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
General
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