Copyright 1996-97 William L. Manning except as otherwise noted. All rights reserved. No copyright claimed to original government works.
Last updated by Bill Manning on 1/18/98
About This Page
The federal and state governments are the largest payors of health care services in the United States. The largest federal programs are Medicare and Medicaid. It has often been said that Medicare is the second largest segment of the federal budget, second only to Social Security payments. It alone accounted for more than 3% of the GDP, insured more than 37 million individuals in 1990, and cost the federal government more than $109 billion in FY 1990. Medicaid, federal-state health care coverage for the poor, is one of the single fastest growing budget areas for states, with federal-state combined outlays in FY 1992 of $118 billion, a 25% increase over FY 1991.
Federal payment policies often determine how and what health care services are provided. Senator Durenburger, in a speech on a bill to restructure Medicare payment to physicians, articulates the role that Medicare and Medicaid payment policies play in influencing health care:
135 CONG. REC. S14424 (daily ed. Oct. 31, 1989) (statements concerning S. 1809, the RBRVS legislation). Compare Senator Durenburger's remarks about the U.S. Congress and health legislation in a law review health care symposium:
"[T]hings are moving on their own - under their own energy. We try to do some fine tuning and maybe influence direction, but sometimes we are just along for the ride." Senator David Durenburger, Health Care Financing: The Challenge for the Future, 20 LOY. CHI. L.J. 705, 708 (1989).
The resources on this page are intended for both the uninitiated and the expert on Medicare and Medicaid reimbursement policy. Of course, it can be no substitute (nor is it intended as such) for digging into the statutes, regulations and provider manuals. Please feel free to contribute material here by e-mailing me at email@example.com