Rebounding with Medicare: Reform and Counterreform in American Health Policy.

America's major health care programs were all enacted on the rebound from defeat of more expansive progressive ideas. Chastened reformers have typically adopted rebound strategies that accommodate some sources of opposition, incorporate elements of counterreforms, and reflect intervening institution...

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Published in:Journal of Health Politics, Policy & Law Vol. 43; no. 4; pp. 707 - 731
Main Author: Starr, Paul
Format: Article
Published: Duke University Press Aug2018
Subjects:
Online Access:View this record in EBSCOhost
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        au: Starr, Paul
        affil: Princeton University
      su:
        United States
        United States. Social Security Administration
        Medicare laws
        Celebrities
        Conflict (Psychology)
        Health maintenance organizations
        Health services accessibility
        Medicaid
        Medical care costs
        Medicare
        Policy sciences
        Political participation
        Public welfare
        Taxation
        Single-payer health care
        Health policy
        History
        Law
        Health insurance exchanges
        Health care reform
        National health services
        Fee for service (Medical fees)
        Patient Protection & Affordable Care Act
      sug:
        subj:
          Medicare laws
          Celebrities
          Conflict (Psychology)
          Health maintenance organizations
          Health services accessibility
          Medicaid
          Medical care costs
          Medicare
          Policy sciences
          Political participation
          Public welfare
          Taxation
          Single-payer health care
          Health policy
          History
          Law
          United States
          United States. Social Security Administration
          HMO Medical Centers
          Community health centres
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Administration of Public Health Programs
          Health and Welfare Funds
          Other Individual and Family Services
          Emergency and Other Relief Services
          Public Finance Activities
          Health insurance exchanges
          Health care reform
          National health services
          Fee for service (Medical fees)
          Patient Protection & Affordable Care Act
      keyword:
        marketplaces
        Medicare Advantage
        Medicare buy-in
        Progressive reform
        universal coverage
        marketplaces
        Medicare Advantage
        Medicare buy-in
        Progressive reform
        universal coverage
      ab: America's major health care programs were all enacted on the rebound from defeat of more expansive progressive ideas. Chastened reformers have typically adopted rebound strategies that accommodate some sources of opposition, incorporate elements of counterreforms, and reflect intervening institutional change. This dynamic has unfolded three times: from the Progressive Era to the enactment of Medicare and Medicaid in 1965, from the late 1960s to the expansion of Medicaid in the 1980s, and from defeat of the 1993 Clinton plan to the enactment of the Children's Health Insurance Plan in 1997 and the Affordable Care Act in 2010. Setbacks in the Trump era will require advocates of universal coverage to coalesce around a rebound strategy that similarly takes account of recent developments and recognizes the Affordable Care Act's limitations and political vulnerabilities. This article argues that Medicare provides a platform for such a strategy and that the next fiscally and politically feasible step is the creation of a new "Midlife Medicare" program that would extend protection to people fifty to sixty-four years of age.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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