The 1997 Medicare reforms were among the most important social and health policy legislation of the past three decades. The legislation was notable in reestablishing a viable health policy process; in disproving predictions that government-run insurance would restrict consumer freedoms more than employer-based health insurance; and in ratifying market-oriented approaches as a national health paradigm. Most important, the legislation achieved a historic philosophical compromise between advocates of govenment health insurance and advocates of private health insurance. The political agreements came at the expense of greater regulatory capture of the Medicare program by health provider and health plan interests and at the expense of deficient consumer protections.

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