Refers to the Federal Healthcare program; for other uses see Canadian Healthcare
Medicare is a socialized medicine program in the United States that reimburses some expenses for covered medical services for persons over 65 years old and for certain persons deemed disabled under 65 years old as follows:
- All hospital charges for covered services are reimbursed under Medicare Part A; and
- Most physician fees for covered services are reimbursed under Medicare Part B for individuals who have enrolled in Part B and make payments for that coverage.
Originally, Medicare covered only those 65 and older. In 1972, Congress added the disabled, now about 15% of beneficiaries. It also covered dialysis for kidney failure. In 2003, Bush asked for and Congress created a drug benefit. Other services such as hospice care and mammograms have been added.
Many elderly individuals buy "Medigap" plans from private industry to cover expenses that Medicare will not cover.
Medicare Advantage is a private health insurance program that competes directly with the government-run Medicare program. In 2009 23% of all Medicare beneficiaries are enrolled in a Medicare Advantage plan. Both insure people age 65 and older and some younger, disabled people. Under Medicare Advantage, the government contracts with private insurers, which offer policies that cover doctor visits, hospitalization and sometimes prescription medications. Medicare Advantage plans must offer at least the same benefits as traditional Medicare, but many providers include more in a bid to attract customers. Such plans were introduced in the 1970s in an effort to cut Medicare costs. However, as the government sought to add coverage in underserved—often rural—areas, costs soared. According to the independent Medicare Payment Advisory Commission, Medicare Advantage now costs the government 14% more per beneficiary than traditional Medicare.
The Federal government pays the private insurers more per patient than under traditional Medicare. The ObamaCare legislation has removed this extra payment and now limits the federal subsidy to the amount spent on traditional Medicare patients.
Medicare began as part of President Lyndon B. Johnson's Great Society in 1965. The Senate voted for the program by 68 to 21, with 13 Republicans joining 55 Democrats in favor, and 7 Democrats joining 14 Republicans in opposition. In 2003, some Democrats in both the House and the Senate voted with most Republicans to add a prescription drug benefit to Medicare.
Medicare accounts for more than one-fifth of all health spending in the U.S.. Its costs per beneficiary, about $12,000 in 2008, rose at an average annual rate of 8.5% a year from 1970 to 2007.
Ann Coulter wrote:
- To much fanfare, in 2006 Medicare announced that only 7 percent of its payments were a result of fraud. Two years later, The New York Times reported that it was actually 31.5 percent—and that Medicare had aggressively hidden the fraud from outside auditors.
The New York Times reported:
- Medicare reported to Congress that, for the fiscal year of 2006, AdvanceMed’s investigations had found that only 7.5 percent of claims paid by Medicare were not supported by appropriate documentation. But the inspector general’s review indicated that the actual error rate was closer to 31.5 percent. Report Rejects Medicare Boast of Paring Fraud - New York Times - August 20, 2008
Medicare is entirely separate from Medicaid, a federal program that provides health benefits for certain poor people without insurance.