The social roles of Medicare: Assessing Medicare's collateral benefits

The Medicare program incorporates a number of functions that go beyond prov iding health insurance to its beneficiaries. These activities, which we ref er to as "collateral" functions, may have important health consequences but are also an increasing source of controversy. In this essay we develop a c onceptual framework for categorizing these involvements, introduce some add itional options that might complement Medicare's current collateral functio ns, assess the reaction of policy elites and Medicare's current beneficiari es to these alternatives, and evaluate the role that collateral activities play for Medicare's core mission. A case can be made for expanding some col lateral involvements, but only if the Health Care Financing Administration has the strategic direction and administrative capacity to effectively impl ement these activities.