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.By 1970, in five years, one out of every four college students in Americawas receiving some form of financial assistance provided by HEA.The lawfacilitated a huge expansion of college enrollments.In 1970, 34 percent ofthe eighteen-to-twenty-one age group in America attended some collegedegree credit program; up from 15 percent in 1950.By 1990, the numberhad grown to 52 percent.The fact that the country s educational system works as well as it doeshas something to do with the federal support Johnson initiated in 1965.Ifhis educational reforms did not lead to a Great Society, they have at leastmade for a better society.It is an achievement for which Johnson deservesthe country s continuing regard.:: medicareFor Johnson, there could be no Great Society no improved quality ofnational life without greater access for all Americans to health care andspecial efforts to conquer the country s most disabling diseases and common killers, heart attack, cancer, and stroke.Johnson had been an advocate of federally supported health care delivery and research since the 1940s when he had backed the Hill-Burton lawassisting states to build hospitals.In 1956, he had attached an amendmentto a Social Security bill making it possible to provide federal health insurance to the elderly.In the first months of his presidency, Johnson sent a message to Congress announcing his determination to make the wonders of modern med King of the Hill :: 197icine available to all Americans.He urged hospital insurance for the aged,more modern hospitals, increased and better medical manpower, andgreater spending on mental health and ways to prevent and cure heart disease, cancer, and strokes, the country s leading causes of death.Johnson s highest initial health care priority in 1964 was not Medicareor hospital insurance for the elderly but the creation of a Commission onHeart Disease, Cancer and Strokes (HDCS).In April, when he introducedthe members of the commission in a White House ceremony, heannounced his keenest, greatest, and most personal interest in theirwork, and urged them to spare no effort in bringing America s three greatkillers and cripplers under control.Buoyed by Johnson s evangelism and by the medical advances of the1940s and 1950s that had produced cures for infectious diseases, especiallypolio, the commission issued a report in December that promised miracles in the near future.A $2.8 billion program implemented over five yearscould bring the ultimate conquest of heart disease, cancer, and strokes.Swept up in the euphoria of overcoming the diseases that had accountedfor 71 percent of the country s deaths in 1962, Johnson declared the worldon the threshold of a historic breakthrough.Heart disease, cancer, andstroke [can] be conquered not in a millennium, not in a century, but inthe next few onrushing decades. During 1964 65 Johnson increasingly focused on hospital insurance forthe aged under Social Security.Although it had been on liberal reformagendas since the 1930s and had failed to win passage in four successiveCongresses beginning with the 85th in 1957, it had gained widespread public appeal by the summer of 1964 as the most desirable change in the coun-try s system of financing and delivering health care.Johnson saw a Medicare law as a realistic goal of the 89th Congress.With two-to-one margins in both Houses, it seemed likely that some kindof hospital insurance for Americans over sixty-five would be approved.Larry O Brien believed that passage of a Medicare bill was now asinevitable as tomorrow morning s sunrise. He predicted Senate passage bya vote of 55 to 45.The key figure in passing Medicare was Arkansas Congressman WilburMills, the chairman of the Ways and Means Committee.Mills and hiscommittee had been staunch opponents of government-sponsored hospital insurance.A fiscal conservative, Mills worried that Medicare would leadto large federal deficits.He was also reluctant to back any controversial legislation that might fail or pass by a small margin.In July 1964, when Cohenhad asked the President to get a commitment from Mills on Medicare, 198 :: lyndon b.johnsonJohnson replied that he hadn t been successful in getting Mills committed to anything. For all Johnson s vaunted talent at persuasion, Mills was not susceptibleto presidential pressure.Nor was he very responsive to national opinionfavoring Medicare legislation.Holding a safe seat and seeing himself as aman of principle who would not jeopardize the country s fiscal future forthe sake of a social reform, however worthy, Mills and his committee hadbeen an insurmountable obstacle to Medicare in 1961 64.Yet, as Johnson appreciated, Mills was a political realist.With the Democratic landslide in November 1964, Mills understood that he would nolonger command a conservative majority on Ways and Means and that itwould be difficult, if not impossible, to resist passing Medicare.Consequently, on November 11, 1964, and again on January 1, 1965, he publiclyacknowledged that his committee would be able to work something out on Medicare, though he continued to insist on the importance of a soundfinancing plan.Mills s comments convinced Johnson that he could get a Medicare lawpassed in the first session of the 89th Congress
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