The Beneficiary's Perspective

Medicare has contributed substantially to the well-being of America's oldest and most disabled citizens. The largest public health care program in the United States, Medicare provides the major source of acute care insurance for elderly and disabled populations. For some, Medicare represents a model of what national health insurance could be in the United States. With low administrative costs, the program is popular with both beneficiaries and the general population. At the same time, Medicare is one of the fastest growing programs in the federal budget, gobbling up new resources at the rate of 12 percent each year during its first 37 years. Critics assail the program as being out of sync with the needs of many senior citizens for failing to provide comprehensive services, while others often refer to it as "unsustainable" because of high costs. Physicians and hospital administrators endlessly criticize and debate Medicare, but rely upon it for a substantial share of their revenues.

This book examines the current status of Medicare and offers options for reform, with a particular focus on the program's beneficiaries: What is Medicare, how does it work, and where is it headed? What are the problems facing the program, and how can they be resolved? What options for the future hold the most promise? And most important, can current and future beneficiaries count on this program to be there for them? To understand the many different pressures on Medicare, it is useful to first examine the program from the perspective of the beneficiaries it serves (this chapter) and then look at it in the broader context of health care, the federal government, and the economy (chapter 2). Later chapters explore the history of Medicare, how the program works, and how it might change. Throughout, however, the intent is to emphasize the impacts on beneficiaries rather than on other players in the health care maze.

Note: The text above is a portion of the complete document. This chapter is available in its entirety in the Portable Document Format (PDF).

Medicare: A Policy Primer, by Marilyn Moon, is available from the Urban Institute Press (paper, 6" x 9", 230 pages, ISBN 0-87766-753-5, $26.50).