ABSTRACT
The difficulty of making accurate cost estimates for the federal share under Medicaid continued to be a focus for sharp criticism in Congressional hearings in 1969 and 1970, as in earlier years. Little more than a year after the Medicare program started, Congress increased Medicare taxes by some 25 percent to meet unexpected hospital cost increases under Medicare's Part A. In terms of cost, although there was no provision in the 1965 legislation that nursing home costs be reimbursed by Medicaid on the reasonable-cost basis required for hospitals, there was considerable pressure on states to do so. Recipients, however, could scarcely attest to the success of Medicaid as "mainstream" medicine. Recipients might well be thought to be discriminated against by the variation of services available to them in the different states. The economic cost of all of this had been high largely because Medicaid was provided through an unreconstructed, predominantly private system of medical care delivery.
