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.During his eight years in the White Housefrom 1981 to 1989, Reagan, despite vigorous efforts to contain Medicare andMedicaid costs, never proposed the dismantling of either program.The el­derly, who had become a powerful voting bloc and had reduced theirchances of falling into poverty with the help of Medicare, were ready topunish anyone at the polls who attacked a program they cherished almostas much as Social Security.Yet all was not perfect with the Johnson health care reforms.Eager toassure the cooperation of hospitals and physicians, the measures includedno real controls over either of them.Hospitals were entitled to be reim­bursed for reasonable costs, which was whatever hospitals said they were.Physicians were to be paid customary fees, which would be based on pastbilling history.There was no inhibition on the freedom of doctors to raisecharges each year and submit their higher fees as  billing history.The results of this generosity were staggering increases in medical costsKing of the Hill :: 201to the entire society.Where total Medicare expenditures were $1 billion inthe first year of the program, they had risen to $237 billion by 2001, despiterepeated attempts by the government to rein them in.The approximately6 percent of gross national product Americans spent on health care in 1965had increased to 13.5 percent by 1997.Though advances in medical tech­nology drove some of this expense, much of it resulted from the increasinguse of health care and lack of medical cost controls.The benefits to the el­derly and the indigent from Medicare and Medicaid are indisputable.Butthey did not solve the problem of care at reasonable cost for all Americans.Nor did Medicare provide drug coverage, which by 2002 had become a sig­nificant part of caring for the elderly.Johnson s reforms were only a partialand imperfect solution to a dilemma that other industrialized societies hadaddressed more successfully.:: selma and voting rightsJohnson s vision of a Great Society included an unprecedented degree ofracial harmony, with blacks granted equal opportunities to advance theirwell-being.He hoped that the 1964 civil rights act would begin the processof integrating African Americans into the mainstream of southern life.Atthe very least, he hoped that all sides in the region s racial strife would givethe act a chance to work and relieve the federal government of the need totake new steps to right historic wrongs.This meant not only southernacceptance of desegregation in public facilities but also full participationby blacks in southern politics.In Johnson s view, allowing blacks to voteand hold local, state, and federal offices would give them the same politi­cal influence other groups had used to serve their interests.Yet Johnson knew that southern accommodation to desegregation underthe 1964 law might not be enough to give blacks, who had been systemati­cally excluded from the polls, the franchise.In Mississippi and Alabama,for example, only 6 and 19 percent, respectively, of voting-age blacks wereon the rolls, and office-holders, whose power rested on the existing politi­cal customs, would not voluntarily alter a system that served their interests.To make southern leaders understand that the alternative to regionalreform was federal intervention, Johnson demanded an end to unconsti­tutional limits on black voting in his January State of the Union address.He asked for the elimination of  every remaining obstacle to the right andthe opportunity to vote and declared that  opportunity for all mustinclude the end to  barriers to the right to vote by  Negro Americans. Atthe same time, he privately asked Nicholas Katzenbach, the acting Attor­202 :: lyndon b.johnsonney General, to draft legislation that would enforce constitutional guaran­tees to vote.Johnson was ambivalent about putting a voting rights bill before Con­gress early in 1965.Not because he doubted the value of giving blacks theballot.He considered such a law  in many ways.even more criticalthan the civil rights act.Rather, he saw prospects for congressional passageas  unpromising, and he was reluctant to force another confrontation withthe South.But in the first three months of 1965, King and the Southern ChristianLeadership Conference masterminded a campaign in Selma, Alabama, thatpersuaded Johnson to sponsor a voting rights act.King and the SCLC lead­ership saw no prospect of black enfranchisement flowing from recent lawsand actions.Efforts by a variety of civil rights organizations to register blackvoters under a  Freedom Summer project in 1964 had brought little morethan violence and intimidation.King saw black enfranchisement in theSouth coming only when the federal government made it happen.And thiswould require another Birmingham or some fresh demonstration of repres­sive police action against black demonstrators peacefully asking for the vote.Selma, the  most oppressive city in the South, where less than 1 per­cent of potential black voters was registered, became the focus of King scampaign.It also had a law enforcement officer who was a caricature ofhimself [ Pobierz caÅ‚ość w formacie PDF ]

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