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The Changing US Health Care Agenda
Eli Ginzberg, PhD
JAMA. 1998;279:501-504.
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INTRODUCTION
WHEN MEDICARE AND MEDICAID were enacted in 1965, informed opinion in Washington, DC, and elsewhere anticipated successive national legislation that would result in universal health insurance coverage within 1 or at the most 2 decades. The federal actuaries estimated that total outlays for Medicare in 1990 would come to $10 billion, a far cry from $180 billion, the staggering total reached in 1996.1 And nobody foresaw the explosive rise of national health care expenditures from $41 billion in 1965 to $1 trillion in 1996, with an expected further doubling to over $2 trillion in 2007 or shortly thereafter.2
A few other reminders: 2 years before the passage of Medicare, Congress initiated a program of financial support to expand the output of medical schools, an effort that it pursued aggressively until 1976 when the "physician shortage" was declared to have ended.3 Yet, 2 decades after the official demise . . . [Full Text of this Article]
GOALS IN FLUX
DOLLARS
INFRASTRUCTURE
THE UNKNOWABLE FUTURE
From the Eisenhower Center for the Conservation of Human Resources, Columbia University, New York, NY.
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