To qualify for the Supplemental Medical Insurance, a person 65 years and over, or disabled, must choose this coverage and pay a monthly premium. Also there is concern that because doctors are being reimbursed by Medicare that they may overuse hospitalization and call for unneeded services. The current unit of service is no the same as the 1966 unit of service. The combination of rising prices, increased and more expensive services has really increased the cost. Greater numbers of users has also driven the cost of Medicare costs much higher.
Cost control is a big factor.
In recent years, effort has been concentrated on stopping price increases and discouraging unnecessary hospital-based services. Under this plan, giving services the patient doesn't need increases the providers cost but not the providers' income. HMOs are quite similar to the prepayment plan, but are used by private organizations. Raising the age of eligibility for Medicare is the major proposal to accomplish that goal. There is some validity in this argument.