America celebrates the 50th Anniversary of Medicare and Medicaid

July 30 marks the 50th Anniversary of Medicare and Medicaid, two landmark programs that changed the face of American medicine.

Both programs were signed into law by President Lyndon B. Johnson and aimed to provide healthcare to seniors (Medicare) and those living in poverty (Medicaid). At the time, 19 million seniors signed up for Medicare. The program has grown to serve56 million Americans, according to the U.S. News & World Report.

In 1965, when the Medicaid program took effect, it served far fewer people. It was available only to those who received government assistance. Today it serves about 70 million low-income Americans.

Today, one in three Americans is enrolled in one of the programs.

"These two programs have become such a fabric of the health care system that it's hard to imagine a world without either of them," said Diane Rowland, executive vice president at the Kaiser Family Foundation, in U.S. News & World Report.

People and public officials around the country celebrated the anniversary, wrote USA Today.

"We must recognize that this work, though begun a half-century ago and continued over the decades that have followed, is not yet complete," Obama said in a proclamation, as reported by USA Today. "For too many, quality, affordable health care is still out of reach — and we must recommit to finishing this important task."

President Obama called Medicare and Medicaid the "cornerstones of the fundamental belief that in America, health care is a right and not a privilege."

Program innovations
Both programs are credited for giving healthcare access to two classes of people who had limited access previously. But they had profound effects on medicine in other ways too.

For instance, patients not only had a means to adequate coverage, they had access to prescriptions as well. U.S. News & World Report wrote that with the government's financial backing, companies were able to invest in research and development because they knew that they would eventually recover those costs from sales of new medicines.

Medicaid and Medicare have changed the face of long-term care as well. Prior to the laws' passage, many seniors and those with debilitating illnesses had to be cared for at home. The programs paved the way for long-term care in nursing homes. Medicaid started providing for nursing home care in the early 1970s.

Joan Alker, executive director at the Center for Children and Families at Georgetown University's Health Policy Institute, says Medicaid's involvement in such care illustrates how the program has been able to provide the type of care that didn't exist prior, according to U.S. News & World Report.

"It is an entitlement program with guaranteed funding, so it can adapt," she says, according to the source.

However, both programs face an uncertain future. Much of that uncertainty has to deal with funding and being able to cover future generations.

In an opinion piece, the Los Angeles Times notes that the cost of both programs is expensive, accounting for about $1 trillion each year. And that problem is compounded by Americans living longer into retirement.

The number of Americans who will live into their 90s is expected to quadruple by 2050. Those rising costs could be offset if more people were to be able to climb out of poverty and get higher paying jobs. Those increase tax dollars would be able to help with funding. 

But beyond that, the LA Times noted that more needs to be done to curb spending. The piece indicates that the Affordable Care Act and other laws have put pressure on doctors and hospitals to move away from a payment system that was based on the amount and intensity of the care they provided, which penalized doctors whose patients recovered quickly.

Prevention and wellness programs to prevent illness and injury have helped. But it still remains to be seen how costs can be curbed in the long run.