JAMA Network November 21, 2022
Micah Johnson, MD1; Donald M. Berwick, MD, MPP

Medicare is one of the great successes in American social policy. It provides universal health insurance to Americans older than 65 years and others while controlling costs better than private insurance and improving health equity. But health care has advanced in countless ways in the half century since Medicare’s passage; and although Medicare has undergone numerous changes since its enactment, these reforms have too often come in a piecemeal fashion that reflects the vagaries of political history more than a concerted attempt to optimize the program for modern needs.

It is time for “Medicare 2.0”: a redesigned Medicare program that meets today’s health care challenges in a comprehensive, cost-effective, and equitable way. Medicare 2.0 includes 5 major reforms to the...

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