Lessons from the first twenty years of Medicare : research implications for public and private sector policy /

In 1986, the Leonard Davis Institute of Health Economics (University of Pennsylvania) convened 60 prominent health policy experts to discuss the evolution of Medicare over its first 20 years and the probable and needed future policy directions. This resultant volume of 16 papers, together with an introductory essay by the editors, is divided into five parts. Section 1 summarizes the development of the Medicare system, identifies current gaps and issues, and describes major policy options and the forces likely to determine future Medicare policy. Section 2 discusses the degree to which Medicare and private insurance protect beneficiaries and how their protective value as insurance could be enhanced. Section 3 presents research results regarding the impact of prospective payment for hospital services and capitated payment for physicians. Section 4 examines the shift in the financial burdens borne by the federal government, by employers, and by beneficiaries as a result of Medicare's changing reimbursement policy. The final section suggests ways that Medicare can promote more and better medical care for the elderly. The volume provides some of the most current findings and thinking on major policy issues related to the primary federal health-care financing program. Chapter references. Written for the most part in nontechnical language, the book is still likely to be limited in readership to health-policy researchers, graduate students, and faculty in economics, public health, and public administration. -J. M. Glasgow, University of Connecticut Health Center