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Analyses in the Economics of Aging
Edited by David A. Wise
University of Chicago Press, 2005
Analyses in the Economics of Aging summarizes a massive amount of new research on several popular and less-examined topics pertaining to the relationship between economics and aging. Among the many themes explored in this volume, considerable attention is given to new research on retirement savings, the cost and efficiency of medical resources, and the predictors of health events.

The volume begins with a discussion of the risks and merits of 401(k) plans. Subsequent chapters present recent analysis of the growth of Medicare costs; the different aspects of disability; and the evolution of health, wealth, and living arrangements over the life course. Keeping with the global tradition of previous volumes, Analyses in the Economics of Aging also includes comparative studies on savings behavior in Italy, the Netherlands, and the United States; an examination of household savings among different age groups in Germany; and a chapter devoted to population aging and the plight of widows in India.

Carefully compiled and containing some of the most cutting-edge research and analysis available, this volume should be of interest to any specialist or policymaker concerned with ongoing changes in savings and retirement behaviors.
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The Coming Health Crisis
Who Will Pay for Care for the Aged in the 21st Century?
John R. Wolfe
University of Chicago Press, 1993
By the turn of the century, the largest generation of Americans in history, the "Baby Boomers," will be approaching 65 years old. But as the demand for health and long-term care is growing dramatically, health care programs have been shrinking instead of expanding to meet the older generation's needs. In this timely book, John R. Wolfe offers practical solutions to the coming health crisis, exploring innovative ways of developing insurance plans for the care of the large, aging "Baby Boom" generation and beyond.

In previous decades, when younger Americans far outnumbered older ones, retirees could depend on financial support through taxes from the population at large. But as "Boomers" retire and the work force begins to shrink, there will be a disproportionately large population of retirees to workers. With such a big jump in the percentage of older Americans in the population, fewer workers will be able to to transfer funds, through taxes, to retirees. Moreover, other traditionally reliable sources of financial assistance—Social Security, Medicare, and Medicaid—have faced serious financial difficulties in recent years. Who will the aged turn to for assistance?

The Coming Health Crisis suggests that as funds from all quarters dwindle, older Americans will have to look to alternative programs for financial assistance. Wolfe urges immediate action to develop new saving programs and increase existing transfer schemes to head off an imminent crisis. Although tax increases might provide some resources, he demonstrates that it is more important to accumulate capital to create solid reserves for the future. Wolfe also explores two roles for government: prefunding new or existing social insurance programs and promoting private insurance options. By exempting insurance fund income from corporate taxation and permitting people at all income levels to defer income tax on accounts earmarked for long-term care, he shows how government could greatly encourage and expand personal saving.

Finally, this work assesses the value of other recent health and long-term-care innovations: social/health maintenance organizations, long-term-care individual retirement accounts, and reverse annuity mortgages, in addition to vouchers, care rationing, mandatory public insurance, and expanded private coverage. Through this wide-ranging survey, Wolfe demonstrates that, through a combination of these programs, we can care for the aging "Baby Boom" generation by anticipating their needs and saving now.
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Explorations in the Economics of Aging
Edited by David A. Wise
University of Chicago Press, 2011

The next two decades will mark a new phase in the demographic transition of the United States as baby boomers become eligible for Social Security and Medicare. Drawing on evidence from the United States and other nations, Explorations in the Economics of Aging yields important new findings on how economic decisions by households and policy choices by governments will influence the effects of this demographic shift. It explores topics such as the implications of differential mortality rates by income on Social Security, the link between cognition and economic outcomes, and scale variations in self-reported work disability. This volume will be an important reference for economists and policymakers alike.

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Fixing Medical Prices
How Physicians Are Paid
Miriam J. Laugesen
Harvard University Press, 2016

Medical care prices in the United States are not only the most expensive in the world, but there are wide variations in what physicians are paid. Doctors at the frontlines of medical care who manage complex conditions argue that they receive disproportionately lower fees than physicians performing services such as minor surgeries and endoscopies. Fixing Medical Prices goes to the heart of the U.S. medical pricing process: to a largely unknown yet influential committee of medical organizations affiliated with the American Medical Association that advises Medicare. Medicare’s ready acceptance of this committee’s recommendations typically sets off a chain reaction across the entire American health care system.

