Medicare at 30. Preparing for the future.

Medicare's 30th anniversary is an appropriate time for celebration. Few programs, public or private, have had so demonstrably beneficial an impact on so many Americans as Medicare. But it is also a time both to reflect on Medicare's role in our society at large and to think strategically about how Medicare can fulfill its missions in the years ahead. In the increasingly contentious political environment, Medicare has been called a dinosaur—a program that is too costly, is too inefficient, and has outlived its usefulness. In the view of Medicare's critics, radical restructuring is the only cure. Although improvements can and should be made to Medicare, those calling for the end of Medicare as we know it are most charitably described as misguided. Medicare is responsible for major improvements in the health of elderly and disabled citizens, is well managed, and provides the financial underpinning for much of the US health