Solving One Social Problem of Medicare on a Macro Level

Introduction There is far-flung disagreement on how Medicare should be fixed. One surface is to crystallise incremental changes in Medicare policy and hope for moderation in next Medicare expenditures, either because of court-containment mechanisms within 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 restrict 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 coupon program (Aaron and Reischauer, 1995). In this approach, competition for Medicare dollars among private insurance companies would admit back cost increases and offer a menu of wellness plans to enrollees. We argue that none of these three proposals deals directly with a uncreated 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 just $3,300 in Minneapolis. There are a flesh of short good reasons why such disparities exist, including differences in e preciseday cost of living, the age structure of the population, and health status. We show, however, that even subsequently adjusting for age, sex, race, price, and illness 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 healt h problems. While such variations have lon! g been recognized in the health services research literature, a different header is, how important are... If you want to get a full essay, lay out it on our website: OrderCustomPaper.com

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