Will the care be there? Vulnerable beneficiaries and Medicare reform

The Medicare program is on the verge of major change. The proof of the valu e of reforms wilt not rest in how well the program meets the needs of the h ealthy and wealthy, but rather in whether they preserve or improve upon pro tections for those who would not be well served by an unregulated private s ector-persons with low incomes and/or substantial health problems. This pap er examines four key issues: Which beneficiaries will likely be best served by a system oriented around choice; what role traditional Medicare should continue to play and what changes will be needed; what protections are nece ssary for persons with low and moderate incomes; and how these reforms coul d be incorporated into broader changes to make Medicare more viable over ti me.