The New England journal of medicine
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Medicare should provide access to care and protection from catastrophic spending while not being so generous that beneficiaries overconsume low-value care, thus driving up costs. Setting cost sharing is a balancing act that the Medicare program doesn't perform very well.
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Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.
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In its decision on the Affordable Care Act, the Supreme Court opened the door for Congress to use its taxing power to achieve myriad policy objectives. The federal government may now increasingly make creative use of taxes to pursue public health goals.