Medicare and the National Debt

1. Medicare and the National Debt Can we guarantee quality health care to the elderly in a way that is both efficient and equitable? Lesson 2

2. Opener • Use Resource 1 to fill in the Opener Chart • Noticings • Inferences • Questions • And answer the first 4 questions on your paper.

3. Facts to debrief the cartoon

4. Health care has been a contentious political issue since at least the 1940s. • −  Although 60% of Americans receive health insurance as a benefit of employment, millions who are elderly, have disabilities, or have chronic diseases receive health care from the government through Medicare. • An additional 50 million people (including the newly unemployed) receive government- subsidized or government-run health care through Medicaid, a state health insurance program for those with limited income.

5. −  The Veterans Administration provides health care for military veterans and their families. • −  Because some patients have access to the most advanced treatment, this public–private hybrid system has rewarded innovation in pharmaceuticals and medical technology, but is criticized because of its high per-person cost and, with millions of people uninsured, its inequitable outcomes.

6. Healthcare Insurance and the Uninsured Resource 2 • Directions: “Read” the cartoon and series of graphs and then, with a partner, write a a short paragraph that tells the same story in words. Identify key problems with and barriers to healthcare coverage.

7. Overview of Medicare • In your packet you will find “Overview of Medicare”. Read and answer the 3 questions on your handout. • Discuss as a class

8. Opener: Distribute Costs and Benefits: Visualizations (resource 3, 5 part) • Use resources 3 (5 parts) to fill out the chart • Observations • Inferences • Questions about the cost of medicare

9. Answer the 4 questions on your handout

10. In a May 12, 2011, column in the New York Times, economist Paul Krugman described the federal budget, writing, “. . . here’s the quick-and-dirty summary of what the federal government does: It’s a giant insurance company, mainly serving older people, that also has an army.” In the same column he wrote, “By my rough count, in 2007, seniors accounted, one way or another, for about half of federal spending” (Krugman, 2011). • What does the above quote seem to say about our priorities as a nation?

11. Ranking U.S. Healthcare Against Other Countries Resource 4 • Closer: How does the performance of the U.S. Healthcare system compare internationally? • In itself, higher spending on health care is not necessarily a “problem.” Indeed, there might be less concern about increasing costs if they yielded commensurate gains in health. But the degree to which the system promotes the population’s health remains unclear. Indeed, substantial evidence exists that more expensive care does not always mean higher-quality care. Consequently, embedded in the country’s fiscal challenge is the opportunity to reduce costs without impairing health outcomes overall. —Congressional Budget Office (2007) • Answer the questions on your handout.

12. Opener: Review the costs and benefits of Medicare. What might you expect to happen if previous trends continue in the future?

13. Projecting Future Costs and Benefits of Medicare (resource 5) • You will find this resource in your packet. • Answer the 4 questions on your handout.

14. Closer • Can we guarantee quality health care to the elderly in a way that is both efficient and equitable?