TY - JOUR
T1 - Medicare's fiscal problems
T2 - An imperative for reform
AU - Holahan, J.
AU - Palmer, J. L.
PY - 1988
Y1 - 1988
N2 - Many observers have noted that Medicare expenditures will significantly outstrip projected revenues over the course of the next 25 years. This paper examines the economic and demographic assumptions behind forecasts of Medicare hospital insurance and supplementary medical insurance expenditures and revenues and analyzes various strategies for closing the impending gap. It is argued that the present forecasts already assume considerable success in controlling hospital costs and physician payments, making substantial further savings unlikely. Shifting more of the burden onto the elderly through increased cost sharing or higher premiums also will not solve the program's fiscal problems over the long term. The remaining alternative - imposing higher income or payroll taxes on the under-65 population - is also unlikely to be a welcome solution. The authors argue that, eventually, the nation must choose between some form of a two-tier system of benefits or a Canadian-style national health insurance system.
AB - Many observers have noted that Medicare expenditures will significantly outstrip projected revenues over the course of the next 25 years. This paper examines the economic and demographic assumptions behind forecasts of Medicare hospital insurance and supplementary medical insurance expenditures and revenues and analyzes various strategies for closing the impending gap. It is argued that the present forecasts already assume considerable success in controlling hospital costs and physician payments, making substantial further savings unlikely. Shifting more of the burden onto the elderly through increased cost sharing or higher premiums also will not solve the program's fiscal problems over the long term. The remaining alternative - imposing higher income or payroll taxes on the under-65 population - is also unlikely to be a welcome solution. The authors argue that, eventually, the nation must choose between some form of a two-tier system of benefits or a Canadian-style national health insurance system.
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U2 - 10.1215/03616878-13-1-53
DO - 10.1215/03616878-13-1-53
M3 - Article
C2 - 3130421
AN - SCOPUS:0023919505
SN - 0361-6878
VL - 13
SP - 53
EP - 81
JO - Journal of Health Politics, Policy and Law
JF - Journal of Health Politics, Policy and Law
IS - 1
ER -