Medicare now and in the future

著者

書誌事項

Medicare now and in the future

Marilyn Moon

Ashgate, c1997

2nd ed

大学図書館所蔵 件 / 全16件

この図書・雑誌をさがす

注記

Includes bibliographical references (p. [257]-260) and index

Previous ed.: Washington, D.C. : Urban Institute Press, 1993

内容説明・目次

内容説明

The fate of the "Medicare" programme - the health care entitlement for all elderly Americans - is a dominant issue in the current political debate and relevant for every US voter. Timed to mark the 30th anniversary of "Medicare's" first beneficiary payment, this volume provides discussion and guidance to the general reader and expert alike on reform alternatives, what is likely to happen, and what would and would not greatly damage the programme.

目次

  • Part 1 Placing Medicare in context: why examine Medicare now? economic status of older Americans - prospects for the future, burdens from health spending
  • the economic status of disabled persons
  • the problem of rising healthcare costs - prices, use of services
  • Medicare as part of federal budget
  • the specific financing issues facing Medicare. Part 2 Assuring access: the genesis - evolution of the legislation, Medicare and its goals
  • expansion in 1972
  • other changes in access
  • who gets what? - rising burdens of Medicare cost sharing, geographic variation. Part 3 Containing costs - impact on providers: sources of growth in Medicare spending
  • changing Medicare's relationship with providers
  • hospitals take the first hit - how PPS works, the immediate response in delivery of care, impacts on hospitals, impact on Medicare administration, changes to improve hospital payment
  • physician payment reform - details of the Medicare fee schedule, the impact of the fee schedule
  • other provider changes - home health services, skilled nursing facility care
  • health maintenance organizations. Part 4 Containing costs - impacts on beneficiaries: direct changes in beneficiary cost sharing - sources of higher beneficiary burderns, offsetting reductions in beneficiary burdens
  • distribution of the impact
  • PPS and indirect burdens on beneficiaries - effects of shorter hospital stays, shifting the site of service, effects of less inpatient care
  • quality of care - Medicare physician payment reform and quality, HMOs and quality, peer review organizations, using effectiveness studies to improve quality, program satisfaction. Part 5 The Medicare catastrophic coverage act: recognizing the need for catastrophic protection - setting the stage for the legislation
  • evolution of the legislation - defining the benefits, financing
  • the Medicare catastrophic coverage act - passage and repeal - overall beneficiary impact, winners and losers, the beginning of the end, repeal
  • lessons for health policy - politics of the supplemental premium. Part 6 Marginal changes and the future: restructuring cost sharing
  • co-containment strategies - hospitals, physicians, other changes in provider payment
  • HMOs and other managed-care approaches - effectiveness studies, cuts directed at beneficiaries
  • modest benefit expansions - administrative simplifications, hospice care and the last year of life, preventing services. Part 7 reducing the cost of Medicare: shifting risks - balancing choice and risk, vouchers, capitated care option
  • reducing coverage - making Medicare the insurer of last resort. (Part contents)

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