicaid Services. Available online at (accessed March 30, 2003).

"Medicare." Social Security Administration. Available online at; website home page: (accessed March 30, 2003).

"—The Official U.S. Government Site for People With Medicare." Centers for Medicare & Medical Services. Available online at (accessed March 30, 2003). The Information Source for Medicare Information. Available online at (accessed March 30, 2003).

"MEDLINEplus: Medicare." U.S. National Library of Medicine and the National Institutes of Health. Available online at; website home page: (accessed March 30, 2003).