Solving One Social Problem of Medicare on a Macro Level

Introduction There is far-flung disagreement on how Medicare should be fixed. One flak is to crystallise incremental changes in Medicare constitution and hope for moderation in coming(prenominal) Medicare expenditures, either because of court-containment mechanisms at heart the Medicare system or sociable spillover effects from private-sector cost-cutting initiatives. The recent balanced-budget agreements reached by President Clinton and the Congressional leadership followed this approach: across-the-board reductions in hospital and managed care reimbursements a foresightful with unspecified future cost saving. The second approach is to encourage the migration of Medicare enrollees to managed care, and thereby bring low the billet of Medicare to unitary of simply negotiating risk-adjusted annual capitation payments, with perhaps a residual role in the fee-for-service market. A third approach proposes turning Medicare into a financial assistance or voucher program (A aron and Reischauer, 1995). In this approach, competition for Medicare dollars among private insurance companies would select back cost increases and offer a menu of wellness plans to enrollees. We argue that none of these three proposals deals directly with a unmannered problem in the Medicare program--the enormous geographic disparity in Medicare spending across the United States. Average 1994-5 Medicare reimbursements per enrollee were $8,537 in Miami and besides $3,300 in Minneapolis.

There are a flesh of dead good reasons why such disparities exist, including differences in e preciseday cost of living, the age structure of the population, and we! llness status. We show, however, that even subsequently adjusting for age, sex, race, price, and sickness related factors, major variations in Medicare spending persist. Thus, we heighten on the supply side of how physicians and hospitals in different regions raise very different levels of resources to people with what appear to be comparable health problems. While such variations have long been recognized in the health services research literature, a different point is, how important are... If you want to get a full essay, ordinance it on our website: OrderCustomPaper.com

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