Copyright 2012 Journal of Health & Biomedical Law
Journal of Health & Biomedical Law
ARTICLE: Medicare Coverage Policy and Decision Making, Preventive Services, and Comparative Effectiveness Research Before and After the Affordable Care Act
Health & Biomedical Law Society
7 J. Health & Biomed. L. 493
Michael J. DeBoer*
The Medicare program is the largest health insurance program in the United States and handles more than one billion claims each year. 1 In 2010, the Medicare program served 47.1 million elderly and disabled Americans enrolled in the program, 2 and cost an estimated $ 451 billion, which was approximately 12 percent of the overall 2010 federal budget of $ 3.7 trillion. 3 Medicare spending is projected to grow more than 6 percent each year from 2009 to 2019. 4 In 2009, the Medicare program expenses accounted for approximately 20 percent of all health care expenses nationally. 5 The Congressional Budget Office estimated that Medicare spending would constitute 3.6 percent of the gross domestic product in 2010. 6
For decades, the cost of the Medicare program has remained a major policy concern warranting attention from federal policymakers. The swelling cost of the Medicare program has led some policymakers and analysts to propose explicit rationing of health care and the use of cost effectiveness in Medicare coverage decision making as a means of controlling cost. 7 In 2009, as the nation's attention turned to the federal legislative effort to reform health care and health insurance, many Americans worried that the reform legislation would adopt such measures, especially in the Medicare program. Since the two days in March 2010 when President Barack Obama signed into law the Patient Protection and Affordable Care Act ("PPACA") 8 and the Health Care and Education Reconciliation Act of 2010 ("HCERA"), 9 Medicare beneficiaries ...
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