HEALTH ECONOMICS, OLD-AGE POLITICS, AND THE CATASTROPHIC MEDICARE DEBATE

For several decades old age benefits saw maintenance of previous gains and periodic improvement in scope. Political accommodations “spread the wealth” to prosperous and poor aged, to health providers and other stakeholders, finessing legislative road-blocks and financing conflicts, but demographic and health economic trends suggest an end to this era. Medicare Catastrophic repeal epitomizes health policy stalemate, presaging a more conflictual era in the 1990s. Divergent economic interests among subgroups of elderly and inflationary economics of fee-for-service medicine are subtexts to the debate suggesting that future benefits expansion will be elusive and that lesser structural reforms in the health care system can be implemented. © 1988 Taylor & Francis Group, LLC.