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50 Years Ago, Medicare Helped To Desegregate Hospitals


Medicare turns 50 years old today. The law creating a national health insurance program for older Americans was signed in 1965 after a long political battle. One big opponent was the American Medical Association. The AMA famously signed up then-actor Ronald Reagan to campaign against Medicare.


RONALD REAGAN: Write those letters now. Call your friends, and tell them to write. If you don't, this program, I promise you, will pass just as surely as the sun will come up tomorrow. And behind it will come other federal programs that will invade very area of freedom as we have known it in this country. Until, one day, as Norman Thomas said, we will awake to find that we have socialism. And if you don't do this and if I don't do it, one of these days, you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free.

MONTAGNE: Well, of course, that ad did not stop the bill from being passed. And when he signed it into law, President Lyndon Johnson made a point of not inviting the AMA to the ceremony. He did invite the National Medical Association. That was the organization for black doctors. They'd long supported the bill. They saw the potential for Medicare to help desegregate health care for patients and professionals.

EDITH MITCHELL: I think that Medicare actually contributed to a new day.

MONTAGNE: Edith Mitchell is the president-elect of the National Medical Association.

MITCHELL: They had access to health care in a way that it had not been provided before. And no longer did individuals have to go through the door that said colored only.

MONTAGNE: Medicare became a force for civil rights because the Civil Rights Act was signed just a year before, and it now barred federal funding for institutions that discriminated on the basis of race. For hospitals, the fear of losing federal funds became a powerful motivator.

DAVID BARTON SMITH: The money and the holding of the dollars to hospitals really created a rather dramatic and amazing transformation in a very short period of time.

MONTAGNE: Temple University professor David Barton Smith is writing a book on Medicare and the Civil Rights Movement. But he says it wasn't just how the law was written, it was how it was enforced. After the signing, a tiny understaffed team of official inspectors was bolstered by hundreds of volunteers.

SMITH: Most of them had already been involved in civil rights activities. They were all very passionately committed people. Early on, they were making sure that all of the white and colored signs were removed. But then, they would go back and insist that hospital employees and patients not self-segregate in the waiting rooms. They were pretty fierce about it. And they had an invisible army in the sense of local civil rights groups that would guide them in their inspections, including a lot of black health workers that helped in providing the eyes and ears for making sure that the hospitals were not just trying to cover everything up.

MONTAGNE: Within a few months, Smith says 2,000 hospitals had desegregated. Dr. Edith Mitchell is from the South. And soon after Medicare was implemented, her grandmother went to the hospital for the first time.

MITCHELL: My grandmother was in the first group of individuals to receive a Medicare card. And it was the first time that my grandmother had ever been admitted to a hospital, although she had given birth to five children. She had a chronic condition, and she was in a hospital room with a Caucasian patient, who we knew, who my grandmother knew. And just to be able to lay in the bed in a room where another Caucasian patient was in the room was something that never happened before.

MONTAGNE: That's National Medical Association President-elect Edith Mitchell. We spoke to her for this 50th anniversary of Medicare. Transcript provided by NPR, Copyright NPR.