Medicare's new benefits: "catastrophic" health insurance

Article Abstract:

New Medicare benefits covering costs related to catastrophic illness suffered by the elderly reflect the growth of federal spending on health and a greater federal involvement in medical care than ever before. The federal action is the most sweeping expansion of Medicare since the program was initiated in 1965. The new regulations place a cap on a patient's obligation to share the costs of hospital coverage. In addition, it will pay for all allowable outpatient prescription-drug charges after a deductible amount has been reached and copayment covered. However, even with the new benefits plan, many types of health-related costs will not be covered, such as an average elderly person's long-term care, dental services, eyeglasses, and most preventive services. The most glaring omission is coverage for long-term care, which costs an average of $25,000 per year. The law provides unlimited coverage of short-term hospital care after an annual deductible of $560 has been paid. The law also liberalizes Medicare benefits for home care. Charges incurred for physicians' services are also limited under the new law; once expenses paid to physicians have reached $1,370 for an individual, Medicare will pay 100 percent of any additional reasonable charges. For the first time, Medicare coverage is extended to the coverage of outpatient drug prescriptions. The Health Care Financing Administration will require that all information about outpatient prescriptions be sent from pharmacies to a data bank, primarily to ensure fast determination of a beneficiary's total out-of-pocket payments that are eligible for the annual deductible, in order to ascertain whether the beneficiary is eligible for drug coverage. The new law also incorporates several important benefits that will ease the burden of medical expenses for the low-income elderly.

Health aspects, Aged, Elderly, Economic aspects, Insurance, Catastrophic illness, Prospective payment systems (Medical care)

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Medicare and graduate medical education

Article Abstract:

It appears that Congress may reconsider the role of Medicare in the financing of graduate medical education. Medicare has traditionally subsidized the training of medical interns and residents by providing direct and indirect payments. However, the Balanced Budget Act of 1997 targets Medicare for cuts of $116.3 billion between 1998 and 2002. This will eliminate several billion dollars for graduate medical education. New York State agreed to cut 2,200 resident positions in return for a continuing but smaller subsidy. Some Congresspersons object to paying hospitals not to train doctors.

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Support for academic medical centers: revisiting the 1997 Balanced Budget Act

Article Abstract:

Academic medical centers should play a more active role in the political debate about the future of Medicare. Medicare is the principle way the federal government finances the training of medical residents. The 1997 Balanced Budget Act led to the largest drop ever in federal funds for teaching hospitals. Many teaching hospitals also provide medical care to the uninsured and underinsured. The Association of American Medical Colleges may take a greater stand against these budget cuts based on the increased anger of its members.

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