By the early 1950s, it was becoming apparent thata growing number of elderly Americans had noeconomic protection from the increasing cost ofhealth care. Most people over 65 had very lowincomes and few owned private health insurance ofany kind.

早在19世纪50年代，医疗保险成本日益高涨的同时，越来越多的美国老人却没有受到经济保护，这一现象日益突出。大多数年龄超过65岁的老人收入微薄，只有少数人参保了各种名目的私人医疗保险。

Congress began a years–long debate on this issue of national health insurance for the elderly.Critics in Congress feared Medicare would lead to substandard and overpriced care, and felt thatit should serve only the indigent. They also predicted that, with growing numbersparticipating, it would eventually bankrupt the federal Treasury.

国会就老年人国家医疗保险这个问题进行了长达几年的争论。国会的批评人士担心医疗保险会衍生出各种低劣、超价收费的保险，并认为医疗保险只能为穷人服务。他们估计，随着参保的人数不断增长，最终会导致联邦财政部门破产。

The legislative compromise that became the final Medicare Act—officially known as the"Social Security Amendments of 1965”—was part of President Lyndon Johnson's "Great Society"program. Today it protects more than 40 million Americans from the high cost of hospital care.

立法上的妥协成就了最终的医疗法案——官方称作“1965年社会保障修正案”，这也是林肯·约翰逊总统“大社会”计划的组成部分。而今在住院花费高昂的美国，它让四千多万人民受益。

Much of the program's costs are covered by payroll taxes paid by workers. Yet costs quicklystarted to exceed expectations, and as Americans' life expectancy increased over the years, theMedicare program became even more expensive.

这项计划的大部分开销来源于工薪阶层的工资税。然而，开支很快开始超出预算。而且多年来美国人口寿命也在不断增加，这使得医疗保险计划变得更加入不敷出。

It has become a matter of national debate and a financial issue for every Congress andPresident since. Today it is still one of the fastest growing items in the federal budget.Nonetheless, Medicare remains a popular program, and a well-established part of the federalgovernment's role in our society.

自此，医疗保险就变成历任总统，历届国会上永恒不变的国家性话题和财政大事。如今，它仍然是联邦预算中增长最快的一项。无论如何，医疗保险仍深受人民欢迎，也是联邦政府社会职能的良好体现。