The Struggle to Reform Medicare

Abstract

The long debate over the future of Medicare grinds on, but the Republican-controlled Congress and the Clinton administration have agreed on the general thrust of reforms that, if enacted, would reshape this massive health insurance program in fundamental ways. Both sides have acknowledged that the growth of Medicare spending must be slowed appreciably, that beneficiaries should have broader choices about insurance coverage, and that provider-sponsored organizations should be permitted to make contracts directly with the Health Care Financing Administration. The most recent legislative effort parallels the nascent movement by networks of physicians and hospitals to contract directly with private employers . . .