Forth-six years ago on July 30, President Lyndon B. Johnson signed the Social Security Act of 1965 into law and created Medicare and Medicaid. Enacting universal, single-payer healthcare for the country's elderly and indigent was a long struggle that began during Harry Truman's presidency.

Medicare and Medicaid were part of Johnson’s Great Society, which had two primary goals: to eliminate poverty and to eliminate racial injustice. After his landslide victory over Barry Goldwater in 1964, Johnson and his Democratic Congress enacted forward-thinking reforms that were reminiscent of the New Deal and began the full-on War on Poverty, which reduced the poverty rate significantly over the subsequent 10 years. Many important Great Society programs– aimed at improving labor conditions, healthcare, and education for poor and working class Americans– are still in existence: Medicare, Medicaid, food stamps, student loans for college, work study, and Head Start. These programs were strengthened under Republican Presidents Richard Nixon and Gerald Ford.

Today, there are forces on the rightwho would dismantle Medicare (1, 2) and dramatically reduce funding for Medicaid . In fact, as many as 15 statesare slashing Medicaid roles to balance their budgets and save money.

But there are equally vocal forces on the left who want to extend Medicare to all Americans in order to provide universal healthcare coverage (4, 5, 6, 7),  improve quality of life for millions of uninsured or underinsured Americans, and reduce costs.

In the current debt ceiling/deficit reduction debates in Congress, Medicare, Medicaid, and Social Secutity-- along with other Great Society programs-- have become political footballs. Republicans led by House Speaker John Boehner have proposed several budget plans that would chip away at the federal budget deficit primarily by cutting non-military discresionary spending-- including Social Security, Medicare, and Medicaid-- but not increase revenue.  

At a time of high unemployment, high gasoline costs, high food prices, escalating college tuition, skyrocketing healthcare expenses, a disintigrating social safety net, and soaring corporate profits– Republicans want workers, the elderly, and the indigent to “tighten their belts”.

President Barack Obama and Congressional Democrats want a deficit reduction plan that would reduce spending and increase revenue. Some-- including the President-- are willing to entertain some spending cuts in Social Security, Medicare, and Medicaid, but many hold those programs sacrosanct. Repeated polling by the Pew Research Center for the People and the Press shows that Americans are less concernedabout the debt than they are about continued social safety net benefits.

At the time of this writing-- with the anniversary of Medicare tomorrow and the August 2 debt ceiling cut-off just a few days away-- no viable deal is in sight.

As Washington politicians ponder the financial fate of millions of Americans, I offer for inspiration the words of President Johnson on the occasion of his first State of the Union speech in 1964:

...let us work together to make this year's session the best in the Nation's history.

Let this session of Congress be known as the session which did more for civil rights than the last hundred sessions combined; as the session which enacted the most far-reaching tax cut of our time; as the session which declared all-out war on human poverty and unemployment in these United States; as the session which finally recognized the health needs of all our older citizens; as the session which reformed our tangled transportation and transit policies; as the session which achieved the most effective, efficient foreign aid program ever; and as the session which helped to build more homes, more schools, more libraries, and more hospitals than any single session of Congress in the history of our Republic.

All this and more can and must be done. It can be done by this summer, and it can be done without any increase in spending. In fact, under the budget that I shall shortly submit, it can be done with an actual reduction in Federal expenditures and Federal employment.

We have in 1964 a unique opportunity and obligation -- to prove the success of our system; to disprove those cynics and critics at home and abroad who question our purpose and our competence.

If we fail, if we fritter and fumble away our opportunity in needless, senseless quarrels between Democrats and Republicans, or between the House and the Senate, or between the South and North, or between the Congress and the administration, then history will rightfully judge us harshly. But if we succeed, if we can achieve these goals by forging in this country a greater sense of union, then, and only then, can we take full satisfaction in the State of the Union.

Here in the Congress you can demonstrate effective legislative leadership by discharging the public business with clarity and dispatch, voting each important proposal up, or voting it down, but at least bringing it to a fair and a final vote. [Emphasis added.]

Personally, I think Obama should stop quoting Reagan and start quoting Johnson.

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