The ongoing debate over Medicare: understanding the philosophical and policy divides

This Article examines the evolution and status of Medicare, as well as the myriad current efforts to reform this longstanding entitlement. The author analyzes why healthcare financing for the elderly follows an administered pricing, fee-for-service model, while the working population generally obtains its insurance under a competitive market model. As a non-means-tested program modeled after Social Security, Medicare embraces both a universal entitlement philosophy of government-provided basic health services, and a need-based entitlement philosophy of caring for the Medicare-eligible elderly.