Medicare and Hospitals

labored under the historic burden of its essential mission being that of carrying out the work of God, a mission for which material reward was deemed unimportant. A second, and lower, minimum wage existed for employed hospital workers, and many institutions were peopled by nuns and others paid far less than the prevailing wage elsewhere. Juxtaposed with this otherworldly view, the hospital was also felt to be a refuge for the disabled, whom society deemed unemployable elsewhere and out of seeming kindness assigned more or less permanently to the entry-level positions in the hospital. Medicare changed all that by providing funding to pay for the care of the population over 65 years of age and the disabled and by triggering reimbursement for the poor through Medicaid. Wage rates became normalized. Equally important was the concept of funding reasonable hospital costs, which allowed for the funding of depreciation, enabling hospitals to begin modernizing their physical plants, acquiring equipment of increasing sophistication, and of course, increasing costs. The growth of the National Institutes of Health led to a burgeoning of biomedical research, and its technological development benefits were brought to the elderly's bedside in large part through the impact of Medicare. The earlier Hill-Burton legislation, which led to the emergence of new hospitals, helped facilitate Medicare's