For decades, the U.S. policymaking structure for pricing has reflected the influence of physician organizations. What Miriam Laugesen’s rich analysis shows is how these organizations navigate the arcane and complex work of this advisory committee. Contradicting the story of a profession in political decline, Fixing Medical Prices demonstrates that the power of physician organizations has simply become more subtle.

Laugesen’s investigation into the exorbitant cost of American medical care will be of interest to those who follow the politics of health care policy, the influence of interest groups on rate setting, and the medical profession’s past and future role in our health care system.

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Harry S. Truman versus the Medical Lobby
The Genesis of Medicare
Monte M. Poen
University of Missouri Press, 1996
“I have some bitter disappointments as President,” reflected Harry Truman after leaving office, “but the one that has troubled me the most , in a personal way, has been the failure to defeat organized opposition to a national compulsory health-insurance program.”
Harry S. Truman versus the Medical Lobby is a study of one aspect of Harry Truman’s domestic leadership and the political conflict it produced. In the book, author Monte Poen examines Truman’s quest for national health insurance in the light of the ongoing debate on the subject in this century. It reveals why Truman was the first president to advocate government-financed health care and why he repeatedly took the idea to Congress, despite insurmountable political obstacles.
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Making Social Welfare Policy in America
Three Case Studies since 1950
Edward D. Berkowitz
University of Chicago Press, 2020
American social welfare policy has produced a health system with skyrocketing costs, a disability insurance program that consigns many otherwise productive people to lives of inactivity, and a welfare program that attracts wide criticism. Making Social Welfare Policy in America explains how this happened by examining the historical development of three key programs—Social Security Disability Insurance, Medicare, and Temporary Aid to Needy Families. Edward D. Berkowitz traces the developments that led to each program’s creation. Policy makers often find it difficult to dislodge a program’s administrative structure, even as political, economic, and cultural circumstances change. Faced with this situation, they therefore solve contemporary problems with outdated programs and must improvise politically acceptable solutions. The results vary according to the political popularity of the program and the changes in the conventional wisdom. Some programs, such as Social Security Disability Insurance, remain in place over time. Policy makers have added new parts to Medicare to reflect modern developments. Congress has abolished Aid to Families of Dependent Children and replaced with a new program intended to encourage work among adult welfare recipients raising young children. 

Written in an accessible style and using a minimum of academic jargon, this book illuminates how three of our most important social welfare programs have come into existence and how they have fared over time. 
 
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Medical Care, Medical Costs
The Search for a Health Insurance Policy
Rashi Fein
Harvard University Press, 1986

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Medicare
Intentions, Effects, and Politics, Volume 26
Mark A. Peterson, ed.
Duke University Press
At a time when Medicare stands at the forefront of national politics, Medicare: Intentions, Effects, and Politics moves past the political rhetoric of the moment to provide a groundwork for informed debate. This special issue of the Journal of Health Politics, Policy, and Law offers a historically-based exploration and understanding of Medicare as well as needed perspectives for intelligent reform.
A complete understanding of the particular and peculiar structure of Medicare can be gained only by considering the ideas, politics, and institutions of the 1960s that shaped it. With this historical perspective, the articles in this collection can move beyond partisan arguments and politically motivated reform proposals. Instead, they outline educated guidelines for improving Medicare and debunk commonly held but false assumptions about the program. In "How Not to Think about Medicare" the field’s most noted scholar, Theodore Marmor, exposes four such misconceptions, including the program’s seeming inability to control costs and ward off what some call a fiscal tsunami—the aging of the baby boomers. Other contributions address frequently overlooked functions of Medicare. While the program is known for its universal health coverage for the elderly and the disabled, for instance, Medicare also serves a crucial role in overseeing hospital performance and furthering health education. This special issue concludes with a discussion of Marmor’s recently revised classic book, The Politics of Medicare, by five leading specialists who interpret the present Medicare program in light of its original construct and current political influences.

