Chapter

Medicare and the Delegated Welfare State in the Postwar Era

Kimberly J. Morgan and Andrea Louise Campbell

in The Delegated Welfare State

Published in print October 2011 | ISBN: 9780199730346
Published online January 2012 | e-ISBN: 9780199918447 | DOI: http://dx.doi.org/10.1093/acprof:oso/9780199730346.003.0003

Series: Studies in Postwar American Political Development

Medicare and the Delegated Welfare State in the Postwar Era

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This chapter examines the creation of Medicare in 1965 and explains why a delegated administrative structure was chosen for this program. Debates over the program are examined through the lens of larger conflicts over state-building in the post-1945 period. The chapter also compares the creation of Medicare to the development of two directly administered programs—Social Security and the Veterans Administration health care system. In contrast to these programs, which were created in the 1920 and 1930s, Medicare was forged at a time when an array of health care interest groups was present on the political scene and could exploit latent public antipathy toward government. To build a coalition around the new program, direct federal administration of Medicare program was abandoned in favour of contracting out to non-state actors. This chapter briefly follows the post-passage trajectory of Medicare administration and discusses how decisions about its governance affected program cost and quality.

Keywords: medicare; social security; veterans administration health care; state-building; welfare state; social services

Chapter.  10896 words. 

Subjects: US Politics

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