Chapter 8.A.4: Medicare

To insert after Ch. 8.A.4 (p. 763):

For discussions of Medicare at 50, see Jonathan Oberlander & Theodore Marmor, Medicare at 50, in The Oxford Handbook of U.S. Health Law (2017); Medicare and Medicaid at 50: America’s Entitlement Programs in the Age of Affordable Care (2015) (Alan B. Cohen et al. eds. 2015); Symposium, The Law of Medicare and Medicaid at 50, 15 Yale J. Health Pol’y L. Ethics (2015).

For historical and political accounts of Medicare (note 1), see Matthew B. Lawrence, Medicare “Bankruptcy”, 63 B.C. L. Rev. 1657 (2022); Nicholas Bagley, Bedside Bureaucrats: Why Medicare Reform Hasn’t Worked, 101 Georgetown L. J. 520 (2013); Henry Aaron & Jeanne Lambrew, Reforming Medicare: Options, Trade offs, and Opportunities (2008); Timothy Stoltzfus Jost, Disentitlement: The Threats Facing Our Public Health-Care Programs and a Rights-Based Response (2003); David Hyman, Medicare Meets Mephistopheles (2006); Jonathan Oberlander, The Political Life of Medicare (2003). The most widely used source for detailed knowledge is the CCH Medicare and Medicaid Guide. See also Terry Coleman, Medicare Law (2d ed. 2006). For a symposium on Medicare’s future, see Symposium, Medicare for All: The Need for a Long Approach. 20 Hous. J. Health L. & Pol'y 1-192 (2020).

For discussion of concierge medicine (note 3), see Troyen A. Brennan, Luxury Primary Care: Market Innovation or Threat to Access?, 346 New Eng. J. Med. 1165 (2002); Jeffrey Hammond, Cash Only Doctors: Challenges and Prospects of Autonomy and Access, 80 UMKC L. Rev. 307 (2011); Note, 17 Wash. U. J. L. & Pol’y 313 (2005); Sandra J. Carnahan, Law, Medicine, and Wealth: Does Concierge Medicine Promote Health Care Choice, or Is It a Barrier to Access?, 17 Stan. L. & Pol’y Rev. 121 (2006); Frank Pasquale, The Three Faces of Retainer Care: Crafting a Tailored Regulatory Response, 7 Yale J. Health Pol’y L. & Ethics 39 (2007); Note, 66 Duke L. J. (2017).

For discussions of Medicare Part D (note 4), see John B. Kirkwood, Buyer Power and Healthcare Prices, 91 Wash. L. Rev. 253 (2016); Janet Cummings et al., Who Thinks That Part D Is Too Complicated?, 66 Med. Care Res. Rev. 97 (2009); Richard H. Thaler & Cass R. Sunstein, Nudge: Improving Decisions About Health, Wealth, and Happiness, ch. 10 (2008); Jerry Avorn, Part “D” for “Defective”: The Medicare Drug-Benefit Chaos, 354 New Eng. J. Med. 1339 (2006); Jonathan Oberlander, Through the Looking Glass: The Politics of the Medicare Prescription Drug, Improvement, and Modernization Act, 32 J. Health Pol. Pol’y & L. 153 (2007); John K. Iglehart, The New Medicare Prescription-Drug Benefit: A Pure Power Play, 350 New Eng. J. Med. 826 (2004); Thomas R. Oliver et al., A Political History of Medicare and Prescription Drug Coverage, 82 Milbank Q. 283 (2004); Susan Channick, The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, 14 Elder L. J. 237 (2006); Symposium, 23(1) Health Aff. 1 (Jan. 2004).

For discussions of long-term care (note 5), see Allison K. Hoffman, Reimagining the Risk of Long-Term Care, 16 Yale J. Health Pol’y, L. & Ethics 239 (2016); Symposium, Health Care Reform, Transition, and Transformation in Long-Term Care, 8 St. Louis J. Health L & Pol’y 1 (2014); Richard Kaplan, Analyzing the Impact of the New Health Care Reform Legislation on Older Americans, 18 Elder L. J. 213 (2011); Joshua M. Wiener et al., Federal and State Initiatives to Jump Start the Market for Private Long-Term Care Insurance, 8 Elder L. J. 57 (2000); Symposium, 29 Health Aff. 6 (2010); Symposium 4 J. Health Care L. & Pol’y 159 (2001); Note, 14 Elder L. J. 485 (2006); Hal Fliegelman & Debora Fliegelman, Giving Guardians the Power to Do Medicaid Planning, 32 Wake Forest L. Rev. 341 (1997); Symposium, 31 McGeorge L. Rev. 703 (2000).

For a deep dive on Medicare Advantage, see 42 Health Affairs (Sept. 2023). According to the journal’s editor, the symposium issue “expands our understanding of the growing levels of enrollment in Medicare Advantage (MA), provides insights into health care prices and patient cost sharing, explores the role of hospice for people with dementia, and more.” For a critical discussion of the cost-savings supposedly  associated with Medicare Advantage, see Hayden Rooke-Ley, Medicare Advantage and Vertical Consolidation in Health Care, American Economic Liberties Project (Apr. 2024), arguing that, due to “excess capitation payments, Medicare Advantage insurance conglomerates are plunging capital into provider acquisitions, and retailers and private equity investors are following suit.”