1965-1995: Medicare at a Crossroads

Bill Thomas
JAMA. 1995;274(3):276-278. doi:10.1001/jama.1995.03530030096044.
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How Medicare Grew  In 1965, after years of debate, Republicans and Democrats joined to pass legislation establishing the Medicare program. Designed originally to provide health insurance coverage for America's low-income elderly, the program has since been expanded beyond its initial scope. Medicare now covers nearly all Americans over the age of 65 and includes benefits not envisioned by the original intent of the program, which have increased costs to the taxpayer and skewed the original sharing formula between the government and beneficiary. We are to the point now where on the 30th anniversary of the establishment of Medicare we are faced with a fundamental challenge: how to make the Medicare Hospital Trust Fund solvent and improve the program through additional choices for our Medicare beneficiaries.Medicare Part A was designed originally in 1965 to pay for the in-hospital expenses of America's seniors. It was set up to be a self-supporting


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