Medicare at 60: Suggestions for balancing access to care and financial protections with fiscal concerns
Year: 2024
Type: article
Abstract: For 60 years, Medicare has been a cornerstone of the American social insurance system, protecting millions of aged, blind, and disabled people from high health care costs and ensuring access to necessary services.Prior to the creation of Medicare, nearly half of all people aged 65 and older were uninsured.1 Today, less than 1% of the elderly population is uninsured.2 More broadly, Medicare influences the U.S. health care system, affecting provider supply, payment rates and methods, and care delivery institutions.Recent news about Medicare's fiscal situation has been encouraging.Since 2021, the projected date of depletion of the Medicare Part A trust fund has been pushed back by 10 years, from 2026 to 2036. 3 More importantly, Medicare spending per beneficiary has grown relatively slowly over the last 10 to 15 years, due to factors such as smaller increases in payment rates for many services, slowerthan-expected growth in the volume of services, demographic changes in the Medicare population, better treatment of cardiovascular disease, a decline in new drug introductions, and a shift to generic medications.4,5 Despite these positive trends, Medicare still faces significant fiscal challenges.The program's demographic challenges are well known.Since Medicare's founding, the worker-to-beneficiary ratio has dropped from 4.6 to 2.9 and is projected to fall to 2.5 by 2030.6,7 Medicare spending as a share of GDP has grown from around 0.7% to
Source: Health Services Research
Authors: Michael E. Chernew, Paul B. Masi
Institution: Harvard University
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,570
OpenAlex ID: W4404976962