Contributors. Michael Gusmano, Jacob Hacker, Nancy M. Kane, Stephen A. Magnus, Theodore Marmor, Jonathan Oberlander, Eric M. Patashnik, Mark A. Peterson, Mark J. Schlesinger, Carolyn Tuohy, Bruce Vladeck, Julian Zelizer

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Medicare Reform
Issues and Answers
Edited by Andrew J. Rettenmaier and Thomas R. Saving
University of Chicago Press, 1999
In 1965, landmark legislation established the national Medicare system as a means of insuring access to medical care for all elderly citizens. Today, rocketing medical costs combined with a rapidly aging population have thrown the Medicare system off balance, moving it perilously close to financial crisis. Medicare already accounts for 2.65 percent of gross domestic product, and by the year 2030 that share is expected to more than double. Further, the trust fund dedicated to Medicare hospitalization coverage is expected to be depleted by 2008. Clearly, Medicare as we know it cannot endure much longer without either imposing a massive tax burden or dissolving altogether under its own financial strain.

Medicare Reform—the first volume in a new series sponsored by the George Bush School of Government and Public Policy at Texas A&M University—tackles the current Medicare predicament head-on, delving into the fundamental issues surrounding the reorganization of the system: whether to allocate Medicare's growing financial load to current workers in the form of higher taxes, shift the onus to future generations, or shortchange both the expectations and care of present recipients by substantially cutting benefits. This volume assembles a group of the most highly respected analysts of health issues to consider the economic forces impacting the surging health care market.

Written for the general reader and offering innovative ideas for policy revision along with critical new data on health care economics, this comprehensive volume provides a timely and thoughtful deliberation on the precarious future of Medicare.

"Because, as Richard Weaver once said, 'ideas have consequences,' this book is important. It will not end the debate on Medicare, but it will begin it."—Phil Gramm, from the foreword
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The Political Life of Medicare
Jonathan Oberlander
University of Chicago Press, 2003
In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.
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The Politics of Policy Change
Welfare, Medicare, and Social Security Reform in the United States
Daniel Béland and Alex Waddan
Georgetown University Press, 2012

For generations, debating the expansion or contraction of the American welfare state has produced some of the nation's most heated legislative battles. Attempting social policy reform is both risky and complicated, especially when it involves dealing with powerful vested interests, sharp ideological disagreements, and a nervous public.

The Politics of Policy Change compares and contrasts recent developments in three major federal policy areas in the United States: welfare, Medicare, and Social Security. Daniel Béland and Alex Waddan argue that we should pay close attention to the role of ideas when explaining the motivations for, and obstacles to, policy change.

This insightful book concentrates on three cases of social policy reform (or attempted reform) that took place during the presidencies of Bill Clinton and George W. Bush. Béland and Waddan further employ their framework to help explain the meaning of the 2010 health insurance reform and other developments that have taken place during the Obama presidency. The result is a book that will improve our understanding of the politics of policy change in contemporary federal politics.

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Poor People's Medicine
Medicaid and American Charity Care since 1965
Jonathan Engel
Duke University Press, 2006
Poor People’s Medicine is a detailed history of Medicaid since its beginning in 1965. Federally aided and state-operated, Medicaid is the single most important source of medical care for the poorest citizens of the United States. From acute hospitalization to long-term nursing-home care, the nation’s Medicaid programs pay virtually the entire cost of physician treatment, medical equipment, and prescription pharmaceuticals for the millions of Americans who fall within government-mandated eligibility guidelines. The product of four decades of contention over the role of government in the provision of health care, some of today’s Medicaid programs are equal to private health plans in offering coordinated, high-quality medical care, while others offer little more than bare-bones coverage to their impoverished beneficiaries.

Starting with a brief overview of the history of charity medical care, Jonathan Engel presents the debates surrounding Medicaid’s creation and the compromises struck to allow federal funding of the nascent programs. He traces the development of Medicaid through the decades, as various states attempted to both enlarge the programs and more finely tailor them to their intended targets. At the same time, he describes how these new programs affected existing institutions and initiatives such as public hospitals, community clinics, and private pro bono clinical efforts. Along the way, Engel recounts the many political battles waged over Medicaid, particularly in relation to larger discussions about comprehensive health care and social welfare reform. Poor People’s Medicine is an invaluable resource for understanding the evolution and present state of programs to deliver health care to America’s poor.

