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First published in 1997, this volume approaches the controversial issue of Medicare and its future. First passed in 1965 to aid payments for elderly and disabled medical care, the costs had ballooned in the 1990s, asking questions about how to improve its efficiency. An original goal of this book was to contextualise Medicare within the anticipated comprehensive restructuring of American healthcare. With Medicare 10% of the federal budget at the original time of publication, Marilyn Moon now takes another look at Medicare and discusses how the budget could be tightened without threatening the function of Medicare, with an emphasis on better targeting. In particular, the novel issue of means testing is explored. Having researched Medicare since 1981, Moon recasts her book by discussing issues including Medicare’s context, ensuring access, containing costs, the Medicare Catastrophic Coverage Act, the potential for marginal changes, reducing costs, expanding Medicare and ultimately how Medicare should look to change.
Published in time to mark the 30th anniversary of Medicare's first beneficiary payment, Marilyn Moon's up-to-the-minute discussion provides guidance to the general reader and expert alike on reform alternatives, what is likely to happen, and what would and would not greatly damage the program.
For fifty years, Medicare and Medicaid have stood at the center of a contentious debate surrounding American government, citizenship, and health care entitlement. In Medicare and Medicaid at 50, leading scholars in politics, government, economics, health policy, and history offer a comprehensive assessment of the evolution of these programs and their impact on society -- from their origins in the Great Society era to the current battles over the Affordable Care Act ("Obamacare"). These highly accessible essays examine Medicare and Medicaid from their origins as programs for the elderly and poor to their later role as a safety net for the middle class. Along the way, they have served as touchstones for heated debates about economics, social welfare, and the role of government. Medicare and Medicaid at 50 addresses key questions for understanding the past and future of health policy in America, including: · What were the origins for these initiatives, and how were they transformed over time? · What marks have Medicare and Medicaid left on society? · In what ways have these programs produced innovation, even in eras of retrenchment? · How did Medicaid, once regarded as a poor person's program, expand its benefits and coverage over the decades to become the platform for the ACA's future expansion? The volume's contributors go on to examine the powerful role of courts in these transformations, along with the shifting roles of Congress, public opinion, and state governors in the programs' ongoing evolution. From Lyndon Johnson to Barack Obama on the left, and from Ronald Reagan to George W. Bush on the right, American political leaders have tied their political fortunes to the fate of America's entitlement programs; Medicare and Medicaid at 50 helps explain why, and how those ongoing debates are likely to shape the future of the Affordable Care Act.
A group of respected analysts of health issues considers the economic forces impacting the surging health care market and examines the ultimate fairness of an intergenerational contract dictating that tomorrow's workers foot the bill for today's elderly."--BOOK JACKET. "Written for the general reader and offering innovative ideas for policy revision along with critical new data on health care economics, this comprehensive volume provides a timely and thoughtful deliberation on the precarious future of Medicare."--BOOK JACKET.
In this cross-cutting analysis, some of the nation's most prominent social insurance experts go beyond recent budget debates to examine the fundamental and technical choices Medicare poses for the American people in the next century. The book begins with a consideration of the underlying social contract between Medicare's beneficiaries and workers. Pointing out that Medicare historically has had particular significance for civil rights and women's economic security in addition to providing health security, the authors debate the appropriate social contract for the future. The book also lays out the challenges in financing Medicare as health care costs rise and the population ages. Several authors explore how the growth in managed care is likely to affect Medicare beneficiaries with particular emphasis on beneficiaries with chronic illness, and they address some of the policy changes needed to make managed care better. In addition, they also look at how managed-care tools could be applied to the fee-for-service sector. The book concludes with an examination of how public opinion, politics, and leadership affect the prospects for significant Medicare restructuring in the near and long term. Copublished with the National Academy of Social Insurance