Fifty years ago today, in Independence, Missouri, President Lyndon B. Johnson signed into law a controversial piece of health legislation we now know as Medicare.
These days, with about 55 million Americans covered by the government health insurance program for those 65 and older and for the permanently disabled, it can be hard to imagine a time when not everybody embraced it.
But Dr. Peter Lee, Sr., 92, of Pasadena remembers that era well.
"I was one of the people who was supporting the idea," says Lee, co-founder and the first chairman of the Department of Family Medicine at the University of Southern California. "And in response to that, some people from the USC Alumni Association wanted me fired because they thought that was socialized medicine."
But that didn’t slow Lee down. He gave speeches and wrote articles in support of Medicare, which earned him the wrath of the Los Angeles County Medical Association. That group, too, called for Lee’s job. And while he didn’t get fired, he did get called a lot of names.
Much the same thing, he says, happened to his younger brother, Dr. Philip Lee, who helped implement Medicare as an assistant secretary of health in the Department of Health Education and Welfare (HEW) under President Johnson.
"They called me a socialist"
"They called me a socialist more often than a communist, but occasionally they referred to me as a communist," says Lee, 91, of Palo Alto, adding that Ronald Reagan was among the Medicare opponents who used that term.
“One of the traditional methods of imposing stateism or socialism on a people has been by way of medicine," Reagan warned in a 1961 ad he voiced for one of Medicare's biggest opponents: the American Medical Association.
The AMA opposed Medicare out of fear the government would become too deeply involved in the practice of medicine, says the elder Lee. But that opposition didn’t sway the Lee brothers. Their work as vocal foot soldiers for Medicare was born in part, they say, from a family legacy of health policy started by their father, Dr. Russell Lee.
Russell Lee was founder of the Palo Alto Medical Clinic in 1930, one of the nation's first group practices. Critics accused the clinic of being a form of socialist- or communist-style medicine.
These days, Russell Lee's grandson, Peter Lee Jr., is executive director of Covered California, continuing the family's health policy legacy as the man in charge of implementing the Affordable Care Act in California.
"One of the things my grandfather did was he was involved in the Truman Commission, which in the early 40s [produced] one of the reports that said we need national health care," says Lee, Jr.
When Medicare became law, it proved to be a game changer, says Lee, Sr. Before Medicare, he recalls L.A. County-USC Medical Center overflowing with elderly patients on gurneys who’d been discharged but needed interim care before going home.
"So we always had patients in the hall," Lee, Sr. says, adding that after Medicare was implemented, "the halls were all empty."
"They were empty because seniors all of a sudden had someone who would pay for long-term care that wasn’t there before," says Lee, Jr. Medicare began paying for transitional nursing home care, hospital care and other treatments for those 65 and older, no matter their income.
"It was a dramatic, overnight change that affected millions of Americans," says Lee, Jr.
Desegregating hospitals in Georgia
Perhaps as significant is a lesser-known legacy of Medicare: the desegregation of hospitals.
Among those at the frontline of that battle: The younger Lee brother, Philip.
"Desegregation was critical," he says. "You couldn’t have a segregated medical care system."
He was among those President Johnson sent into the south during the mid-60s to make sure hospitals became integrated. Lee was assigned to Georgia, where it took the threatened loss of federal Medicare dollars to overcome resistance by many hospitals, he says. Ultimately, racial integration applied to everyone and everything – from patients and staff all the way to the blood supply.
Today, both of the elder Doctors Lee say the biggest issue facing the nation’s health care system is making sure everyone gets the medical care they need.
Peter Lee Jr. agrees, and says that’s what he’s trying to do in California, by following the example set by his father and uncle 50 years ago.
Correction: A previous version of this story misidentified Dr. Hewett Lee (former CEO of Palo Alto Medical Clinic) as Dr. Peter Lee, Sr. That photo has since been replaced. We regret the error.