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Redesigning the Medicare Contract
Politics, Markets, and Agency
Edward F. Lawlor
University of Chicago Press, 2003
Recent debates on Medicare reform focus on prescription drug coverage, expanding managed-care choices, or technical issues of payment policy. Despite all the heat generated by these issues, Edward F. Lawlor's new book, Redesigning the Medicare Contract, demonstrates that fundamental questions of purpose and policy design for Medicare have been largely ignored.

Challenging conventional ideas, Lawlor suggests that we look at Medicare as a contract between the federal government, the program's beneficiaries, and health care providers. Medicare reform, then, would involve rewriting this contract so that it more successfully serves the interests of both beneficiaries and taxpayers. To do this, Lawlor argues that we must improve the agency of the program—the informational, organizational, and incentive elements that assure Medicare program carries out beneficiary and taxpayer interests in providing the most appropriate, high-quality care possible. The book includes a chapter devoted solely to concepts and applications that give definition to this brand of agency theory. Lawlor's innovative agency approach is matched with lucid explanation of the more comprehensive groundwork in the history and politics of the Medicare program.

Lawlor's important and timely book reframes the Medicare debate in a productive manner and effectively analyzes alternatives for reform. Lawlor argues that effective policy design for Medicare requires greater appreciation of the vulnerability of beneficiaries, the complexity of the program itself, its wide geographical variations in services and financing, and the realistic possibilities for government and private sector roles. Tackling difficult problems like end-of-life and high-tech care—and offering sensible solutions—Redesigning the Medicare Contract will interest political scientists, economists, policy analysts, and health care professionals alike.
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Redirecting Innovation in U.S. Health Care
Options to Decrease Spending and Increase Value
Steven Garber
RAND Corporation, 2014
New medical technologies are a leading driver of U.S. health care spending. This report identifies promising policy options to change which medical technologies are created, with two related policy goals: (1) Reduce total health care spending with the smallest possible loss of health benefits, and (2) ensure that new medical products that increase spending are accompanied by health benefits that are worth the spending increases.
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Research Findings in the Economics of Aging
Edited by David A. Wise
University of Chicago Press, 2010
The baby boom generation's entry into old age has led to an unprecedented increase in the elderly population. The social and economic effects of this shift are significant, and in Research Findings in the Economics of Aging, a group of leading researchers takes an eclectic view of the subject. Among the broad topics discussed are work and retirement behavior, disability, and their relationship to the structure of retirement and disability policies.

While choices about  when to retire are made by individuals, these decisions are influenced by a set of incentives, including retirement benefits and health care, and this volume includes cross-national analyses of the effects of such programs on these decisions. Furthermore, the volume also offers in-depth analysis of the effects of retirement plans, employer contributions, and housing prices on retirement. It explores well-established relationships among economic circumstances, health, and mortality, as well as the effects of poverty and lower levels of economic development on health and life satisfaction. By combining micro and macro evidence, this volume continues a tradition of expanding the research agenda on the economics of aging.
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Who Should Pay for Medicare?
Daniel Shaviro
University of Chicago Press, 2004
Good news first? The good news is that Americans today are living longer, in part because of continual advances in healthcare. But the bad news is that with our aging population larger than ever before, nothing is being done to ensure that we can continue to afford the increasing costs of care. How Medicare—with the Bush administration's reforms and a slumping economy—will meet the needs of its recipients without adequate financing is among the most pressing issues facing this country today.

Daniel N. Shaviro sees the future of our national healthcare system as hinging on the issue of funding. The author of books on the economic issues surrounding Social Security and budget deficits, Shaviro is a skilled guide for anyone seeking to understand the financial aspects of government programs. Who Should Pay for Medicare? offers an accessible overview of how Medicare operates as a fiscal system. Discussions of Medicare reform often focus on the expansion of program treatment choices but not on the question of who should pay for Medicare's services. Shaviro's book addresses this critical issue, examining the underanalyzed dynamics of the significant funding gap facing Medicare. He gives a balanced, nonpartisan evaluation of various reform alternatives—considering everything from the creation of new benefits in this fiscal crunch to tax cuts to the demographic pressures we face and the issues this will raise when future generations have to pay for the care of today's seniors.

Who Should Pay for Medicare? speaks to seniors who feel entitled to expanded coverage, younger people who wonder what to expect from the government when they retire, and Washington policy makers who need an indispensable guidebook to Medicare's future.
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