Medicare and the American Social Contract

February 1999

Medicare and the American Social Contract examines the philosophical principles and rationales that underlie Medicare and the ways in which the program fits into the larger social insurance and welfare structures. The report explores the question of what social values the nation is trying to pursue through Medicare and how the program relates to other programs to help the aged and disabled.

Medicare and the American Social Contract is designed as a primer for further discussion. Accordingly, this report includes an overview of Medicare, its problems, and its strengths, and reviews public attitudes and understanding of the program. It also suggests criteria that readers can use to identify the values that they believe should be preserved or strengthened as Medicare is reformed and provides a guide to how the major proposals embody those values.