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Briefcase from the White House Conference on Health, 1965
Cleveland internist and medical politician Charles L. Hudson (1904-1992) received this briefcase when attending the White House Conference on Health on November 3 and 4, 1965. Years later, the briefcase must have been a poignant reminder of the tumult he faced as President of the American Medical Association. In the United States, government involvement in medical care became a reality when President Lyndon B. Johnson signed Medicare into law on July 30, 1965. In the preceding decades the AMA fought vigorously against government intervention, but it failed to halt passage of the legislation.Then, under Hudson's leadership, the AMA had to move forward. The White House Conference provided an opportunity to discuss last minute problems likely to arise when Medicare went into effect on July 1, 1966. Anticipated difficulties included the new paperwork facing physicians, the cost and price formulas for reimbursing physicians, the relation of hospital-based medical specialists, such as radiologists and pathologists, to hospital operation, and most important, the impact of the authority vested in the carriers of Medicare insurance, which directly challenged physician autonomy.
As President of the AMA, Hudson was conciliatory; newspapers of the period called him an "eloquent moderate." Just before he was installed as President, some delegates at the 1966 AMA convention in New York called for a boycott, euphemistically termed "non-participation." They labeled out-going AMA President James Z Appel an "appeaser" and viewed Hudson in much the same light. But Hudson prevailed, urging that Medicare be given a fair trial. During his year as AMA President, Hudson toured the country, speaking out on issues of concern to the medical profession.He addressed the imperfections of Medicare, counseling patience. To forestall further governmental inroads into medicine, Hudson preached voluntarism. He admonished physicians to initiate programs to care for the poor and disadvantage, and thereby halt the extension of Medicare benefits to a larger portion of the American population.
Indeed, efforts to secure passage of Medicare had carefully presented it solely as a program to protect the elderly middle classes from burdensome health care costs, and did not envision its extension to become a national health insurance program. Medicare remains today a health insurance program for people 65 years or older, as well as certain people with disabilities and with permanent kidney failure requiring dialysis or a transplant.
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