The Political Life of Medicare

In recent years, bitter partisan debates 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. But as Jonathan Oberlander demonstrates in The Political Life of Medicare , these recent developments are an exception in the long-term history of the program. Contrary to popular belief, from Medicare's inception in 1965 until 1994, a remarkable bipartisan consensus governed Medicare politics. In The Political Life of Medicare , Oberlander provides the first comprehensive history of Medicare politics, from the decades of consensus to current debates over Medicare reform. He shows how tensions embodied in the program since its enactment drove the politics of Medicare benefits, regulation and financing policy during the consensus period. For instance, rising Medicare costs led both liberal and conservative policymakers to embrace stronger government regulation of the program while rejecting expansion of benefits. Both parties also accepted the liberal vision of Medicare as a universal government program to provide federal health insurance for the elderly. Oberlander incisively traces how this consensus unravelled because of fundamental changes in American politics, the health care system and policymakers' attitudes about the elderly. Revealing how Medicare politics and policies have developed over the past several decades, and what the program's future holds, Oberlander's analysis should interest anyone concerned with American politics and public policy health care, aging and the welfare state.