Lisa B. Caruso, MD, MPH
Caruso LB. Medicare Matters: What Geriatric Medicine Can Teach American Health Care. Ann Intern Med. 2006;145:476. doi: 10.7326/0003-4819-145-6-200609190-00024
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Published: Ann Intern Med. 2006;145(6):476.
Cassel CK. 269 pages. Berkeley, CA: Univ California Pr; 2005. $27.50. ISBN 0520246241. Order at http://www.ucpress.edu.
Fields of medicine: Geriatrics and health policy.
Format: Hardcover book.
Audience: Anyone interested in better and more cost-effective care for current and potential Medicare recipients, “especially … the baby boom generation.”
Purpose: “To accurately characterize Medicare as it exists today, affirm why it matters now more than ever, and suggest some definite ways we might improve it.”
Content: The author begins and ends her book by describing the “social contract[s]” from which Medicare was born: Health care should be there when we need it, and it is in all of our best interests to provide good health care to the older adults of our society. She discusses the successes and problems with Medicare but supports its existence, its reform, and its expansion. Medicare must be reshaped using principles established by those who specialize in caring for older adults—geriatricians. In chapter 4, the author uses a case to illustrate the impact of care management on the quality of geriatric care delivery and proposes that Medicare finance care management separately. In chapters 5 and 6, she reviews many gaps in Medicare coverage, specifically in palliative care, the care of chronic conditions, and medication expenses. She applies the principles of managed care to show that with infrastructure for care coordination, cost-effective, high-quality care delivery can be achieved. In chapter 9, she reviews the evolution of the Medicare Part D plan, and in chapter 10, she explains how Congress runs Medicare and identifies the political forces that drive reform. In chapter 11, she argues that although rationing health care is inevitable, resources must be allocated not by age alone but by “health, functional status, and the chances of successful treatment.”
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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