The Host
On July 30, 1965, President Lyndon B. Johnson signed landmark legislation creating Medicare and Medicaid. Sixty years later, the programs represent a fifth of the federal budget and provide coverage to nearly 1 in 4 Americans. In addition, the way Medicare and Medicaid structure and pay for medical care has set the standard for the private sector as well.
On this week’s special episode of KFF Health News’ “What the Health?” podcast, host Julie Rovner interviews two experts on the history, development, impact, and future of Medicare and Medicaid.
First, Rovner talks with Medicare historian and University of North Carolina health policy professor Jonathan Oberlander. Oberlander is the author of the book “The Political Life of Medicare” and a former editor of the Journal of Health Care Policy, Politics and Law.
Then, Rovner chats with Sara Rosenbaum, professor emerita at George Washington University. Rosenbaum has spent nearly her entire career working on Medicaid policy and has helped shape key priorities at the federal and state levels.
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Transcript: Happy 60th, Medicare and Medicaid!
[Editor’s note: This transcript was generated using both transcription software and a human’s light touch. It has been edited for style and clarity.]
Julie Rovner: Hello, and welcome back to this special episode of “What the Health?” I’m Julie Rovner, chief Washington correspondent for KFF Health News, and I’m usually joined by some of the best and smartest health reporters in Washington. But this week we’ve got something special for you. It’s an episode marking the 60th anniversary this summer of Medicare and Medicaid, the twin government health programs that have largely shaped the way the U.S. pays for and delivers health care for the past half-century. To bring us the story, I sat down with two of my favorite experts on the subject, University of North Carolina professor Jonathan Oberlander and George Washington University’s Sara Rosenbaum. Here are my chats, starting with Jonathan Oberlander on Medicare.
I am so pleased to welcome Jonathan Oberlander to the podcast. He’s a professor of social medicine, professor of health policy and management, and adjunct professor of political science at the University of North Carolina School of Medicine in Chapel Hill and one of the nation’s leading experts on Medicare. John, welcome to “What the Health?”
Jonathan Oberlander: Great to see you, Julie.
Rovner: So Medicare, to me at least, remains the greatest paradox in the paradox that is the U.S. health care system. It is at once both so popular and so untouchable that it’s considered the third rail of politics, yet at its core, it’s a painfully out-of-date and meager benefit that nevertheless threatens to go bankrupt on a regular basis. How did we get here?
Oberlander: Wow. Let’s talk about the benefits for a minute. And I think one of the things we can say about Medicare in 2025 as we mark this 60th anniversary is it still bears the imprint of Medicare in 1965. And when Medicare was designed as a program — and the idea really dates back to the early 1950s — it was not seen as a comprehensive benefit. It was intended to pay for the most consequential costs of medical care, for acute care costs. And so when i …