Medicare now insures one of every seven Americans. Medicare remains at the forefront of political debate because of the aging of the baby-boom generation and the likelihood that health care expenditures will continue to increase. There are three major issues involving Medicare. First, since the late 1970s, legislators have sought to revise the program in order to improve its management and efficiency and thereby slow the growth in federal expenditures. Second, Medicare's benefit package is inadequate.
Many beneficiaries rely on supplemental policies, which results in inefficient delivery of care.
Thus, about 85 percent of Medicare beneficiaries have some type of supplemental coverage. These three issues overlap. For example, many of those who want to restructure Medicare also propose that the program provide additional benefits, such as coverage of prescription drugs. In 1965, before the establishment of Medicare, only about half of those in the United States who were 65 years of age or older had health insurance. Part A of Medicare covers inpatient services, skilled nursing care, and home health care.