The political economy of medicare

Health Affairs

Volumn 18, Issue 1, 1999, Pages 22-36

  Vladeck, Bruce C ^a,b,c,d  

^a MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^b NEW YORK UNIVERSITY MEDICAL CENTER   (United States)

^c Natl Bipartisan Commn Fut M ^*

^d Health Care Financing Administration   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ECONOMICS; HEALTH CARE COST; HEALTH CARE POLICY; HUMAN; INCOME; MEDICARE; POLITICS; UNITED STATES;

HEALTH CARE REFORM; HEALTH CARE SECTOR; HEALTH POLICY; HUMANS; INCOME; MEDICARE; POLITICS; UNITED STATES;

EID: 0038920742     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.18.1.22     Document Type: Article

References (8)

1. U.S. Department of Health and Human Services, Health Care Financing Administration, A Profile of Medicare (Washington: HCFA, May 1998), 16.
2. Ibid., 18.
3. Compare The Federalist, no. 10 (New York: Mentor Books, 1961), 77-83.
4. K.R. Levit et al., "National Health Spending Trends in 1996," Health Affairs (January/February 1998): 35-51.
5. Ibid.
6. BNA's Medicare Report, 1 May 1998, 447.
7. The data that make up these "balance-of-payments" tables are too extensive to be presented comprehensively in this paper. For more concisely prepared tables, contact the author at Institute for Medicare Practice, Mt. Sinai Medical Center, One Gustave Levy Place, Box 1077, New York, NY 10029, or via e-mail at Bruce_Vladeck@smtplink.mssm.edu.
8. The historical ties between academe and the Progressive tradition pose what should be a worrisome parallel for this generation of health services researchers. Just as an earlier generation of social "scientists" provided much of the intellectual rationale through which dominant Protestant elites maintained sovereignty at the expense of newly emergent immigrant populations a century ago, so the increasing influence of health services research may serve, if health services researchers are not careful, to advance the interests of particular contemporary elites. In today's social sciences this danger is primarily the result of the simple fact that nothing ever works as well in practice as it does in theory, so no real program can ever compete with abstract microeconomic hypotheticals. The greater power that markets give to those with more wealth thus is reinforced in the political arena by analyses that confuse market models with reality.