ABSTRACT
Medicare at the opening of the decade was not among the major preoccupations of American national politics. A consensus on the seriousness of American medical care problems did not signify agreement on the shape, magnitude, or priority of those problems. Nor did a negative consensus bring with it agreement on remedies, as was amply demonstrated by the battle over Medicare's enactment in the 1960s. There was also a serious political danger—one involving Medicare directly—that lurked just beneath the surface of the discussion of overarching, national health reform. The prospects for bringing Medicare expenditures under control were, in fact, considerably better than most Americans—and most members of Congress—realized at that time. Medicare beneficiaries who chose to move to the new health alliances would not be guaranteed to receive any additional benefits or services. It was only in mid-1995, when the Medicare trustees forecasted the program's trust fund "insolvency" by 2002, that broad public attention was drawn once again to Medicare.
