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Letter to Secretary Gardner Requesting a Progress Report on Preparations for Launching Medicare.

April 08, 1966

[Released April 8, 1966. Dated April 7, 1966]

Dear Mr. Secretary:

I expect shortly to sign the bill to extend until May 31 the deadline for initial enrollment of persons 65 years and over in Medicare's supplementary health insurance program.1 According to your report, more than 16.8 million people or about 88 percent of the estimated 19 million eligible have already signed up. I want you to spare no effort to raise that percentage as high as possible. I realize the magnitude of the task, but we should not be satisfied so long as anyone who is qualified for this program fails to enroll because he did not learn in time.

1 See Item 168.

The launching of Medicare is a historic undertaking. Under your leadership the Department of Health, Education, and Welfare has been making a great effort to insure a successful launch. I want to be sure that we leave nothing undone to prepare the Federal Government, the States, the providers of hospitals and health services, and the American people for the massive job ahead. Will you, therefore, provide me with a progress report on tooling up for Medicare and on what remains to be done between now and July 1. I would like your report, particularly to cover the following:

1. Are persons covered by Medicare fully informed of their benefits?

2. Are hospitals, nursing homes, and other institutions in compliance with necessary conditions of participation? What assistance are we giving to be sure that they meet requisite quality standards?

3. Are all the administrative agents, e.g., Blue Cross, Blue Shield, and private insurance companies fully prepared to carry out their appropriate functions?

4. Have the various professional organizations been fully consulted and are their views reflected in implementing regulations?

5. Have cooperative arrangements with the states been worked out to cover their functions? What progress have they made?

6. Have methods of reimbursement been established for hospitals, nursing homes, and physicians that are equitable and efficient?

7. What is the status of hospital committees to ensure effective use of beds?

8. What alternative arrangements are being developed to provide facilities, services, and personnel to meet the increased demand for medical care?

9. Are the Social Security Administration, the Public Health Service, the Welfare Administration, and all other elements of your Department administratively staffed with people trained and in position to handle public inquiries and the administrative tasks ahead?

I am concerned not only that we be ready to launch Medicare on July 1. We must take steps to provide the quality and quantity of medical care of which this nation is capable. This requires better health facilities, more doctors and other health personnel, and better utilization of health personnel. It is imperative that we secure the new legislation which I have requested of the Congress--to modernize our hospitals and nursing homes, to train new types of health personnel, and to develop a partnership in health with the states and communities. I hope you will keep me advised of the progress of this legislation.

I am convinced that we must reexamine on a broad scale our nation's use of health manpower. I shall shortly appoint a National Advisory Commission on Health Manpower. It will consider ways in which the health care provided to all our citizens can be improved by more effective use of doctors and supporting health personnel.



[Honorable John W. Gardner, Secretary of Health, Education, and Welfare, Washington, D.C.]

Note: On May 24, 1966, the White House made public a progress report to the President from Secretary Gardner on steps taken to put the Medicare program into effect on July 1, 1966. The report, dated May 23, noted these developments:

(1) Ninety percent of Americans 65 or over had signed up for the voluntary part of Medicare covering doctors' bills;

(2) Over 90 percent of the Nation's hospitals had asked to participate in providing services under the basic program;

(3) State health departments, the Blue Cross Blue Shield plan, private insurance companies chosen to help administer the program, and professional organizations such as the American Hospital Association and American Medical Association were helping hospitals to meet the conditions of participation.

The report is printed in the Weekly Compilation of Presidential Documents (vol. 2, p. 687).

On May 21, 1966, the White House announced that Operation Medicare Alert, a community action program under the Office of Economic Opportunity, had contacted 4 1/2 million senior citizens in its program to enroll the elderly poor for health benefits under the new Medicare legislation. Throughout the country 13,000 paid workers from among the elderly poor, assisted by 67,000 volunteers, contacted those who had not enrolled to encourage them to sign up for benefits under the new program. There were 467 Medicare Alert projects in 47 States, Puerto Rico, and Guam, the release stated. In Maine, Medicare Alert workers rode horses to visit those living in areas where there was no access by road. In other States the problem was to reach those who could not read or did not speak English (2 Weekly Comp. Pres. Docs., p. 681).

The National Advisory Commission on Health Manpower was established, along with the President's Committee on Health Manpower, by Executive Order 11279 of May 7, 1966 (2 Weekly Comp. Pres. Docs., p. 621; 31 F.R. 6947; 3 CFR, 1966 Comp., p. 110).
The letter was released at San Antonio, Texas.

Lyndon B. Johnson, Letter to Secretary Gardner Requesting a Progress Report on Preparations for Launching Medicare. Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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