Medicare at 50: Did It Solve the Right Problems Without Creating New Ones?
4th August 2015
Hint: No.
Aside from the basic numbers of budgetary imbalances and continuing fiscal pressures, Medicare’s institutionalization as the dominant payer in US health care also has locked in the worst features of a costly and inefficient fee-for-service delivery system that still rewards providing more volume, instead of better value, in most health care decisions. The mismatch between Medicare’s claims on the economy and our political willingness to pay for them in turn has produced an ever-more complex web of reimbursement rules and health care regulations in response that are far more successful in hiding or transferring costs than in reducing them. Moreover, although elderly Americans achieved substantial gains in insurance coverage and financial security through Medicare, younger ones fared far less well.
Imagine the worst insurance company you can think of. Then imagine it run by the government. That’s Medicare.