The Political Life of Medicare

The Political Life of Medicare PDF Author: Jonathan Oberlander
Publisher: University of Chicago Press
ISBN: 0226615960
Category : Business & Economics
Languages : en
Pages : 275

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Book Description
In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

The Political Life of Medicare

The Political Life of Medicare PDF Author: Jonathan Oberlander
Publisher: University of Chicago Press
ISBN: 0226615960
Category : Business & Economics
Languages : en
Pages : 275

Get Book Here

Book Description
In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

The Politics of Medicare

The Politics of Medicare PDF Author: Theodore R. R. Marmor
Publisher: Routledge
ISBN: 1351476920
Category : Medical
Languages : en
Pages : 267

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Book Description
On July 30, 1965, President Johnson flew to Independence, Missouri to sign the Medicare bill. The new statute included two related insurance programs to finance substantial portions of the hospital and physician expenses incurred by Americans over the age of sixty-five. Public attempts to improve American health standards have typically precipitated bitter debate, even as the issue has shifted from the professional and legal status of physicians to the availability of hospital care and public health programs. In The Politics of Medicare, Marmor helps the reader understand Medicare's origins, and he interprets the history of the program and explores what happened to Medicare politically as it turned from a legislative act in the mid-1960s to a major program of American government in the three decades since. This is a vibrant study of an important piece of legislation that asks and answers several questions: How could the American political system yield a policy that simultaneously appeased anti-governmental biases and used the federal government to provide a major entitlement? How was the American Medical Association legally overcome yet placated enough to participate in the program? And how did the Medicare law emerge so enlarged from earlier proposals that themselves had caused so much controversy?

Medicare Prospective Payment and the Shaping of U.S. Health Care

Medicare Prospective Payment and the Shaping of U.S. Health Care PDF Author: Rick Mayes
Publisher: JHU Press
ISBN: 0801888875
Category : Medical
Languages : en
Pages : 274

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Book Description
This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system. Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.

Who Should Pay for Medicare?

Who Should Pay for Medicare? PDF Author: Daniel Shaviro
Publisher: University of Chicago Press
ISBN: 0226750760
Category : Art
Languages : en
Pages : 185

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Book Description
Good news first? The good news is that Americans today are living longer, in part because of continual advances in healthcare. But the bad news is that with our aging population larger than ever before, nothing is being done to ensure that we can continue to afford the increasing costs of care. How Medicare—with the Bush administration's reforms and a slumping economy—will meet the needs of its recipients without adequate financing is among the most pressing issues facing this country today. Daniel N. Shaviro sees the future of our national healthcare system as hinging on the issue of funding. The author of books on the economic issues surrounding Social Security and budget deficits, Shaviro is a skilled guide for anyone seeking to understand the financial aspects of government programs. Who Should Pay for Medicare? offers an accessible overview of how Medicare operates as a fiscal system. Discussions of Medicare reform often focus on the expansion of program treatment choices but not on the question of who should pay for Medicare's services. Shaviro's book addresses this critical issue, examining the underanalyzed dynamics of the significant funding gap facing Medicare. He gives a balanced, nonpartisan evaluation of various reform alternatives—considering everything from the creation of new benefits in this fiscal crunch to tax cuts to the demographic pressures we face and the issues this will raise when future generations have to pay for the care of today's seniors. Who Should Pay for Medicare? speaks to seniors who feel entitled to expanded coverage, younger people who wonder what to expect from the government when they retire, and Washington policy makers who need an indispensable guidebook to Medicare's future.

The Delegated Welfare State

The Delegated Welfare State PDF Author: Kimberly J. Morgan
Publisher: Oxford University Press
ISBN: 0199875634
Category : Political Science
Languages : en
Pages : 322

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Book Description
Why are so many American social programs delegated to private actors? And what are the consequences for efficiency, accountability, and the well-being of beneficiaries? The Delegated Welfare State examines the development of the American welfare state through the lens of delegation: how policymakers have avoided direct governmental provision of benefits and services, turning to non-state actors for the governance of social programs. Utilizing case studies of Medicare and the 2009-10 health care reform, Morgan and Campbell argue that the prevalence of delegated governance reflects the powerful role of interest groups in American politics, the dominance of Congress in social policymaking, and deep contradictions in American public opinion. Americans want both social programs and small government, leaving policy makers in a bind. Contracting out public programs to non-state actors masks the role of the state and enlists private allies who push for passage. Although delegated governance has been politically expedient, enabling the growth of government programs in an anti-government political climate, it raises questions about fraud, abuse, administrative effectiveness, and accountability. In probing both the causes and consequences of delegated governance, The Delegated Welfare State offers a novel interpretation of both American social welfare politics and the nature of the American state.

Power, Politics, and Universal Health Care

Power, Politics, and Universal Health Care PDF Author: Stuart Altman
Publisher: Prometheus Books
ISBN: 1616144572
Category : Political Science
Languages : en
Pages : 479

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Book Description
Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.

