It was 47 years ago today that President Johnson signed the bill creating Medicare, assuring health security for the first time to 40 million Americans, age 65 and older as well as millions more with disabilities. The law also established Medicaid for low income Americans.

It was one of the most significant social reforms in U.S. history, and the product of years of struggle by nurses, union members, healthcare activists, and many others against the virulent opposition of the insurance industry, the American Medical Association, other corporate interests, and far right politicians.

Nearly half a century later, the law endures in the face of repeated attempts by those on Wall Street and in the healthcare industry, and the politicians they influence to privatize or gut the law.

Presidents Johnson and Truman with Lady Bird Johnson, Vice President Humphrey, and Bess Truman.

Johnson made a point of traveling to Independence, Mo. to have former President Harry Truman by his side at the historic bill signing in recognition of Truman’s effort 20 years earlier to pass national health insurance. Medicare cards 1 and 2 were given to the 81-year-old Truman, who called the bill signing a “profound personal experience for me,” and his wife, Bess.

Indeed, within a few hours of becoming President after John Kennedy’s assassination, Johnson told aides (in a story recounted in Robert Caro’s latest biography of Johnnson), “By God, I’m going to pass Harry Truman’s medical insurance bill.”

“For these long decades,” Johnson said, “bill after bill has been introduced to help older citizens meet the often crushing and always rising cost of disease and crippling illness.”

“Each time, until today,” Johnson continued, “the battle has been lost. Each time the forces of compassion and justice have returned from defeat to begin the battle anew. And each time the force of increased public understanding has added to our strength.”

Today Medicare remains one of the most popular and successful reforms in U.S. history.

Harry Truman’s first Medicare card.

Compared to our broken and dysfunctional private system for people under 65, Medicare is far more efficient with less bureaucracy and administrative waste. It is genuinely universal, not based on ability to pay. It assures choice of provider with no restrictions or huge cost hikes for going out of network. And it controls costs -- people on Medicare are the one age bracket not facing bankruptcy due to un-payable medical bills.

And, it is wildly popular, even among the most vociferous opponents of the Obama healthcare law.

Yet it also remains under repeated attack. Republicans in Congress have passed budget proposals to turn Medicare into a privatized voucher program. And many Democrats have proposed slicing and dicing Medicare through cuts in benefits, higher out of pocket costs, or raising the eligibility age to qualify.

How do we defend one of the crown jewels of our nation? By improving it and expanding it to cover everyone. Here’s a few ways how:

•    End the creeping privatization, through the various sub parts of Medicare, including the privatized Bush Medicare drug plan and other Medicare supplement programs that rely on private insurance companies

•    Expand the benefits under Medicare to include vision, dental, and long term care (as is provided in Medicaid, though at too low reimbursement rates).

•    Full and proper funding to enable the program to eliminate co-pays and deductibles.

•    Extend Medicare to cover everyone, which makes for an expanded risk pool that would help lower costs, and create jobs through the ripple effects documented in a 2009 CNA/NNU study which found Medicare for all/single payer would create 2.6 million, desperately needed, new jobs.