Health Affairs, doi: 10.1377/hlthaff.28.1.w29 (Published online November 24, 2008) © 2008 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Medicare Advantage Plans At A Crossroads--Yet Again

¹ Bob Berenson is a senior fellow in the Health Policy Center, Urban Institute, in Washington, D.C.
² Bryan Dowd is a professor in the Division of Health Policy and Administration, School of Public Health, at the University of Minnesota in Minneapolis.

^*Corresponding author.

Abstract

Since risk-taking, private health insurance plans were introduced into Medicare twenty-five years ago, policymakers have disagreed on these plans' fundamental purposes. Articulated objectives, which include improving quality, reducing government spending, providing additional benefits (without expanding the entitlement), increasing choices for beneficiaries, and providing benchmark competition for traditional Medicare, are plausible but sometimes conflicting. The program's history demonstrates continuous shifts in emphasis on these objectives. We enumerate the differing advantages of public and private plans in Medicare and argue that policymakers should focus their efforts on leveling the public-private playing field, thereby dealing forthrightly with the reality of growing fiscal problems. [Health Affairs 28, no. 1 (2009): w29-w40 (published online 24 November 2008; 10.1377/hlthaff.28.1.w29)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Elderly, Health Reform, Managed Care - Medicare, Medicare

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