Budget for Medicare


  • Before Medicare, the federal government was not involved in healthcare financing
  • Medicare is now the second largest program in the federal budget
  • Financed through two trust funds - Hospital Insurance (HI) and Supplementary Medical Insurance (SMI)
    • Hospital Insurance is primarily funded by payroll taxes
    • Supplementary relies heavily on general fund contributions
  • Labor Unions supported government funded healthcare, while organization like the AMA (American Medical Association) and AHA (American Hospital Association) opposed it due to being a "socialization of medicine"
  • Health costs increase in old age while income usually declines
  • heavy reliance on general fund support raises concerns about long-term sustainability
    • Hope to shift over time towards decreased reliance on payroll taxes and increased dependence on general fund contributions