Entitlement Politics: Medicare and Medicaid, 1995-2001

Entitlement Politics: Medicare and Medicaid, 1995-2001

by David G. Smith

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Overview

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.

Product Details

ISBN-13: 9780202307190
Publisher: Taylor & Francis
Publication date: 11/30/2002
Series: Social Institutions and Social Change Series
Edition description: New Edition
Pages: 441
Product dimensions: 6.00(w) x 9.00(h) x 0.90(d)

About the Author

David G. Smith is Richter Professor Emeritus of Political Science at Swarthmore College. He is the author of The Children’s Health Insurance Program and Paying for Medicare. His book, Paying for Medicare, won the Elizur Wright Award from the American Risk and Insurance Association.

Table of Contents

Acknowledgmentsvii
1Introduction1
Notes11
2Historical Background13
I.Medicare and Medicaid-Initial Legislation13
II.Medicare: Reform Efforts16
III.Medicare and the Contemporary World20
IV.Medicaid: Perennial Issues and Reform Efforts24
Notes35
3Medicaid and the Balanced Budget Act of 199539
I.Background and Early Moves40
II.Budget Resolution44
III.Budget Reconciliation53
Notes66
4Medicare--199571
I.Preparing the Way73
II.The Democrats Counter82
III.The Medicare Preservation Act92
IV.Denouement122
Notes137
5A Year of Transition--1996147
I.The Three-Part Reconciliation148
II.The Health Insurance Portability and Accountability Act155
III.Reflections165
Notes167
6Medicare and Medicaid, 1997173
I.The Context of Events in 1997174
II.The Budget Resolution: Setting Strategic Limits177
III.The Budget Reconciliation187
IV.The Conference223
V.Some Accomplishments231
Notes235
7Implementation243
I.Background244
II.Medicare Implementation247
III.Medicaid and SCHIP295
IV.Design and Construction316
Notes319
8Old Business and New329
I.Managed Care Reform and Patients' Bills of Rights331
II.Beyond the Balanced Budget Act: Rhetoric and the Future343
Notes363
9Postscript369
Appendix383
A.BBA 97: Table of Contents383
B.HCFA (CMA): Activities and Organization386
Glossary395
Bibliography405
Index417

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