In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.
"A brilliant little book, combining a grasp of programmatic and political detail sure to appeal to scholars of health policy with crisp prose and careful argument accessible to policymakers and most of Medicare’s beneficiaries. . . . Oberlander’s analysis is organized around three persistent tensions in Medicare politics: the gap between the program’s promise and its performance; the fiscal and administrative tug-of-war between private provision and public payment; and the political and actuarial dilemma of delivering ‘service’ benefits on a foundation of social insurance financing. . . . The meat of the book tackles the post-1965 history of Medicare’s fragile consensus regarding program benefits, financing, and administration.”—Colin Gordon, Health Affairs