Health Care in the Early 1960s

My topic, health care in the early 1960s, has a double set of meanings for me. I am a historian, and the 1960s are now “history,” ripe for new interpretations. Yet I was also an immigrant to the United States in 1961, fresh from working as an administrator in the British National Health Service. The period immediately before the Medicare legislation in 1965 shines in my memory with the vividness of new impressions: those of a young health care student trying to make sense of the U. S. health care system, and indeed, of the United States. The health care system and the United States as a society stand, in many ways, as proxy for each other, now as then: The whole tells you much about the part, and the part about the whole. In the early 1960s, health care was already a massive enterprise. By the late 1950s, hospitals employed far more people than the steel industry, the automobile industry, and interstate railroads. One of every eight Americans was admitted annually as an inpatient (Somers and Somers, 1961). To study health care, with all its contradictions and complexities, in the 1960s as in the present, is to explore the character and ambiguities of the United States itself, that vast, brash, divided yet curiously hopeful Nation. On the face of it, the United States was a country blessed by plenty in the 1960s, with hospitals and professionals that were the envy of the world. Among the marvels of modern hospitals that provoked