A Medicare primer

Medicare is a massive and essential safety healthcare net for the elderly in the United States. It covers 45 million people in 2009 (almost one-sixth of the population) and projected to cover an increasing number of aged beneficiaries with a decreasing number of workers paying into the system. Medicare spending is about 13% of the federal budget and 3.2% of gross domestic product. A 7.4% annual growth rate in spending is expected to lead to potential insolvency by 2019. Spending on physician services and other suppliers is about 20% of Medicare outlays. Payment updates for physician services are insufficient in relation to the cost of providing services. The most serious issue remains a permanent fix for the sustained growth rate formula used for calculating payment updates for physicians. Further procrastination of difficult but essential decisions on funding has dire implications for Vascular Surgery and the patients we serve.