Thomas Langhorne has an interesting article in the Evansville Courier Press interviewing a long time Evansville doctor on his opinions about the creation of Medicare. He was opposed to the socialized medicine it represented. In fact, many of his objections to Medicare then sound similar to the objections to a public health insurance option now.

One thing the doctor thought back then was that the health program shouldn’t be based on age, rather it should be based on indigency.

“Medicare helps people who need it, but it also helps people who don’t need it,” said Nicholson, now Vanderburgh County health officer. “If you were a millionaire, you were just as eligible for Medicare as if you didn’t have a penny in your pocket. It didn’t seem fair to me. I felt anyone who became medically indigent should be covered.”
. . .
Throughout the 1950s and early 1960s, the American Medical Association repeatedly mobilized to defeat a succession of bills aimed at establishing federal Medicare programs.

While early advocates proposed to address the catastrophic effects of large hospital and surgical bills for all the aged participating in the Social Security system regardless of income, opponents wanted to target aid based on need. They proposed comprehensive benefits to people for whom savings, private insurance, medical charity, or state and local aid were inadequate to meet health expenses.

My sense is that if whatever reform comes out of the health care debate is limited to the poor, it is doomed to failure. Nobody wants another entitlement for the poor. The program will come to be resented pretty quickly if it doesn’t benefit a broad swath of the population. It will then be starved for resources and, when for lack of resources it performs poorly, will be held up as an example of government not working. Rather, in my mind, the new program should use the premium dollars already being paid by the middle class to rationalize health care prices and deliver health care without the need to route those premium dollars through an insurance bureaucracy committed to denying as many claims as possible and maximizing return to insurance company shareholders.