Medicare and America's healthcare system in transition: from the death of managed care to the Medicare Modernization Act of 2003 and beyond

This Article traces the transition--in Medicare, specifically, and in the American healthcare system, generally--from the aftermath of the Balanced Budget Act of 1997 to the passage of the Medicare Modernization Act of 2003. During this time, restrictive managed care died under an onslaught of resurgent cost pressures, legislative and legal attacks, and a vehement physician and consumer backlash. The subsequent reversion to more generous (and more expensive) health plans coincided with a recession in 2001 to trigger a return to rapidly escalating healthcare spending and yet another in the Nation's series of healthcare crises. Current trends suggest that future policymakers will have no choice but to confront the consequences of rapidly rising rates of healthcare spending.