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FISCHER v. UNITED STATES

Opinion of the Court

ity of medical care, all in the interest of both the hospital
and the greater community.

Here, as we have explained, the provider itself is the ob-
ject of substantial Government regulation. Medicare is de-
signed to the end that the Government receives not only re-
ciprocal value from isolated transactions but also long-term
advantages from the existence of a sound and effective
health care system for the elderly and disabled. The Gov-
ernment enacted speciﬁc statutes and regulations to secure
its own interests in promoting the well being and advantage
of the health care provider, in addition to the patient who
receives care. The health care provider is receiving a bene-
ﬁt in the conventional sense of the term, unlike the case of a
contractor whom the Government does not regulate or assist
for long-term objectives or for signiﬁcant purposes beyond
performance of an immediate transaction. Adequate pay-
ment and assistance to the health care provider is itself one
of the objectives of the program. These purposes and ef-
fects sufﬁce to make the payment a beneﬁt within the mean-
ing of the statute.

The structure and operation of the Medicare program
reveal a comprehensive federal assistance enterprise aimed
at ensuring the availability of quality health care for
the broader community. Participating health care organiza-
tions, as our above discussion shows, must satisfy a series
of qualiﬁcation and accreditation requirements, standards
aimed in part at ensuring the provision of a certain quality
of care. See 42 CFR pt. 482 (1999). By reimbursing partic-
ipating providers for a wide range of costs and expenses,
including medical treatment costs, overhead costs, and edu-
cation costs, Medicare’s reimbursement system furthers this
objective. This scheme is structured to ensure that provid-
ers possess the capacity to render, on an ongoing basis, medi-
cal care to the program’s qualifying patients. The struc-
ture, moreover, proves untenable petitioner’s assertion that
Congress has no interest in the ﬁnancial stability of pro-