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A majority of the data is in graphical form, forcing the user to interpolate from the plots to get numerical data. However, each material has numerical data listed for room temperature properties. Mechanical properties tend to be stated in english units. Sources of the data are cited.
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The compilation of essays begins with an introduction describing just how inefficient the governmentâs second largest entitlement program has become. According to government actuaries, Medicareâs ability to cover hospital funds will expire in 2015. This expiration has major implications considering that the program covers and estimated 39 million elderly and disabled persons, according to the book. Furthermore, as the baby boom generation ages into its retirement years the number receiving care will grow substantially and that is not taking into account the rising costs of health care. Judging by this information alone, it becomes apparent to the reader that something must be done. Yet what?
In the first essay, Joseph Antos and Linda Bilheimer outline the differing policy changes that could be possible solutions or at least the very least corrections to the program as it works presently. To correct the problem, they explain, either requires reducing the costs or improving efficiency. Efficiency is achieved when the marginal cost of producing an additional unit of care is equal to the additional unit of care that the patient receives. They then group the solution into three categories; ones that reduce costs without improving efficiency, ones that reduce costs and improve efficiency, and ones that simply restructure the way Medicare is financed. After describing all these policy changes the authors note a pathetic truth. None of the policy changes they outlined have even been looked at by congress â" even after, congress passed the Balanced Budget Act of 1997, which was intended to address this exact point. By the end of the second chapter it becomes frightening clear to the reader, if it had not already, how bad Medicare is functioning.
The remainder of the essays expand on the ideas put forth by Antos and Bilheimer, but also go further in asserting the idea of fairness. By fairness the authorsâ mean the disparities between the rates of return for high-income individuals compared to those with lower incomes. Due to their higher tax rates, the richer see a lesser return in health care from the government. Mark Pauly, a professor in health care systems, says this problem is due to the politics of Medicare. If a courageous politician took a stance and said that those who paid more should receive better benefits, then he or she is vilified as being indifferent to the plight of the needy. Conversely, if a politician declared that the wealthier members of society should pay more money for the care of others, then he or she loses support from those higher income earners.
Medicare in the Twenty-first Century: Seeking Fair and Efficient Reform takes a critical, unbiased look at the situation Medicare is faced with today. The authors seek innovative policy changes to the second largest government entitlement program. But after reading the collection of essays and the mountain of difficulties their policies would have to surpass to be implemented, it seems Medicare is not likely to escape from its current crisis situation.
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