This research considers the enactment of Medicare legisla tion in the United States within the context of the Self Inter est Model. The initial Medicare legislation is considered briefly, in the context of Feldstein's (1988) Self Interest Model assessment of its passage; however, the principal focus of this current research is on the Medicare Catastrophic Coverage Act of 1988, which was rescinded in late 1989. In contemporary society, prospects for the health of individuals are ". . . determined by public policy, by those decisions which shape contemporary environments . . . " (Milio, 1981, p. 3). Health, thus, is ". . . not a 'state' to be cap tured and dealth with; nor is it some achievement to be attained with finality. It is rather the response of people to their environments . . ." (Milio, 1981, p. 3).
Public health policy at the national level is required, because the factors affecting individual health are, in many instances, pervasive in society. Development of acceptable levels of public health within a large and complex society such as that of the United States
. . . requires and interpretation of the nature of today's health problem. . . . Its focus is on the interconnection between "causes" and illnesses and the ways they affect each other, as well as the link ages among "causes" and among illnesses. All these
ties suggest the plausibility of viewing today'shealth problem as a response to modern environments,and one therefore amenable to improvement throughpublic policy measures (Milio, 1981, p. 9).
Medicare is a health insurance program for the elderly (Minahan, 1989a). The program is partly funded by premiums paid by the recipients of the program's benefits (Minahan, 1989). Medicare was designed as a program to provide coverage for acute illnesses, as opposed to chronic ailments requiring extensive long term care. Medicare was enacted as a universal program (Feldstein, 1988). While the...