Trends in Medicare payments in the last year of life

Article Abstract:

The proportion of Medicare expenditures devoted to patients in the last year of life has not significantly increased. This is contrary to the notion that in recent years, an ever increasing portion of health resources is spent on expensive techniques to prolong the lives of terminally-ill, elderly patients. Between 1976 and 1988, annual Medicare payments for both survivors and patients in their last year of life nearly quadrupled. However, the percentage of Medicare payments made to people over 65 in the last year of life was 28.2% in 1976, 30.8% in 1980 and 28.6% in 1988. In 1976 and 1988, about 50% of Medicare payments to patients in the last year of life were for the last 60 days of life. This is because over half of elderly patients die in the hospital. Payments for inpatient hospital care comprise over 70% of expenditures for patients in the last year of life compared with 53.3% of payments for survivors. As age at death increased, Medicare payments in the last year of life tended to decrease in both 1976 and 1988.

Terminal care

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Putting power into patient choice

Article Abstract:

The American Medical Association proposes a method of financing health care that would shift control from the employer to the employee. Most Americans get their health insurance through their employer but the employer chooses the plan. If the employer changes plans or the employee changes jobs, the employee often must choose another doctor. This makes continuity of care very difficult. Under the AMA's proposal, employees would select their preferred plan and would receive a tax credit. This credit would also be available to the self-employed and unemployed. Employees could continue in the plan even if they change jobs.

Health insurance

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Medicare policy for future generations - a search for a permanent solution

Article Abstract:

Medicare can be saved by moving all Americans 43 years old or younger into an investment-based system and maintaining the current Medicare payroll deduction. Eventually, the current payroll tax of 4.39% could be reduced to 1.58% for all young adults in the workforce. At a rate of return of 3.5%, these 20-year-olds could still accumulate enough money by the age of 65 to pay future medical bills. This plan would cost about half the amount the government will pay to maintain the current system. The government has set aside no money to pay beneficiaries when the baby-boomers retire and leave the workforce.

Retirement planning

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