Medicare's projected spending growth is unsustainable. The programalready strains the resources of beneficiaries and taxpayersalike and will someday crowd out other public- and private-sectorpriorities, given that Medicare spending as a percentage ofthe gross domestic product is expected to nearly double in thenext 20 years. At the same time, neither beneficiaries nor taxpayersare getting good value from the program. Per-beneficiary spendingin high-spending regions of the country exceeds that in low-spendingregions by one third, and yet beneficiaries in high-spendingregions receive no better quality of care.1 The incentives inherentin the dominant fee-for-service payment . . . [Full Text of this Article]
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Mr. Hackbarth is chair, Dr. Reischauer vice-chair, and Ms. Mutti a senior analyst at MedPAC, and Dr. Reischauer is president of the Urban Institute — both in Washington, DC.