1st Edition

Paying for Medicare The Politics of Reform

By David G. Smith Copyright 1992
    286 Pages
    by Routledge

    277 Pages
    by Routledge

    ** Paying for Medicare received the American Risk and Insurance Association's Elizur Wright Award for itsoutstanding contribution to risk management and insurance literature.

    The Prospective Payment System and the Medicare Fee Schedule, two of the most effectively sustained and successful efforts at policy innovation in history continue to shape decisions about Medicare and cost containment efforts.

    Smith shows how particular policy alternatives were developed; why chosen or rejected; and how provider interests and American political institutions have shaped their design and implementation.

    Acknowledgments1 IntroductionThe Policy Environment2 Prospective Payment System: DevelopmentHospital Cost ContainmentA Decisive Turning PointA Decade of DevelopmentDeveloping a ProposalLegislating the Prospective Payment SystemInitial ImplementationChronology: Prospective Payment SystemNotes3 Prospective Payment System: ImplementationImplementation ActivitiesSubstantive PolicyPPS: The FutureChronology: ImplementationNotes4 Physician Payment Reform: BackgroundMedicare: Early ImplementationThe Reagan AdministrationAction by CongressChronological: Physicians Payment: BackgroundNotes5 Physicians Payment: Designing the SystemIntroduction— The PPRCPolitics and the DeficitElements of a Fee ScheduleLegislating the Medicare Fee ScheduleChronology: Physician Payment: Designing the SystemNotes6 ConclusionTwo Payment Reforms: Alike and Not AlikeMedicare and the American Political SystemNotesGlossaryTermsMajor LegislationSelected BibliographyIndex


    David G. Smith