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Medicare Reform: Fundamental Problems, Incremental Steps


  • Mark McClellan


This paper presents an overview of the Medicare reform debate. I begin by reviewing some of the features of Medicare and then turn to a discussion of reforms, both on the benefits side and on the financing side of the program. The reform proposals raise difficult policy and political issues, and could have important implications for the federal budget, the efficiency of the health sector, and the well-being of the elderly and disabled.

Suggested Citation

  • Mark McClellan, 2000. "Medicare Reform: Fundamental Problems, Incremental Steps," Journal of Economic Perspectives, American Economic Association, vol. 14(2), pages 21-44, Spring.
  • Handle: RePEc:aea:jecper:v:14:y:2000:i:2:p:21-44 Note: DOI: 10.1257/jep.14.2.21

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    References listed on IDEAS

    1. McClellan, Mark & Skinner, Jonathan, 2006. "The incidence of Medicare," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 257-276, January.
    2. Mark McClellan, 1997. "Hospital Reimbursement Incentives: An Empirical Analysis," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 6(1), pages 91-128, March.
    3. David M. Cutler & Sarah J. Reber, 1998. "Paying for Health Insurance: The Trade-Off between Competition and Adverse Selection," The Quarterly Journal of Economics, Oxford University Press, vol. 113(2), pages 433-466.
    4. Julie Lee & Mark McClellan & Jonathan Skinner, 1999. "The Distributional Effects of Medicare," NBER Chapters,in: Tax Policy and the Economy, Volume 13, pages 85-108 National Bureau of Economic Research, Inc.
    5. Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September.
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    Cited by:

    1. Khwaja, Ahmed, 2010. "Estimating willingness to pay for medicare using a dynamic life-cycle model of demand for health insurance," Journal of Econometrics, Elsevier, vol. 156(1), pages 130-147, May.
    2. Andrew Goodman-Bacon & Yukako Ono, 2007. "Who are temporary nurses?," Economic Perspectives, Federal Reserve Bank of Chicago, issue Q I, pages 2-13.
    3. David M. Cutler, 2003. "Supplementing Public Insurance Coverage with Private Coverage: Implications for Medical Care Systems," NBER Chapters,in: Labor Markets and Firm Benefit Policies in Japan and the United States, pages 183-204 National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • E10 - Macroeconomics and Monetary Economics - - General Aggregative Models - - - General


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