"A brilliant little book, combining a grasp of programmatic and political detail sure to appeal to scholars of health policy with crisp prose and careful argument accessible to policymakers and most of Medicare’s beneficiaries. . . . Oberlander’s analysis is organized around three persistent tensions in Medicare politics: the gap between the program’s promise and its performance; the fiscal and administrative tug-of-war between private provision and public payment; and the political and actuarial dilemma of delivering ‘service’ benefits on a foundation of social insurance financing.  . . . The meat of the book tackles the post-1965 history of Medicare’s fragile consensus regarding program benefits, financing, and administration.”

“Clearly, no one can claim to understand contemporary American politics and policymaking without understanding the Medicare program. Few scholars are more knowledgeable about Medicare politics than health policy expert Jonathan Oberlander. Combining rich, detailed narrative with acute political analysis, Oberlander offers an illuminating guide to Medicare’s evolution since the program’s creation in 1965. The book immediately takes its place as the best short monograph on Medicare’s political development, current status, and future prospects. . . . Well-organized, elegantly written, and jam-packed with sophisticated insights about the substance and process of U.S, policymaking, the book deserves to be read by anyone concerned with American national government, health-care politics, and the welfare state.”