The familiarity of Medicare after 48 years of experience disguises the limits of dice throwing. The system needs a major money infusion in order to continue.
Never mind that, says the current president and his Congress, who are rolling the dice more grandly, swaggeringly and with bigger stakes than ever before, as they corral one-sixth of the U.S. economy.
The Kennedy style -- caution, a certain prudence in action, a defensiveness when it came to government overreach -- looks better than it looked at the time. We might have appreciated it better at the time if we could have recognized Kennedy caution as the last remnant of old-style American skepticism as to the efficacy of federal meddling in affairs large and small. The founding principles of the republic had included faith in the ability of "the states and the people respectively" (in the language of the Tenth Amendment) to address most of their own problems. The New Deal undermined that principle; the Great Society, under Johnson, knocked it in the head.
We didn't know in November 1963 what was coming our way. Who could have foreseen the likes of Obama, Pelosi or Sen. Reid -- or for that matter, the Clintons? The dam burst after Nov. 22 1963, on account of powerful, pent-up forces pounding hard against the spirit of restraint. The American past -- the past of responsible freedom -- no longer inspired, no longer satisfied. It was onward to the Affordable Care Act.