Academic journal article Health Care Financing Review

Growth of the Medicare Population

Academic journal article Health Care Financing Review

Growth of the Medicare Population

Article excerpt

The growth rate of Medicare enrollees significantly exceeds the growth rate of the general population. Moreover, the group of enrollees aged 85 years or Over is growing Proportionately faster than all other groups of the aged. These phenomena and other interesting trends of the Medicare population are explored in this article.

The rapidly escalating cost of delivering health care services through the Medicare program has generated much interest in exploring ways to control the growth of benefits paid. It should be noted that, in addition to rising medical costs and increasing per capita utilization, another factor contributing to these increases is the growing number of persons enrolled for coverage. In no small way, implementation of the Medicare program has made available to the Nation affordable medical services and enhanced medical delivery systems. Medicare was first implemented in 1966, under title V of the Social Security Act, as health insurance for the aged (65 years of age or over). Later, it was amended in 1972 by legislation to include the disabled, persons with end stage renal disease, and certain aged persons not previously entitled.

Medicare is organized in two parts: * Part A (hospital insurance) pays for inpatient hospital services, regular nursing services, meals, semiprivate rooms, operating rooms, laboratory tests, some drugs, and medical supplies. Part A also pays for special care units, rehabilitation services, post-hospital skilled nursing facility care, home health care, and hospice care for the terminally ill. * Part B (supplementary medical insurance), which is elective coverage, pays for private physicians' services, diagnostic tests, outpatient hospital services, outpatient physical therapy, speech pathology services, home health services, medical equipment, and supplies.

Since the inception of Medicare (July 1, 1966), its rolls have increased by more than two-thirds, and as of July 1, 1987, affordable medical care was available to 32.4 million Medicare beneficiaries with Part A and/or Part B coverage. In this article, the increases in the number of Medicare enrollees by census region from 1966 through 1987 and some demographic trends of these enrollees are highlighted. * In 1966, the estimated total resident population of the United States was 195.9 million people. Medicare provided some type of coverage to 18.8 million U.S. residents, essentially most of the population 65 years of age or over. Medicare enrollees represented 9.5 percent of the total resident population (Table 1). * The number of aged enrollees has grown from 19.1 million in 1966 to 29.4 million in 1987, an increase of 53.8 percent. This represents an average annual increase of 2.1 percent (Table 2). * In 1987, the estimated resident population of the United States was 243.4 million. Of this total, 29.8 million were 65 years of age or over. Medicare, with all age groups represented, provided some type of coverage for 31.7 million persons, or 13 percent of the total resident population of the United States (Table 1). Medicare provided some type of coverage for 28.8 million aged residents of the United States, representing more than 96.6 percent of the total U.S. aged population (Table 2). * Statistical examination of the aged population (65 years of age or over) within the Medicare program indicates longer life expectancy for beneficiaries. The median age for this population has increased from 72.8 years in 1966 to 73.5 years of age in 1987. Although the overall aged population of the program has been increasing at an average annual rate of 2.1 percent, the category of persons 85 years of age or over has been increasing at an average annual rate of 4.6 percent. * In 1966, each census region had more than 5 million enrollees except the West, which had 2.8 million enrollees (Table 1). By 1987, the South region had significantly outgrown the Northeast and Midwest, with more than 10.7 million enrollees, or 33. …

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