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Christine K. Cassel

Medicare Matters

What Geriatric Medicine Can Teach American Health Care

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978-0-520-24624-9
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269 pages, 6 x 9 inches,
October 2005, Available worldwide
Categories: Health & Medicine; Public Policy; Aging; Health Care

Downloadable eBook version available:
Adobe E-Reader at ebooks.com, $12.95
"For many stakeholders in American health care, this book provides a concise, readable primer on the Medicare program: its history, cultural symbolism, politics, vulnerabilities, and organizational structure, as well as how it operates, what it has accomplished, where it has failed, and what challenges and opportunities remain for it in the years ahead."—New England Jrnl of Medicine

"a concise and thoughtful discussion of Medicare with much to offer for policy makers, clinicians, and other citizens."—Jama

"Attention to this book could immeasurably improve policymakers' understanding of this crucial program."—Marilyn Moon, Health Affairs

"An excellent study."—Sanford Lakoff, The New Leader
"I read Christine Cassel's new book and loved it. Medicare Matters is now the definitive book on Medicare. It explains, critiques, praises and expounds on Medicare with breadth, clarity, insight and an occasional flash of dry humor. It will be the book to read to understand where Medicare has been and it will be a needed stimulant for heated but fully informed discussions about where Medicare should be going. This book will have a significant impact on the debate ahead."—George C. Halvorson, Chairman and Chief Executive Officer, Kaiser Foundation Health Plan, Inc.

"One of the great leaders of our time in American medicine tackles one of the great health care issues of our generation: the design, fate, and principles of Medicare as a system. Care for our aging population, and coverage through Medicare, provides one of the key testing grounds for our nation's moral and technical capacity to extend health and relieve suffering. Dr. Cassel is unique in her ability to bridge the worlds of clinical science, health care policy, and social ethics, as she helps us think through how best to meet that test. This book is a welcome guide and a clear charter for a nation that cares – or ought to care – deeply about addressing the needs of its aging population."—Donald M. Berwick, MD, MPP, President and CEO, Institute for Healthcare Improvement
Savvy, comprehensive, and authoritative, this book, written by a physician with more than thirty years' experience caring for elderly patients, assesses the current state and the future prospects of Medicare, perhaps the most influential health care program of our time. Christine K. Cassel draws upon the latest developments in science and medicine in a sweeping analysis of Medicare's social, demographic, institutional, political, and policy contexts. Writing in accessible language, using case studies to illustrate how policies translate to everyday lives, and applying lessons from the practice of geriatric medicine, Cassel makes a powerful argument for reforming and modernizing Medicare. She offers a new vision of what healthy aging could be and delineates what is needed to reach this vision, including changes in the medical sector, in the policy arena, and in our cultural beliefs about aging.

Cassel sheds light on a wide range of issues pertaining to Medicare, including debates about coverage and the looming deficit in the Medicare Trust Fund. Perhaps the most controversial issue she addresses is the challenge of rationing some kinds of care. Anchoring her discussion of Medicare in the idea that care for the elderly represents a social contract between government and its citizens, Cassel describes both the principles and potential of a progressive approach to geriatric medicine. She further argues that with this approach, we can also address the chronic problems of our larger health care system and provide all Americans, no matter what their age, with high-quality and affordable medical care.
List of Figures
Foreword, by Daniel M. Fox

Introduction
1. Medicare and the Social Contract
2. Longevity and Health
3. Quality of Care
4. Care Management: The Key to Modern Geriatric Medicine
5. Palliative Care
6. Coverage
7. Why Sixty-five?
8. Prescription Drugs
9. Finance
10. Politics
11. Rationing is Inevitable
12. The Social Contract

Notes
Index
Christine K. Cassel, M.D., is President and CEO of the American Board of Internal Medicine.