Medicare Meltdown

Medicare Meltdown PDF Author: Rosemary Gibson
Publisher: Rowman & Littlefield Publishers
ISBN: 1442219807
Category : Medical
Languages : en
Pages : 225

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Book Description
Medicare affects everyone. If you are a boomer, you are counting on Medicare to protect you from the cost of health care when you retire. If you have turned 65, you already depend on Medicare. If you are a Gen-X or Gen-Y, you are contributing to Medicare from your paycheck. Will Medicare continue to exist as we have known it? Will it be there when you need it? How much will it cost? As the future of Medicare is debated in Washington, Rosemary Gibson and Janardan Prasad Singh shine a light on a rarely-seen side of this storied program: the business of Medicare. Medicare is known as an entitlement for the nation’s seniors. It is also the largest entitlement-based program for any business sector in the US economy. Its beneficiaries include hospitals, doctors, drug companies, device manufacturers, Wall Street investment banks, private equity firms, hedge funds, and others that rely on the $600 billion that Medicare spends a year. The ties that bind Wall Street and Washington in the healthcare industry are strong, and they will play an outsized role in determining Medicare’s future. Gibson and Singh reveal how the industry’s interests are often at odds with those of seniors and boomers. While some politicians point to the culture of dependence of the public on Medicare, the authors suggest that policymakers turn their attention to the culture of dependence of the healthcare industry on Medicare, which is the predominant force pushing the program toward a fiscal cliff. The amount of waste in the Medicare program is equivalent to the entire economy of New Zealand. For Medicare to be sustained, this culture of dependence -- and the habits it breeds, namely waste, excessive pricing, and overuse of unnecessary services -- should be the first priority for the chopping block. By parings back the excess, the authors argue, Medicare can be sustained for future generations. This is essential reading for anyone interested in how Medicare works, how it could work better, and where it will go if reforms are not made.

The Power to Heal

The Power to Heal PDF Author: David Barton Smith
Publisher: Vanderbilt University Press
ISBN: 0826521088
Category : Medical
Languages : en
Pages : 257

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Book Description
In less than four months, beginning with a staff of five, an obscure office buried deep within the federal bureaucracy transformed the nation's hospitals from our most racially and economically segregated institutions into our most integrated. These powerful private institutions, which had for a half century selectively served people on the basis of race and wealth, began equally caring for all on the basis of need. The book draws the reader into the struggles of the unsung heroes of the transformation, black medical leaders whose stubborn courage helped shape the larger civil rights movement. They demanded an end to federal subsidization of discrimination in the form of Medicare payments to hospitals that embraced the "separate but equal" creed that shaped American life during the Jim Crow era. Faced with this pressure, the Kennedy and Johnson Administrations tried to play a cautious chess game, but that game led to perhaps the biggest gamble in the history of domestic policy. Leaders secretly recruited volunteer federal employees to serve as inspectors, and an invisible army of hospital workers and civil rights activists to work as agents, making it impossible for hospitals to get Medicare dollars with mere paper compliance. These triumphs did not come without casualties, yet the story offers lessons and hope for realizing this transformational dream.

When Politics Comes Before Patients

When Politics Comes Before Patients PDF Author: Shawn Whatley, MD
Publisher: ECW Press
ISBN: 088890312X
Category : Health & Fitness
Languages : en
Pages : 385

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Book Description
How Successive Governments Have Weakened the Foundation of All Canadian's Social and Economic Security At some point you will find yourself lying in a hospital bed. There is a good chance that your bed will be a firm, rubber pad held secure between two rails and parked along a corridor in a busy emergency department. Moans of “Nurse!” will echo from the beds ahead of you in line. Those pleas will fall largely on deaf ears. Your hospital is underfunded and understaffed. Welcome to the current reality of Medicare in the 21st century. Using searing analogies and first-hand accounts, Dr. Whatley makes the argument that the current Medicare system is unsustainable and unless critical choices and changes are made soon, the publicly funded, single-payer system in Canada will implode. Successive governments, regardless of political stripe, know all too well that Canada's system of health care is one of the defining characteristics of “being a Canadian”, and any changes deemed harmful will have them thrown out of power. Thus, decades of cuts around the margins, centralized control, federal/provincial infighting, and government oversight has left doctors and hospitals with little input on how your health dollars are allocated and spent. Citizens are being left to languish in pain for months, sometimes years, because the current cost and delivery system is programmed for the benefit of governments staying in power. That was not what was intended. Medicare should be about delivering high-quality and timely healthcare value for Canadians. This is not an easy fix. Treatment starts with a serious look at the disease, and Dr. Whatley pulls no punches. But what sounds like a radical new approach is neither new nor radical. He is not arguing for the end of Medicare per se but is making the case to let medical professionals — those providing the services — become equal partners in its design, implementation and delivery.

Fragmented Democracy

Fragmented Democracy PDF Author: Jamila Michener
Publisher: Cambridge University Press
ISBN: 1108245323
Category : Political Science
Languages : en
Pages : 239

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Book Description
Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.