HIRP Research Brief
Paradigm Shifts in Medicare Reform
Lynn Etheredge & Stanley Jones
Reforms passed by Congress and vetoed by the president during the past year would have accelerated initiatves already transforming Medicare. Operating in a rapidly changing insurance marketplace, Medicare is shifting from a social insurance model toward a private individual insurance model---expanding the number and type of alternative health plans it offers---and growing numbers of beneficiaires are enrolling in these plans. Such reforms, especially if bolstered by legislative reforms that are likely to resurface after the November elections, will rewrite the social contract enacted more than 30 years ago. They require fundamental shifts in ways of thinking about the federal government's responsibilities; the Medicare program's management; relations between the Meicare program and doctors, hospitals, and other health care providers; and the role of beneficiaries in the Medicare program.