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The U.S. Medical Care System for the Elderly

The U.S. Medical Care System for the Elderly

(p.43) 2 The U.S. Medical Care System for the Elderly
Health Care Issues in the United States and Japan
David M. CutlerDavid A. Wise
University of Chicago Press

This chapter investigates the structure of the American medical care system, especially the system of care for the elderly. It concentrates on three sets of interactions: coverage rules (how people get health insurance and who pays for it), the reimbursement system (how providers are paid), and access rules (what are the financial and nonfinancial barriers to receipt of care). Medicare is significantly less generous than the typical private insurance policy. The various reimbursement systems differ enormously in the incentives they provide. The United States' medical care system has become substantially less generous in payment for care in the past two decades, and this has affected the care provided. About three-quarters of the elderly have some supplemental insurance, through Medicaid or private supplements. In general, the coverage in the United States is spotty—quite good for the elderly, especially those with supplemental insurance, but not guaranteed for the nonelderly.

Keywords:   elderly, American medical care system, coverage rules, reimbursement system, access rules, Medicare, Medicaid, United States, private insurance policy

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