Established in 1965, the Medicare program is the primary health insurance program for adults aged 65 and older and people younger than 65 with permanent disabilities. Although Medicare has made a significant contribution to the lives of beneficiaries by improving their economic and health security, the program presents a number of challenges. It is of interest to note that some of the problems we currently face, e.g., rapidly rising costs and overwhelming complexity, were already present in the first year of the Medicare program. Thus, we believe that we will not solve the problem by relying on continuing piece-meal "tinkering" with various program components. Medicare must be fundamentally reformed and made sustainable in a manner that is fair to seniors, to their children and their grandchildren who are or will be paying the taxes for the Medicare program.The four key recommendations outlined in "A Roadmap to Medicare Sustainability" are:1) Raising the eligibility age to 69 years, with the option to enter the program at age 65.2) Moving to a premium support model.3) Establishing true pay-for-value approaches for providers.4) Carrying out tort reform.
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