Medicare (United States)
Overview
Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). Its primary purpose is to provide health insurance for Americans aged 65 and older, but it also provides coverage for some younger people with disability status as determined by the SSA, as well as people with end stage renal disease and amyotrophic lateral sclerosis.
History
Medicare was signed into law in 1965 by President Lyndon B. Johnson as amendments to Social Security legislation. At the bill-signing ceremony, former President Harry S. Truman was enrolled as the first Medicare beneficiary and received the first Medicare card. Johnson wanted to recognize Truman, who, in 1945, had become the first president to propose national health insurance, an initiative that was opposed at the time by Congress.
Coverage
Medicare has four parts: A, B, C, and D. Part A covers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted for three days and not for custodial care), and hospice services. Part B covers outpatient services including some providers' services while inpatient at a hospital, outpatient hospital charges, most provider office visits even if the office is "in a hospital", and most professionally administered prescription drugs. Part D covers mostly self-administered prescription drugs. Part C is an alternative called Managed Medicare which allows patients to choose health plans with at least the same service coverage as Parts A and B (and most often more), often the benefits of Part D, and always an annual out-of-pocket spend limit which A and B lack.
Funding
Medicare is funded by a combination of a payroll tax, premiums and surtaxes from beneficiaries, and general revenue. It provides health insurance for Americans aged 65 and older who have worked and paid into the system through the payroll tax. It also provides health insurance to younger people with some disability status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis.
Criticisms and Controversies
Despite its wide acceptance, Medicare has been the subject of several controversies since its inception. These have often revolved around funding, service coverage, and the program's overall impact on the national debt. Critics argue that Medicare's costs are unsustainable and that the program may not be able to continue in its current form in the long term. Supporters argue that Medicare provides a vital service to seniors and disabled individuals, and that reforms can be made to ensure its financial stability.
Future of Medicare
The future of Medicare is a subject of much debate in the United States. With the aging of the Baby Boomer generation and the rising cost of healthcare, there are concerns about Medicare's ability to continue providing care at current levels. Proposals for reform include means-testing, increasing the age of eligibility, and privatization.