A Philosophy of Privatization: Rationing Health Care through the Medicare Modernization Act of 2003

The trend in coping with these rising Medicare costs has been to increase the role that private insurance plays in providing coverage for Medicare recipients. Much of this movement towards an increased privatization of Medicare has been born of the belief that the private sector of health care insurance coverage has been made more efficient by existing market forces and will provide a way to both continue providing health care to elderly Americans while containing Medicare costs through these increased efficiencies as exemplified through the managed care model. This premise will be further explored in this article. First, this article will review an abbreviated history of private sector managed care as well as the origins of Medicare. Second, it will review the basic structure of the Medicare Modernization Act of 2003 (MMA) as it was first introduced and discuss how the MMA continues to evolve in the face of escalating health care demands. Finally, it will address how the MMA seeks to ration health care within the Medicare system and how such rationing has proven problematic in the private sector as well as discussing some of the troubling implications of our current parameters for rationed health care