Nearly two-thirds of this increase is due to the assumption that per capita health care expenditures will grow faster than per capita GDP. The Congressional Budget Office (CBO) projects that federal spending on major health programs will increase from 7.4 percent of GDP in 2022 to 10.4 percent in 2037 if current policies remain in place. High and rising health care costs are the biggest fiscal challenge our country faces.State and federal programs now directly or indirectly cover 45 percent of health care costs in the United States. As fewer Americans are covered by employer-sponsored insurance, government has taken up the slack. Government picks up nearly half the tab.Despite this higher spending, health outcomes are no better than in other developed countries. Americans spent a total of around $7,600 per person on health care in 2010, compared with around $3,900 on average for countries with similar standards of living, according to the Kaiser Family Foundation. The United States spends nearly double what other countries spend.The Social Transformation of American Medicine, Paul Starr.Celebrating Medicare and Medicaid’s 47th birthday this week, here are some quick thoughts on government’s role in ensuring access to affordable health care:.Although neighborhood health centers managed to survive (and even grow in the later seventies), they never became more than a marginal alternative.” It covered what would otherwise have been bad debts for hospitals and raised no challenge to private interests in the medical sector. Medicaid simply had the advantage of institutional compatibility. “ …policy makers did not deliberately choose to push Medicaid over neighborhood health centers on the basis of any evaluation of relative cost effectiveness. Why didn’t policymakers choose to use community health centers rather than Medicaid to treat the poor? These proposals were never adopted even though some studies had shown them to be more cost-effective. In fact proposals in 1967 called for one thousand community centers to serve 25 million people. The objective of Medicaid was to allow the poor to buy into ‘mainstream’ of medicine, but neither the federal government nor the states were willing to spend the money that would have been required.”Īnother option for proving health services for the poor would be to establish federally funded community centers. Medicare allowed physicians to charge above what the program would pay Medicaid did not and participation among physicians was far more limited. While Medicare had uniform national standards for eligibility and benefits, Medicaid left the states to decide how extensive their programs would be. Medicare was buoyed by popular approval and acknowledged dignity of Social Security Medicaid was burdened by the stigma of public assistance. ![]() “ Though adopted together, Medicare and Medicaid reflected sharply different traditions. Why is Medicare so much more popular than Medicaid? Paul Starr provides an answer: State legislatures fight constantly to reduce Medicaid spending in their states. Whereas Medicare beneficiaries qualify primarily due to age, most Medicaid beneficiaries qualify based on income. Then there is the famous “ Keep Your Goddamn Government Hands Off My Medicare!” statement. Americans prioritize spending on only Social Security and education more than Medicare. Most American support increasing taxes rather than making cuts to Medicare spending.
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