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A Successful Start With Room for Improvement

Dana P. Goldman, PhD; Geoffrey F. Joyce, PhD

JAMA. 2008;299(16):1954-1955.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Medicare Part D represents a bold experiment to publicly fund, but privately sell and administer, prescription drug insurance. Part D is only a relatively small part of the overall Medicare program; Medicare spent $432 billion overall in 2007, of which Part D accounted for only 11.6% ($50 billion).¹ However, the Medicare program is so large that Part D alone should account for 1% of the entire economy in less than 2 decades.¹ Furthermore, there is little room for more spending, given the trustees' recent forecast of $12 trillion in unfunded liabilities over the next 75 years—a debt just slightly smaller than the entire US economy.¹ So much appears to be riding on Part D's success or failure, including possible models for the provision of health insurance to the currently uninsured. Two articles^2-3 in this issue of JAMA raise important concerns about the . . . [Full Text of this Article]

Author Affiliations: RAND Corporation, Santa Monica, California (Drs Goldman and Joyce), and National Bureau of Economic Research, Cambridge, Massachusetts (Dr Goldman).

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