In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

On July 30, 1965, President Johnson flew to Independence, Missouri to sign the Medicare bill. The new statute included two related insurance programs to finance substantial portions of the hospital and physician expenses incurred by Americans over the age of sixty-five. Public attempts to improve American health standards have typically precipitated bitter debate, even as the issue has shifted from the professional and legal status of physicians to the availability of hospital care and public health programs. In The Politics of Medicare, Marmor helps the reader understand Medicare's origins, and he interprets the history of the program and explores what happened to Medicare politically as it turned from a legislative act in the mid-1960s to a major program of American government in the three decades since. This is a vibrant study of an important piece of legislation that asks and answers several questions: How could the American political system yield a policy that simultaneously appeased anti-governmental biases and used the federal government to provide a major entitlement? How was the American Medical Association legally overcome yet placated enough to participate in the program? And how did the Medicare law emerge so enlarged from earlier proposals that themselves had caused so much controversy?

Medicare Politics examines how media coverage, political information, and political participation affect Medicare policy choices. This book is an excellent reference for political science literature concerning the impact of media, the roles of political information with respect to public opinion, and political participation. Each chapter provides analysis that expands political science and health services research by testing political science questions in a way that further our understanding of a significant health policy program affected by the political process: Medicare. The introduction ties the chapters together and discusses the importance of understanding Medicare politics as the impending retirement of the baby boom generation forces policymakers to grapple with how Medicare will support future generations. The first chapter shows how Medicare coverage varied throughout the 1995 debates concerning Medicare reform and links coverage with public opinion about policymakers. The second chapter demonstrates how knowledge of the Medicare program affected the public's support for Medicare reform options in 1995. The final chapter examines the impact of the political participation and mobilization of Medicare beneficiaries in recent presidential elections. Medicare Politics ends with a discussion of implications for future Medicare reform debates.

Discusses Medicare's emergence as a political issue and the responses it elicited within the federal government and American society

Entitlement Politics describes partisan attempts to shrink the size of government by targeting two major federal health care entitlements. Efforts to restructure or eliminate entitlements as such, and to privatize and decentralize programs, along with more traditional attempts to amend and reform Medicare and Medicaid have radically transformed policymaking with respect to these programs. However, they have failed to achieve fundamental or lasting reform.Smith combines historical narrative and case studies with descriptions of the technical aspects and dynamics of policymaking to help the consumer understand how the process has changed, evaluate particular policies and outcomes, and anticipate future possibilities. His account intentionally goes at some length into the substance of the programs, the policies that are involved, and the views of different protagonists about the major issues in the dispute.One unhealthy consequence of politicizing Medicare and Medicaid policy has been to separate public debate from the technical and organizational realities underlying issues of cost containment or program structure. Smith considers this development unfortunate, since it leaves even informed citizens unable to evaluate the claims being made. Ironically, strife over Medicare has complicated the political and policy issues in American life. Only a serious and genuine bipartisan effort bringing forth the best efforts of both political parties--and some of the best industry leaders and policy experts in the field--is likely to achieve genuine reform. The more people and parties know about the history, politics, and policies of these programs, the better our prospects for devising workable, equitable, and lasting solutions. This volume leads the way toward that understanding.

Discusses Medicare's emergence as a political issue and the responses it elicited within the federal government and American society.

Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.