Medicare beyond age 50: Lessons for the future

(By – Thomas P. Miller, American Enterprise Institute)

As Medicare reaches age 50, we see periodic signs of limited efforts to move beyond its youthful exuberance as a full-fledged pay-as-you-go, fee-for-service, universal entitlement program and toward a somewhat more market-oriented direction. Most notably, the last decade since the passage of the Medicare Modernization Act of 2003 has produced rapid growth in enrollment in Medicare Advantage private plan options. Over 30% of Medicare beneficiaries are enrolled in these more market-based alternatives to the traditional Medicare fee-for-service program. Give or take 50 years, that might be considered modest progress in moving back toward a path not taken by Medicare’s original architects, even as they needed to maintain more of a “private market” face to cover such an unprecedented expansion of the federal government’s role in health care financing and regulation. Read more…


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