Reforming Medicare: Options, Tradeoffs, and Opportunities (A Century Foundation Book) (Hardcover)

by Henry J. Aaron (Author), Jeanne M. Lambrew (Author)
Key Phrases: excess cost growth, premium support, risk corridors, Medicare Advantage, Social Security, Strengthening Medicare (more...)

Editorial Reviews

Product Description
Everyone agrees on the need to reform Medicare but not on how to do it. Some argue the program is too comprehensive, others that it is not comprehensive enough. Some suggest it pays too much for health care, others, too little. Meanwhile, the financial stakes continue to mount. Medicare spending exceeded $400 billion in 2007, making it more expensive than the entire health systems of most other nations, as well as the largest national public program other than Social Security and national defense. In Reforming Medicare, Henry J. Aaron and Jeanne M. Lambrew deftly guide readers through this complex debate. They identify and analyze the three leading approaches to reform. Updated social insurance would retain the current system while rationalizing coverage and reducing bureaucracy. Premium support would replace the current system with a capped, per-person payment that beneficiaries could use to buy health insurance. Consumer-directed Medicare would have beneficiaries pay for care up to a high deductible from government- supported savings accounts and offer premium-support coverage above the deductible. In addition to rating each option on its ability to promote access to health care, improve the quality of care, and control costs, the authors evaluate each reform s political strengths and weaknesses. Given the heat generated by the Medicare debate, it is unlikely that any single approach will be implemented in full. Consequently, Aaron and Lambrew describe incremental strategies that blend elements of each plan. Their analysis provides essential insight into the types of hybrid policies that Congress will consider in coming years.

About the Author
Henry J. Aaron is a senior fellow in Economic Studies at the Brookings Institution, where he holds the Bruce and Virginia MacLaury Chair. Among his many books are Can We Say No? The Challenge of Rationing Health Care, with William B. Schwartz and Melissa Cox (Brookings, 2006), and Reforming Medicare: Options,Tradeoffs, and Opportunities, written with Jeanne Lambrew (Brookings, 2008). Jeanne M. Lambrew is associate professor of public affairs at the Lyndon B. Johnson School of Public Affairs, University of Texas Austin, and a senior fellow at the Center for American Progress. From 1997 to 2000, she worked on health policy in the Clinton White House.

Product Details

• Hardcover: 224 pages
• Publisher: Brookings Institution Press; 1 edition (May 1, 2008)
• Language: English
• ISBN-10: 0815701241
• ISBN-13: 978-0815701248
• Product Dimensions: 9 x 6.2 x 1 inches
• Shipping Weight: 1 pounds (View shipping rates and policies)
• Average Customer Review: 3.5 out of 5 stars See all reviews (2 customer reviews)
• Amazon.com Sales Rank: #820,734 in Books (See Bestsellers in Books)

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Customer Reviews

Most Helpful Customer Reviews

1 of 1 people found the following review helpful:

5.0 out of 5 stars Excellent Guide to Medicare Policy, August 15, 2008

By	Paul Van de Water (Virginia, USA) - See all my reviews (REAL NAME)

Henry Aaron and Jeanne Lambrew are two of the nation's leading experts on health policy. President Obama has named Lambrew Deputy Director of the new White House Office of Health Reform. Together Aaron and Lambrew have written an informative and accessible overview of the issues facing Medicare--the federal program that provides health coverage for older Americans and persons with disabilities. Their analysis is commendably free of the rhetoric of crisis that too often infuses discussions of the topic. They point out that Medicare's cost growth has roughly paralleled that of private health spending and that systemic reforms in the U.S. health care system would do far more to control Medicare spending than any reform in the program alone.

Medicare nevertheless confronts major long-run financial challenges and leaves gaps in benefit protection. Aaron and Lambrew explain and analyze three distinct approaches for restructuring Medicare to deal with these challenges--an improved government-run social insurance program, competing private insurance plans with government premium support, or high-deductible insurance policies coupled with health savings accounts. Their analysis is extremely well balanced and will not fully satisfy die-hard advocates of any of the approaches. My only reservation is that the options are highly stylized, whereas the most likely outcome will feature a mixture of public and private plans competing on a relatively level playing field. Overall, however, the authors have succeeded in their goal of providing a clear, even-handed guide to the debate over Medicare reform.

2.0 out of 5 stars Not much substance., December 25, 2008

By	Margaret M. Manning - See all my reviews (REAL NAME)

Very short on text; much of the book is appendices. No amazing insights here.