This year the months of June and July mark two milestone anniversaries in a history of all Americans’ quest for full and equal access to health care.
Fifty years ago, on June 7, 1965, the United States Supreme Court ruled in the case Griswold v. Connecticut. The decision invalidated a nineteenth-century, Connecticut Comstock law which made “the use of any drug, medicinal article, or instrument for the purpose of preventing conception” illegal. The Court in a 7-2 decision held that this law violated a “right to marital privacy,” securing people against governmental intrusion and decriminalized contraception.
Then on July 30, 1965, amendments to the Social Security Act creating Medicare and Medicaid were signed into law, extending health insurance to all Americans over 65 and creating a welfare program designed to help the most indigent of Americans under 65 get health services.
These two powerful events took place less than two months apart halfway through one of the most transformative and tumultuous decades in American history. Together, they represent a turning point in the relationship between our government and its citizens’ health. Yet 50 years later, recent reflections on these two milestone events seem to have put greater distance between them than when they were first enacted.
Fifty Years Later
In their recent annual meeting in New Haven, CT, the appropriate site to memorialize the 50th anniversary of Griswold, historians of American medicine reviewed the decision which, in the ensuing years, has played a leading if contentious role in abortion decisions and LGBT rights cases.
Griswold has had tremendous significance in the field of women’s health. Decriminalizing contraception has allowed broad access to family planning and the use of contraceptives for other health-related purposes besides preventing conception such as treatments for endometriosis and acne. And by allowing women to plan their pregnancies, it has dramatically reduced the rate of maternal death in childbirth. In 1965, at the time of the Griswold decision, 32 women were dying for every 100,000 live births in America. Today, the rate is less than half that.
Curiously, while the historians celebrated Griswold at their Spring 2015 meeting, no presentations focused on the 50th anniversary of US Medicare or Medicaid and few presentations focused on the historic nature of the Affordable Care Act.
The reverse could be said of Academy Health’s Annual Research Meeting in June 2015 where sessions were devoted to the 50th anniversary of Medicare and Medicaid and health services researchers pored over preliminary results of the Affordable Care Act while waiting with trepidation for the current Supreme Court’s decision in King v. Burwell — but no sessions focused on Griswold.
A Renewed Convergence
Yet, not long after these two meetings, both historians and health service researchers received what might be viewed as a pair of birthday presents marking the 50 years that have passed since that historic summer. These gifts came in the form of two late-June Supreme Court decisions: In King v. Burwell, the Court upheld the subsidies created to help people buy health insurance through exchanges and in Oberbergefell v. Hodges, the court legalized same-sex marriage in all 50 states. Both built on case law stretching back to 1965 and beyond.
Perhaps the time twinning of these decisions will also help undo the silos between historians and the health services researchers. It might be helpful after all to view all of these developments, 50 years ago and today, in the light of a sweeping 1960s Civil Rights movement to extend a wide range of rights—voting, health, marriage, privacy—to vast numbers of Americans, who by race, economic status, age, or gender did not fully have access to them.
Sing It
Of course to truly celebrate the extension of trends of the 1960s, if would be helpful to conjure up the era’s music which had a unique way of giving voice to that moment-in-time’s powerful political and social currents. Unfortunately, health care did not quite have the same appeal musically as the anti-war movement did, but there actually is a smattering of vocal popular culture about health care.
The decade opened with Ronald Reagan speaking out as part of Operation Coffee Cup, the American Medical Association’s (AMA) campaign to paint Medicare as socialized medicine. Less well-known is the possible countercultural response to that campaign from folksinger Phil Ochs, who in 1963 sang The AMA Song. Ochs rails against the AMA’s lobbying with sarcastic lyrics like “If you can’t afford your bill, don’t tell me that you’re ill, because that’s the free enterprise way.” Ochs, perhaps the most authentic voice of 60s protest music, was the son of a physician.
The final word, or in this case song, however, goes to Pete Seeger who outlived both his friend Phil Ochs and probable foe Ronald Reagan. In 1962 he wrote a song about Canada’s quest to provide Medicare in the provinces in the wake of a physician strike in Saskatchewan. The Ballad of Dr. Dearjohn is sung from the point of view of a husband caring for his sick wife:
Hospital therapy, medicine too. The bills are gigantic but what can I do?
A friend of my own come to see me one day. He saw that my wife was a-fading away.
But he knew of a method that could make her strong, ‘twas the Medicare plan of Saskatchewan.
It’s government sponsored and they pay the bill when you or your wife or your children get ill.
It lessens the worry when sickness is near and there is something left over for skittles and beer.
Perhaps it’s not research meetings or even the Supreme Court, but the enduring music of the 1960s that will ultimately remind historians and health services researchers of just how much they have in common.
Author’s Note
The information and background on the Pete Seeger recording comes from Jacalyn Duffin’s presentation at the American Association for the History of Medicine annual meeting, May 2, 2015 titled: “Mrs. Robinson’s Revenge: The Medicare Protest Song.”
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