Medicare was enacted in 1965 as a uniform health care services financing program for individuals eligible for federal benefits under the social security program (Cockerham, 1992, p. 253). All persons, regardless of financial situation, are eligible for participation in the Medicare program at age 65. Certain other persons afflicted by specified medical problems and disabilities are eligible for participation in Medicare regardless of age or financial condition. This research will focus on the primary objective of Medicare, which is the financing of health care services for elderly persons.
It is important to understand that the Medicare program does not provide any health care services. Rather, the program provides funding for such services. Funding is through two separate provisions of the Medicare Act. Hospital services for medical conditions covered by the Act are funded under Part A at no cost to the recipient. Physicians' services and other covered procedures are funded under Part B. Funding for services under Part B is a coinsurance scheme under which recipients are required to pay an annual fee plus 20 percent of the fee levels approved by Medicare (Phelps, 1992, p. 345). The level of the annual Part B fee was raised to $24.80 per month in 1988.
It is also important to note that Medicare was designed as a program to provide coverage for acute illnesses, as opposed to chronic ailments requiring extensive longterm care (Minihan, 1993b, p. 462). Chronic ailments, in contrast to acute illnesses cannot be cured. Therefore, persons afflicted with
chronic ailments "require sustained supportive health and social services as well as ongoing medical and medically related treatment" (Minahan, 1993a, p. 111). Sustained supportive services and ongoing medical and medically related treatment translates into longterm care.
The concept upon which the Medicare program was designed held that the removal of the financial ...