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How Medicare's 1965 Launch Forced the Desegregation of American Hospitals

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Medicare's own description covers what the program pays for and whom it covers, but not what its 1966 launch forced hospitals to do in order to collect its checks. Title VI of the Civil Rights Act of 1964 barred federal payment to any institution that discriminated by race, and once Medicare's benefits took effect a hospital could no longer collect a Medicare payment while it still ran a segregated ward, waiting room, or medical staff. Because nearly every hospital in the country depended on those payments to survive, integration became, in practice, a matter of accounting rather than persuasion. The scale of the change was immediate. The historical record describes Medicare spurring the desegregation of thousands of hospital waiting rooms, wards, and physician practices within about a year of its 1966 start, as administrators who had resisted a decade of moral and legal argument reorganized their facilities rather than lose the single largest source of hospital revenue in the country, a leverage the civil rights movement had not had access to before Medicare's payments existed to withhold. The same year carried a smaller, more personal marker of the program's start. President Lyndon Johnson signed the Social Security Amendments of 1965 into law on July 30, 1965, at the Harry S. Truman Presidential Library in Independence, Missouri, and former president Harry S. Truman and his wife, former first lady Bess Truman, became Medicare's first enrollees. 1
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1. Wikipedia: Medicare (United States)
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In 1966, Medicare spurred the racial integration of thousands of waiting rooms, hospital floors, and physician practices by making payments to health care providers conditional on desegregation.
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